Membership Application - Tax Club of Cleveland

Membership Application - Tax Club of Cleveland

Tax Club of Cleveland 1120 Chester Avenue, #470 - Cleveland OH 44114 216-771-0577 – phone 216-696-2582 – fax Email: [email protected] APPL...

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Tax Club of Cleveland 1120 Chester Avenue, #470 - Cleveland OH 44114 216-771-0577 – phone 216-696-2582 – fax Email: [email protected]

APPLICATION FOR MEMBERSHIP TO APPLICANT: The By-Laws of the Club provide that membership shall be open to persons whose work is principally concerned with problems of taxes or tax administration. Acceptance or refusal of membership is determined by the Board of Directors. Annual dues are $75. Please mail your check with the application or insert credit card information in the space provided if you are faxing the membership application. Please complete this form, and send it to the Tax Club of Cleveland at the contact information listed above.

1.

Applicant's Name: □ Mr. □ Mrs. □ Ms.

2.

Business/Firm Name: Business Address:

Title: Phone:

E-mail: 3.

Home Address: Phone:

4.

Indicate to which address you would like meeting notices sent:

5.

Indicate which of the following best describes you: I work in a professional services firm. I work for a business or nonprofit. I am a full-time student. I am a full-time government employee involved in a taxrelated position. Other (please describe) ________________________ ___________________________________________

6.

□ Home

□ □ □ □ □

Indicate in which of the following tax areas you actively work: Federal Corporate Partnership/ S Corp Individual Employee Benefits Excise Financial & Estate Planning

7.

□ Business

□ □ □

State Franchise Personal Property Sales, Use & Excise

□ □

Local Income Real Property

□ □

International Income Other

□ □



□ □ □

If paying by credit card, please include the following information and fax the form to 216-696-2582:

Name (as it appears on card): ________________________________________________________________ Type of Card (Visa, etc.) ___________________________ Credit Card #: ___________________________________________ Exp. Date: ________________________