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Business Questionnaire

Business Tax Problem

Business Information

 

Full Legal Name of the Business:

Type of Business:

Legal Structure:

Mailing Address line one:

Suite or Internal Mail Stop/Code:

City:

State:

Zip code:

Business Telephone with Extension:

Private Telephone with Extension:

Business Cellular Phone:

 

Personal Information

 

Salutation:

First Name:

Last Name:

Email:

Business Title:

Mailing Address:

Suite or Apartment:

City:

State:

Zip code:

Home Telephone:

Cellular Telephone:

Telefax:

Type of tax owed:

What years are Involved:

Approximate Amount:

The best time to contact:

Please contact me by:

I have been audited

I have been levied through My bank AccountI have been levied through My Payroll Earnings

I have not filed my tax returns

I have not received notices of levies and/or lien

Additional Information

 
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