CLH Solutions LLC – Tax Preparation & IRS Debt Relief Intake
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  • CLH Solutions LLC – Tax Preparation & IRS Debt Relief Intake

    Virtual or In-Person • Secure • Confidential • Nationwide Service If you owe the IRS, are behind on taxes, or need help filing — you’re not alone. We’re here to help.
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  • Are you the Taxpayer or your Spouse a U.S. citizen, U.S. national, or U.S. resident alien?*
  • Check All That Apply
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • What do you need help with? (select all that apply)*
  • Preferred Contact Method*
  • How did you hear about us?*
  • Were you referred?*
  • Filing Status?*
  • What type of income do you have? (select all that apply)*
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  • Are you over age 18 and a full-time student at an eligible educational institution?*
  • Do you have any dependent(s) you plan to claim?*
  • Check All That Apply
  • Check All That Apply
  • Check All That Apply
  • Check All That Apply
  • Check All That Apply
  • Was your dependent(s) a U.S. citizen, U.S. national, or U.S. resident alien? If they were not, they are ineligible for the child tax credit or the credit for other dependents. If you do not wish to claim these credits for religious purposes, answer this question NO.
  • Do you have a 1098-T Form for either you or any dependent(s)?
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  • Did all of your dependent(s) live with you more than half the year?
  • Has anyone else claimed your dependent(s) in a previous year?
  • Are there any legal agreements in place for anyone else claim your dependent(s)
  • Are there any dependent(s) in daycare?
  • Have you ever been denied Earned Income Credit (EITC) in the past?*
  • Is there someone who can claim you as a dependent(s)?*
  • Did you have health Insurance the entire year of 2025?*
  • Did your dependent(s) have health insurance the entire year of 2025?*
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  • Are you currently dealing with any of the following IRS actions?*
  • Do you currently owe the IRS? (To get information about a tax refund offset, you should call the Bureau of the Fiscal Service (BFS) at 800-304-3107).*
  • Estimated IRS balance
  • Are you receiving IRS notices?
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  • Are you wages or bank account being garnished?
  • Have you files all previous tax years?*
  • Are you interested in audit protection?*
  • How would you like to meet?*
  • Cash Advance?

  • Please Note: Eligibility and amounts are determined by the bank and IRS approvals.

  • How would you like to receive your tax refund?
  • Type of account

  • For your security, bank routing and account numbers will be collected securely during your appointment or entered directly into our tax preparation system.

  • Appointment (Optional)
  • Date*
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  • Submitting this form does not grant Power of Attorney or authorize CLH Solutions LLC to contact the IRS without a separately signed Form 2848.

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