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Tax Fraud Information Center

Tax Fraud Information Center

Taxation Contact Form

Name

Email Address

Phone Number

Business Phone

Cellular or Pager

Address

City

State

Zip

Are you known by any other names?
Yes No 

If yes, list other names you have used:

What is your marital status?

Does this matter involve a business you own or run?
Yes No 

If yes, provide the business name, address and phone:

If a business is involved, how is the business organized?

Are you employed?
Yes No 

If yes, please provide your job title and employer's name and address:

Can you be contacted at work?
Yes No 

What area of law does your situation involve?

Describe your situation, including any relevant dates:

How would you rate your legal needs described here?

Are any other people involved?
Yes No 

If yes, provide names, addresses (if known), and their relationship to you, if any:

Do you have any documents that could help explain your situation?
Yes No 

If yes, list those documents and their dates:

Are there other documents that you do not have access to that could be of assistance?
Yes No 

If yes, list those documents and their dates and locations (if known):

Describe how this situation has affected you:

Describe what you would like to happen to resolve your issue (your preferred outcome):

Have other attorneys worked on this matter?
Yes No 

If yes, provide names, addresses and a brief description of their involvement:

Special concerns:

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