Brand — Case Diagnostics

4. Have wages been levied (garnished) or have you been notified of an imminent wage levy?

Note

Yes No

How often do you get paid?

How much is being (or will be) levied per paycheck?

Is the wage levy causing (or will cause) economic hardship which is not enabling you to pay for necessities such as rent, mortgage, groceries, etc.?

Note

Yes No

Immediate Taxpayer Advocate intervention

Engagement LetterIRC 7216 DisclosureForm 2848Form 911

Since wages are being (or will be) levied and it is (or will be) causing economic hardship, immediate Taxpayer Advocate assistance/intervention is required to release (or halt) the wage levy.

Have any bank accounts been levied?

Note

Yes No

Was the levy issued to the bank within the past 21 days??

Note

Yes No

+ Add a record

Bank name	Amount	Actions

Is the bank levy causing economic hardship which is not enabling you to pay for necessities such as rent, mortgage, groceries, etc.?

Note

Yes No

Immediate Taxpayer Advocate assistance

Engagement LetterIRC 7216 DisclosureForm 2848Form 911

Since a bank account(s) has been levied within the past 21 days and this is causing economic hardship, immediate Taxpayer Advocate assistance is required to release funds.

5. Have you been contacted by, or presently dealing with, a Revenue Officer?

Note

Yes No

6. Have you received an IRS notice dated within the past 30 days that had any of the following specific headings? Select all that apply.

Note

Notice of Intent to Levy and Notice of Your Right to a Hearing Notice of Jeopardy Levy and Right of Appeal Notice of Levy on Your State Tax Refund- Notice of Your Right to a Hearing

Date(s) of IRS notice(s)

Note

Date of IRS notice

Immediate Collection Due Process Appeal

Engagement LetterIRC 7216 DisclosureForm 2848Form 12153

Since a “…Right to a Hearing or Right to Appeal” notice was received and dated within the past 30 days, an immediate Collection Due Process Appeal needs to be filed. Have client immediately send this notice to you.

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