Tax Resolution Form

First Name:

Last Name:

Email:

Phone:

Address (# and Street):

City:

State:

Zip Code:

How would you like to be contacted

Amount owed to IRS

Is your tax issue related to:

Are you current with all tax return filings?

Tax Type Owed
 Business Income Tax
 Personal Income Tax
 Employment/Unemployment Tax
 Trust Fund Recovery Penalty
 Lien/Levy
 Other

Additional Comments