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If you require urgent assistance, please call for a free confidential consultation. Our tax professionals will immediately put a halt to ongoing or impending IRS actions.

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1) Please fill out this section COMPLETELY:

* = required field

General Information *First Name:
*Last Name:
Company:
Address:
Address:
City:
State/Province:
Zip or Postal Code:
Country:
*Phone:
Fax:
*E-mail:

2) Please complete the amount(s) owed in the corresponding boxes below:

Taxes Owed Personal Income Tax $:
Business Income Tax $:
Payroll Tax $:
State Tax $:
*Total Taxes Owed = $: Must be at least $10,000

3) Please check all that apply:

IRS Collection Activity No current collection activity (no mail or phone calls regarding my tax debt for the last 6 months):
I received a letter/or letters, but no CERTIFIED MAIL regarding my tax debt:
I received some CERTIFIED mail or a PHONE CALL regarding my tax debt:
I received a GARNISHMENT, WAGE LEVY, BANK LEVY or PROPERTY SEIZURE:

Any added tax history or financial information in regards to your tax problem is appreciated:

4) Please read the agreement statement below:

Nationwide Tax Relief will not share the contents of this form. nor shall the contents of this form be sold or distributed to a third party. Any other use of these contents is a violation of privacy laws and the ethics of Nationwide Tax Relief.

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NTR is not a law firm. NTR's Founder and CEO, Richard Boggs is an expert in the field of tax resolution and not an attorney. While NTR does employ licensed attorneys, enrolled agents, tax experts and support staff who are committed to serving its clients in negotiations with the taxing authorities and in preparing tax returns, NTR does not provide legal services and does not represent its clients in court proceedings, including proceedings before the tax court. If you have received or been served with legal papers, or summoned to appear in court, you should consider consulting with a private attorney immediately, even if you retain NTR to resolve your tax problems or negotiate your tax debt. Your failure to respond to legal papers or appear in court may result in serious legal consequences.