First Name *

Last Name

SSN (Last 4 digits only for initial intake) *

Phone *

Email *

Address *

Street Address

City

State

Country

Postal Code

Preferred Contact Method *

Phone

Text

What year(s) are affected? *

Have you filed all required tax returns? *

Yes

Not Sure

If Yes, what notice number(s)? If known

Have you spoken with the IRS recently? *

If yes, what were you told?

Current Employment Status: *

W-2 Employee

Self-Employed

Both

Unemployed

Monthly Income: *

Under $2K

$2K - $4K

$4K - $7K

$7K+

Do you have additional sources of income? *

Yes

If yes, explain,

Estimated Monthly Expenses: *

Are you currently able to make monthly payments toward your tax balance?

Yes

Maybe

Have you tried to resolve this before? *

Yes

If yes, what was done?

Payment Plan

Offer in Compromise

Filed missing returns

Spoke with another tax professional

Please check if you have all of the following: *

IRS notices/letters

Previous tax returns

Income documents (W-2, 1099, etc.)

Anything you would like us to know?

By submitting this form, you acknowledge:

• This is a preliminary intake only, not a guarantee of representation
• Additional documentation may be required
• Services will be discussed after review of your case

By submitting this form, you acknowledge and agree to the following:

• The information provided is accurate to the best of your knowledge and will be used solely for the purpose of reviewing your tax situation.

• Submission of this form does not establish a client relationship with Freedom Financial SFL and does not guarantee representation or services.

• Freedom Financial SFL is conducting a preliminary review only based on the information provided. Additional documentation and verification may be required before any services are offered.

• Any advice or recommendations will not be finalized until a full review of your tax records, IRS transcripts, and supporting documentation is completed.

• You understand that tax resolution outcomes vary and are dependent on individual circumstances, IRS regulations, and eligibility requirements. No guarantees of specific results have been made.

• You authorize Freedom Financial SFL to contact you via phone, text message, or email regarding your inquiry and next steps.

• You understand that certain services, including consultations and case work, may require additional fees which will be discussed prior to engagement.