Consultation Form | Straight Tax LLC.

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Monday-Thursday 10am-8pm | Friday 10am-5pm | Saturday 10am-2pm

(704)524-3464

| Serving All of NC

Straight Tax LLC.

Your Trusted Tax Partner Since 2019

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Straight Tax Services Intake Form

*Filing Status

Single

Head of Household

Married

Widower

*First name

*Last name

*Number of Dependents

*Occupation

*SSN

*DOB

*Email

*Phone

*License No.

*Mailing Address

*City

*State

*Zip Code

Spouse Information

Spouse First Name

Spouse Last Name

SSN

Spouse DOB

Phone

Occupation

Email

License No.

Dependent(s) Information

Dependent 1

First Name & Last Name

SSN

Dependent 1 DOB

Relationship

No. of Months In Home

Dependent 2

First Name & Last Name

Dependent 2 SSN

Dependent 2 DOB

Relationship

No. of Months In Home

Dependent 3

First Name & Last Name

Dependent 3 SSN

Dependent 3 DOB

Relationship

No. of Months In Home

List any other dependent information. Include first and last names, DOB and SSN.

Additional Information

Select all that apply.

Self Employed

Received IRS Notice

Health Insurance (Private or through Employer)

Market Place/Obamacare

Services

*Signature

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Your Trusted Tax Partner Since 2019.

Straight Tax LLC.

info@straighttax.net
219 W Main Ave, Gastonia, NC 28052
www.straighttax.net

(704)524-3464

Hours of Operation

Sunday Closed

Monday 10am - 8pm

Tuesday 10am - 8pm

Wednesday 10am - 8pm

Thursday 10am - 8pm

Friday 10am-5pm

Saturday 10am - 2pm

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