New Client Intake

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.

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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 ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

SSN/ITIN *

*Required for Power of Attorney

Marital Status *Select OneMarriedSingle

Spouse Name

First

Last

Spouse SSN/ITIN

*Required for Power of Attorney

Next

How Much Does the IRS Claim You Owe?

Are You Currently Being Audited?Select OneYesNo

Does Your Tax Debt Involve Your Own Business? *Select OneYesNoNot 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 ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Next

Have You Filed All Required Tax Returns During the Last 10-Years? *Select OneYesNoNot 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 OneYesNoNot 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 OneYesNo

You can apply for financing via our partner (Affirm) when paying your invoice.

How Did You Hear About Us? *

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