Pre-Asset Seizure and/or Wage Garnishment Questionnaire


We need some basic information about your situation - we'd like you to answer the questions on this form.  Do the best you can - we understand you may not have all the information requested.  It's much easier for everyone if we can come to our first discussion prepared.  As an added incentive, if you submit a completed questionnaire, the initial consultation is free.


  If you prefer not to complete this form, either go to the "Book Online" tab or call us to schedule your initial consultation.   If you choose this option, the initial consultation fee is $300.  However, that amount will be applied as a one-time credit to fees incurred in the future. 


This form is meant to facilitate our interview process and creates no future obligations or relationship between the parties.  If you do not retain our services, your form will be removed from our system and securely destroyed.   This questionnaire is for the use of Tax Defense ONLY.   Tax Defense will never share, sell, or allow a third-party access to this form or ANY of the information on this form.

If you prefer to have your initial consultation without completing this questionnaire,

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How much do you estimate you currently owe the IRS for unpaid taxes, penalties and interest?
Have you previously entered into any agreement(s) with the IRS to pay all or part of the taxes you owe?
Check the box next to each year unpaid taxes have been assessed against you:
What type of payment agreement did you have? Click the box for any that apply:
Did you fail to comply with the terms of that earlier payment agreement?
Were you in “currently not collectible” status with the IRS for any period of time?
Has the IRS sent you a Notice and Demand for Payment (Form CP501)?
Is that the first Notice and Demand for Payment you received?
If NOT the first notice, how many other notices have you received?
Has the IRS sent you a Final Notice – Notice of Intent to Levy and Notice of Your Rights to a Hearing?
Do you have current assets (e.g. – interest(s) in real property, vehicles, stocks, bonds, cash, inventory) or contingent future assets (e.g. – potential inheritance rights) sufficient to pay all or part of this tax debt?
Do you contend that you do not owe all or part of the taxes assessed?
Have you previously challenged all or any part of the taxes the IRS currently seeks to collect through another proceeding – Collection Appeals Program, Taxpayer Advocate Service and/or an audit reconsideration?
Have you transferred or disposed of any assets in the past 120 days?
Are you currently employed?
Check all forms of compensation you receive:

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