Business Consultation Form
Full Legal Name of Business
Type of Business
Legal Structure
Please select
S Corporation
C Corporation
Non-profit or Tax Exempt
Partnership
Sole Proprietorship
LLC - Limited Liability Corporation
Mailing Address
Suite or Internal Mail Stop
Business City
Business State
Business Zip Code
Business Telephone and Extension
Private Business Telephone and Extension
Business Cellular Telephone Number
Salutation
Please select
Mr.
Mrs.
Miss
Dr.
Full Legal Name
Business Title
Home Mailing Address
Suite or Apartment
City
State
Zip Code
Home Telephone
Cellular Telephone
Telefax
E-mail Address
Type of Tax Owed
Unfiled Personal Return(s)
Unfiled Business Return(s)
Unpaid Payroll Withholding Taxes
Taxes Alleged by IRS Audit
Other
What Years are Involved
Approximate Amount
Please select
$1,000 to $5,000
$5,000 to $10,000
$10,000 to $25,000
$25,000 to $50,000
$50,000 to $100,000
$100,000 or more
Please Contact Me By
Please select
Office Telephone
Private Business Telephone
Business Cell Phone
Home Telephone
Personal Cell Phone
Please Select All that Apply
Audited
Levied through my Bank Accounts
Levied through my Payroll Earnings
Have not filed my tax return(s)
Have received notices of levies and
Additional Information/Message
Have you seen our TV commercial?
No
Yes