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New Client Intake Form
Thank you for choosing The Law Office of Jason Carr to assist with your legal issue! To get started, please complete the intake form ASAP and we’ll reach out with the next steps.
Please enable JavaScript in your browser to complete this form.
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Step
1
of 4
Name
*
First
Middle
Last
Email
*
Telephone
*
Next
Current Mailing Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
SSN/ITIN
*
*Required for Power of Attorney
Marital Status
*
Select One
Married
Single
Spouse Name
*
First
Last
Spouse SSN/ITIN
*
*Required for Power of Attorney
Spouse Email
*
*Required to e-Sign Power of Attorney
Next
How Much Does the IRS Claim You Owe?
Are You Currently Being Audited?
Select One
Yes
No
Does Your Tax Debt Involve Your Own Business?
*
Select One
Yes
No
Not Sure
Business Name
Business EIN
*Required for Power of Attorney
Business Address (if different from above)
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Next
Have You Filed All Required Tax Returns During the Last 10-Years?
*
Select One
Yes
No
Not Sure
Please Select Year(s) NOT Yet Filed
*
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
Have You Received Any IRS Notices (i.e. letters) in the Last 30-Days?
*
Select One
Yes
No
Not Sure
IRS Notice Upload (Optional)
Click or drag files to this area to upload.
You can upload up to 2 files.
Note: You can upload these to our Client Portal later if they're not currently available.
Anything Else We Need to Know About Your Tax Situation?
Optional: Do you need to pay our fee over time (financing)?
*
Select One
Yes
No
You can apply for financing via our partner (Affirm) when paying your invoice.
How Did You Hear About Us?
*
Submit for Attorney Review