Prospective Client Online Application

We are currently not accepting online applications. We will open for application review again on May 20, 2024. If you submit an application before then, it will not be processed.​

Please note that you do not automatically become a client b​y submitting this form. After receiving your completed form, the LITC will contact you to set up an initial consultation meeting. After the consultation meeting, a clinician will inform you about your status.

Please bring copies of the following items (when applicable) to your first consultation:

  • IRS 30-Day Letter
  • Tax returns you filed for any year in controversy, supporting schedules that are part of the tax returns, W-2's, and other documentation relating to the tax returns
  • Any correspondence to and from the IRS
  • Any other notices recei​ved from the IRS.​
    How did you hear about us?
    First Name:
    Last Name:
    Date of Birth:
    Select a date from the calendar.
    Preferred Telephone:
    Alternate Telephone:
    Tax years in question:
    Amount due to the IRS:
    Briefly describe your tax issue:

    Please tell us how much income you receive from the following sources. Type "N/A" if it does not apply to you.     :
    Type of   IncomeSource of Income
      (Ex: Name of your Employer)
    Amount of income/Month
    (Ex: $878/month)


    Social   Security/Disability

    Self-   Employment

    Rental   Income

    Gambling   Winnings



    Child   Support

    Alimony Received

    Do you own any real estate?:
    If Yes, what type and where?:
    Do you own a small business?:
    If   Yes, how much income do they receive?
      Person 1 income:
      Person 2 income:
      Person 3 income: