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Tax Professional Liability Basic Information
Legal Name of Firm
*
Year Established
*
Your "trade name" or "doing business as" name
*
Effective date requested
*
Your address
*
City
*
State
*
Zip
*
Mailing Address (if different)
Mailing City
Mailing State
Mailing Zip Code
Your primary contact name
*
Telephone Number
*
Your website address
Email Address
*
Your annual gross revenues
*
Less than $100,000
More than $100,000