Tax Liens Form

First name

Last name

Email

Mobile phone number

City

County

State

Spouse, First name

Spouse, Last name

Spouse, Email

Spouse, Mobile phone number

Are the tax liens (if more than 1) City, County, State, or Federal tax liens?
CityCountyStateFederal

Approximately how much is alleged to be owed?

Have you had a court enter a judgment against you yet?
YesNo

If not, did you receive a court date yet?

Are you employed full time?
YesNo

Are you 1099'd, W-2'd, or not working?
1099W-2Not working

Have you filed tax returns every year, for the last 7 years?
YesNo

If not, which years didn't you file?

How much equity do you currently have (approximate, not including your home, car, or retirement accounts)?