FORM # 4a
STATUS & HISTORY
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1. Who is filling out this form?
King Law Associate
Taxpayer's spouse or other relative
Taxpayer's enrolled agent or CPA
1a.Name of associate of Morgan King's tax practice
1b. If a King Associate, please indicate:
I have Account Transcripts or state tax entity's records of account.
I have other tax transcripts
I have IRS or state Notice of Levy or Lien
I have the name and phone number of the tax collector's representative with whom I have been in contact.
I have other important documents.
2. Taxpayer's Name
3. Spouse's name
4. Marital status
Single - never married
Married and living together
Married but living apart
Formerly married - spouse deceased
5. Taxpayer's E-mail Address
6. Taxpayer's preferred Phone Number
7. Preferred way to Contact?
8. Taxpayer's current occupation:
9. Taxpayer's previous occupation:
10. Taxpayer's current state of residence:
11. Taxpayer's previous state(s) of residence within last 2 years.
11a Identify "other"
12. Taxpayer is represented by:
Attorney - being retained
Attorney - dismissed or being dismissed
No one at present
Other Tax help person
12a IF OTHER, PLEASE IDENTIFY
13. If attorney or other tax professional has been, or is being dismissed, please name and explain why:
14. Person Mr. King should contact about this matter:
Other tax help person
14a IF OTHER, PLEASE IDENTIFY
15. Attorney's name, phone number, and email address
16. Enrolled Agent's name, phone number, and email address
17. Upload documents relevant to your problem (Max 35 pages)
18. Prior bankruptcy?
Filed bankruptcy and finished it
Filed and still in bankruptcy
Never filed bankruptcy
Thinking about filing bankruptcy
19. Have you at any time:
1. Did a CDP - Collection Due Process appeal
2. Applied for an installment payment plan
3. Applied for an offer-in-Compromise
4. Litigated a tax issue in U.S. Tax Court
5. Been audited by the IRS and assessed additional taxes
6. Been in "non-collectible status"
7. Failed to file a tax return
8. Filed a tax return late
9. Appealed anything to a higher office or court
10. Been ruled an innocent spouse
11. Charged with tax fraud or evasion?
12. Plead to or found guilty of tax fraud or evasion
13. Applied for "innocent spouse"
14. Been audited
15. Military deferment
16. Appeared in Tax Court for any reason
17. Agreed to an extension of the statute of limitations with the IRS
20. What kind of taxes do you owe that are over 3 years old?
IRS personal income taxes
IRS payroll taxes
State personal income taxes
State payroll taxes
IRS tax penalties
State tax penalties
Restitution for tax offense
21. HOW MUCH OWED FOR IRS INCOME TAXES?
22. HOW MUCH OWED FOR IRS PAYROLL TAXES?
23. HOW MUCH OWED FOR STATE INCOME TAXES?
24. HOW MUCH IS OWED FOR STATE PAYROLL TAXES?
25. HOW MUCH IS OWED FOR STATE TAX PENALTIES?
26. HOW MUCH IS OWED OWED FOR STATE SALES TAXES?
27. HOW MUCH IS OWED FOR IRS PENALTIES?
28. HOW MUCH IS OWED FOR OTHER TAXES?
29. HOW MUCH IS OWED FOR RESTITUTION?
30. WHICH STATE?
31. Liens & Levies
Tax entity has filed liens on your property
No tax liens have been filed
Taxpayer owns no property of value
Taxpayer owns real estate
There is a tax levy currently in effect
There are no levies in effect
32. Are you currently being audited?
33. Have you been audited in the past?
34. Are there any unfiled IRS tax returns? If yes, what tax years are missing returns.
35. Are there any unfiled state tax returns? If yes, what years?
36. Have you at any time:
Filed or been accused of filing a fraudulent tax return
Attempted or been accused of tax evasion
Charged with or been accused of any other tax crime
Lied to any tax collector
Assaulted or attempted to assault a tax officer
Tried to hide assets
Transferred title to anything to a minor?
Transferred title to a spouse, friend, business associate, family member
Deposited money in a friend's, associate's, or family member's bank account
Deposited money in an off-shore bank account
Forged any tax or financial documents
Filed a lien against a tax officer
Deposited property or money into a trust
Deposited property or money into a close corporation
Purchased property in someone else's name
Lost, concealed, or destroyed financial records
Sold or traded valuable assets for less than fair value
Lived a "lavish lifestyle" while owing back taxes
Changed banks frequently to avoid levies
Changed your name, social security number, or similar documents
Been a member of a tax protest organization
37. For which tax years or periods do you owe? Identify
38. Why did you not pay taxes?
Losses due to fire, theft, or other similar events
39. Explain other reasons for not paying taxes
40. Why did you fail to file one or more returns?
41. Do you presently have a court hearing or a tax collection hearing coming up? If so, when is it calendared for?
42. Have you been notified or served with a tax action that you must reply or respond to?
Yes - criminal charges - fraud or evasion
Yes - Notice of Deficiency
Yes - reply to audit
Yes - IRS claim in bankruptcy
Other pending matter
42a Deadline to reply or file:
43. Has the tax collector seized or is holding any of your money or property? Describe:
44. Are there other issues that King should know about?
45. Do you have a question?
PLEASE DOWNLOAD AND SIGN THE ATTACHED IRS FORM ON THE THANK YOU PAGE (after you hit "SUBMIT" below
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