NEW TAX CLIENT INTAKE FORM
Get the max back with Top Tier Refunds. We promise to make this your BEST tax season yet!
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Number
*
Format: (000) 000-0000.
Can you receive text messages at this number? We send only 2-3 texts out each tax season to help keep you updated.
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Email Address
example@example.com
How did you hear about us?
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Are you a U. S. Veteran, First Responder, or Teacher? If you select yes, you can save money on tax prep fees when filing with Top Tier Refunds.
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No
Other
*
Will you be willing to recommend us?
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Maybe
No
We pay $100 per referral! Please give reference of any two people whom you feel deserve extraordinary customer care this tax season.
Rows
Full Name
Contact Number
Email Address
1
2
Choose your preferred Tax Professional you would like to work with this tax season.
Please Select
I do not have a preference
Tamara Van Buren
Nilisha Jelks
Lakisha Kelly
Armani Hathaway
Jacqueline Taylor
Arlisha Milam
Teri Blaydes
Breionna Hurt
Takisha Wilson
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