TAX INTAKE

TAX CONSULTATION INTAKE

(To be conpleted by the prospective client)

The purpose of an initial consult is for the Attorney to advise you, the prospective client, whether the Law
Office of Thomas Hogan will represent you. The purpose is not to render a definite legal opinion as it may
be impossible to fully assess a matter within the time frame allotted for a consultation or with the
(information and documents) that you may be able to provide at the initial consultation.
Note: The following questions will help us to understand the reason for your visit today. Your responses
are protected by attorney/client privilege and will be held in strict confidence. Thank you

Primary Tax Payer

Date

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Mailing Address (if different)

Address Line 1

Address Line 2

City

State

Zip Code

Country

Email Address

Telephone

Social Security #

Date of Birth

Filling Status (Circle One)

Single

Married, Filing Joint

Married,Filing Single

Head of Household

Spouse Name

Street Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Mailing Address (if different)

Address Line 1

Address Line 2

City

State

Zip Code

Country

Email Address

Telephone

Social Security #

Date of Birth

Do you claim any dependents? If yes, provide age and relationship of dependent(s) to you

INCOME AND EXPENSE SECTION

Current Occupation(s)

Please fill out the income and expense section below.
Use the “Spouse” column only if you and your spouse do not live together

Taxpayer

Spouse

Gross Monthly Income:

Net (Take-Home) Monthly Pay:

Rent/Mortgage:

Utilities:

Groceries, misc. household expenses:

Medical Expenses (not covered by insurance):

Gasoline/Repairs/Maintenance/Registration:

Auto Insurance:

Child or Spousal Support:

Child or Care / Day Care:

Car payment(s):

Please provide any additional information that is helpful for us to know to properly manage your case

CONSULTATION NOTES

Please read carefully and sign below:
Following your initial interview, if you agree to hire the firm, and the firm agrees to represent you, both you and
the firm will sign a Fee Agreement. The Free Agreement will set forth the terms and conditions of representation.
If the firm is willing to represent you and you decide not to sign a Fee Agreement today, you are strongly urged
to schedule a second appointment at the earliest possible time or to immediately consult with other legal counsel
to protect your rights. There may be strict time limitations concerning your matter.
NOTICE: This office does not represent you with regard to the matter set forth by you in this information sheet
or discussed during your consultation until both you and the attorney sign a written Fee Agreement.
Your signature acknowledes only that you received a copy this completed information sheet and does not mean you
have hired the attorney.

Signature

Sign Here

Date

TAX CONSULTATION INTAKE

OUESTIONNAIRE

INCOME AND EXPENSE SECTION

Taxpayer

Spouse

About Us

Areas Of Law

Contact Details