Questionnaire - Ed Babitzke, Enrolled Agent

Name *

First

Last

Email *

Please enter your email, so we can follow up with you.

Phone Number *

Please enter you phone number so we may contact you.

Best to call

Please enter the best time to contact you.

Preferred Contact Method

Phone
Email

How do you prefer to be contacted?

What would like assistance with?

Tax Debt
Missing Tax Returns
Both
Other

Subject *

Enter a short subject.

Message *

How much do you owe the IRS? If you do not owe, enter 0 *

Please enter the amount you owe.

Do you owe state taxes?

No
Yes

If Yes, How much do you owe?

What type of taxes do you owe?

Personal - 1040
Business - 1120, 1065
Employment - 941, 940, 944
Trust Fund Penalty

Check all that are applicable.

Have you paid your current Federal Tax Deposits or Estimated Tax Payments on time and in full?

Yes
No
Unknown

Check which tax forms that are past due/unfiled.

What years (or quarters) for the checked tax forms have not been filed?

Example: 2018, For 941 - 06/30/18

What was the date and title of your last letter received from the IRS?

Usually there is a “form”/”letter” number in the upper or lower right corner of the letter.

Please describe, in your own words, the circumstances that gave rise to your tax liability:

Do you currently have a representative?

Form 2848 - Power of Attorney
Form 8821 - Tax Information Authorization
None

If yes, please indicate which form is active.

Please describe any actions you or a representative have taken recently to address your tax matters:

If a Revenue Officer is assigned to your case, what are the most recent actions they have taken against you or requests they have made? If there are deadlines set, what are they?

Have they issued a levy and/or what are they asking for?

Have there been any recent bank account levies, seizures, wage garnishments, or other aggressive collections action? If so, when and what action was taken?

Has the IRS issued an adverse action?

Do you have any currently filed IRS Appeals in progress? If so, what is the status?

What are your expectations as to an outcome? What do you want to see happen?