Refer Agent Program Enrollment Form

Referral Agent Program Enrollment Form

ENROLL BY DECEMBER 31, 2026 TO QUALIFY FOR $100 PER QUALIFYING REFERRAL. IF YOU DO NOT ENROLL BY DECEMBER 31, 2026, THE PAYOUT IS $50 PER QUALIFYING REFERRAL. Complete this enrollment to qualify for the promotional referral payout for qualifying referrals submitted through December 31, 2026.
Applicant Information
Full Legal Name

First NameMiddle NameLast Name
Preferred Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City
State
ZIP Code
Preferred Contact Method
Emergency or Alternate Contact (Name, Relationship, Phone/Email, or Not Applicable)
Agent Background and Referral Plan
Referral agent type/status

Other
How did you hear about this program?
Social media handles and/or marketing channels you plan to use
Estimated referrals per month
Experience with referrals or marketing
Referral sources you plan to use
Referral Agent Payout Information
Apple Pay payment information
Enter the phone number, email, or $Cashtag actually registered to the selected Apple Pay account.
Zelle payment information
Enter the phone number, email, or $Cashtag actually registered to the selected Zelle account.
Cash App payment information
Enter the phone number, email, or $Cashtag actually registered to the selected Cash App account.
I confirm that I verified the payout information is accurate and understand incorrect payment information may delay payment.
Payment and Tax Information
Preferred Payout Method
Payee Full Legal Name
Tax Reporting Form Type
Tax Identification Number
Bank Account or Payout Email
Mailing Address for Tax Documents

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Referral Agent Program Terms & Acknowledgment
Referral Agent Program Terms & Acknowledgment

PAYOUT IS ISSUED ONCE THE REFERRED TAX RETURN IS FUNDED.

No referral payout is issued before the taxpayer’s return is funded. Once the return is funded, the referral agent will be paid the applicable referral amount: $100 for agents who enrolled by December 31, 2026, or $50 for agents who enrolled after the deadline.

Referral must be funded before payment is issued. Once the taxpayer is funded, the referral agent becomes eligible for the applicable referral payout. No payment is issued before funding.

The $100 or $50 amount applies per qualifying funded referral, depending on the agent’s enrollment date.
I confirm that I have read, understood, and agree that no referral payout is due until the referred taxpayer’s return is funded, and that if I do not enroll by December 31, 2026, the standard payout is $50 per qualifying funded referral.
I acknowledge that qualifying referrals only are payable, and that duplicate, self, fraudulent, canceled, rejected, or otherwise ineligible referrals are not payable.
I authorize the company to contact me about referrals and program updates, and I consent to receive program communications.
Electronic Signature and Date
Should be Empty:

Referral Agent Program Enrollment Form

Applicant Information

Agent Background and Referral Plan

Referral Agent Payout Information

Payment and Tax Information

Referral Agent Program Terms & Acknowledgment