First Name *

Last Name *

Email *

Phone *

State *

Are you a new client or existing client? *

New Client

Existing Client

Is this for business or individual? *

Business

Individual

Both

Do you owe federal or state taxes? *

State

Federal

Both

Do you have any unfiled tax years? *

Yes

No

Not Sure

Estimated, how much in taxes do you owe? *

What would you like to discuss during our meeting? *

Are you willing and able to spend in the solution to your tax problems? *

Yes

No

How did you hear about us? *

Please share anything else that will help prepare for our meeting.

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