Form

HOTLINE CONTACT FORM
URGENT CONFIDENTIAL INQUIRY ABOUT TAX EMERGENCY
I owe back taxes and need professional help.
DATE & TIME
- Month - Day Year
at
/ Hour Minutes
TAXPAYER NAME:
TAXPAYER e-MAIL ADDRESS:
TAXPAYER DAY PHONE NO.
TAXPAYER EVENING PHONE NO.
TAXPAYER CELL PHONE NO.
NAME OF BUSINESS (if any)
I'M LOCATED IN:
CONSULT ABOUT:

STOP TAX LEVY STOP TAX LIEN STOP OTHER TAX COLLECTION TALK TO TAX COLLECTOR FOR ME NEED HELP FOR BACK TAXES SETTLE OR COMPROMISE TAX CLAIM BANKRUPTCY PENALTY ABATEMENT AUDIT REPRESENTATION FILE OLD TAX RETURNS CONTEST PROPOSED ASSESSMENT OTHER
I OWE TAXES TO:

Not applicable IRS personal income taxes IRS payroll taxes California income taxes California payroll taxes Sales taxes Other taxes
EST. $ AMOUNT OWED:
PLEASE CONTACT ME

DAY PHONE EVENING PHONE CELL PHONE E-MAIL ANY OF ABOVE
URGENCY LEVEL:

URGENT! PLEASE CALL ASAP! CONTACT ME THIS WEEK AT LAWYER\'S CONVENIENCE
NO CONFERENCE FEE:

I understand there is no charge for this initial contact
BEYOND INITIAL CONTACT: CONSULTATION FEE:

I understand that if the taxpayer authorizes attorney to provide services, including counsel and advice, a fee is tyically charged, but only with taxpayer's consent.
OPTIONAL: ATTACH relevant documents (if any) such as notice of levy, that may be helpful to explain the situation:
Type figures at right into box below and hit "Submit"*
Should be Empty:

URGENT CONFIDENTIAL INQUIRY ABOUT TAX EMERGENCY