New Client Form

NEW CLIENT FORM

ALL INFORMATION RECEIVED BY AXTAX.COM WILL
BE KEPT IN STRICT CONFIDENCE

Name:

Address#1:

Address#2:

City, State, Zip:

Phone (Day):

Phone (Evening):

Best Time(s) to call:

Fax:

E-mail Address:

Audit

Collection

What kind of tax problem do you have?

Penalty

Tax Levy/Lien

CP-2000

Other

Description of your tax issues? What has been done so far?

Size of federal tax debt (approximate):

Type of tax returns for which you are liable:
(e.g., 1040, 1120, 940, 941, etc.)

Tax years for which you are liable:

Have you received any mailed notices from the IRS?:

Were those tax returns filed, if so when?
(those for which you owe):

Have you been personally contacted by any IRS agent?:

Do you have state tax debts or other debts?
If so, in what amount:

Are you?

Retired

Employed

Self-Employed

Questions, Comments:

Axtax Inc.
33919 9th Ave S Ste 202 Federal Way, WA 98003
Email: taxhelp@axtax.com