IRS Representation Intake | YJCRUMP SOLUTIONS

Full Name

Business Name (if applicable)

Phone Number

Email Address

Mailing Address

Have you received an IRS notice or letter?

Yes

No

If yes, please upload a copy

What type of IRS issue are you dealing with?

Approximate amount owed to IRS

Have you already spoken with the IRS about this issue?

Yes

No

Have you previously worked with a tax professional on this matter?

Yes

No

Have you filed your last 3 years of tax returns?

Yes

No

Unsure

Are there any unfiled tax years? If yes, please specify which years.

Yes

No

Please describe your situation in your own words

I certify that the information provided is true and complete to the best of my knowledge.

Electronic Signature

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Date

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