2017 Wisconsin -REGISTRATION FORM

(See page 2 for instructions)

Name of Registrant: ______

PTIN: ______(PTIN Required for IRS Continuing Education Reporting)

Company: ______

Mailing Address: ______

City: ______State: ______Zip Code: ______

Daytime Telephone: ______

Email Address: ______

(This will be used for emailing your confirmation letter and certificate(s) of completion.)

Check the boxes for the course(s) you want to attend

Comprehensive S-Corporation Tax Course, $345

□ Baraboo/Wisconsin Dells, July 24–25 (Monday-Tuesday)

Agricultural Tax Issues Course, $95 (8:30 a.m. – 12 noon)

□ Eau Claire, Thursday, Oct 5 □Madison, Monday, Oct 9 □ Appleton, Tuesday, Oct 10

Farm Succession Planning Course, (Price not available yet) (1:00 p.m. – 4:30 p.m.)

□ Eau Claire, Thursday, Oct 5 □Madison, Monday, Oct 9 □ Appleton, Tuesday, Oct 10

Annual Income Tax Course, $295

□Eau Claire, Nov 1-2

□ Milwaukee, Nov 13-14□Oshkosh, Nov 14-15□Stevens Point, Nov 15-16

□Pewaukee, Nov 27-28□Green Bay, Nov 28-29□Madison, Nov 29-30

Total Fees: ______

If paying by check, Total amount of check enclosed $______

(Make check payable to Tax Insight, LLC. You must include payment for us to process a registration. We DO NOT hold a place without receipt of payment.)

If you are paying by credit card, which card are you using? □ VISA □ MasterCard □ Discover Card

Credit Card Number ______Expiration Date ______

Total Amount $______

Instructions

Please print out the registration form and complete all information, using one name per form. Duplicate registration forms as needed. NOTE: Each registrant will need to supply their PTIN in order to get credit for the continuing education hours with the IRS.

Mail registration form(s) and payment to:

Tax Insight, LLC

W6409 Moon Shadow Drive

Greenville, WI 54942

-or-

Fax registration form with your credit card information to: 608-831-1065

Within 2 weeks of registering we will send you a Tax Insight Confirmation Letter that will serve as your receipt. You will receive this via e-mail, so it is important to include your legible e-mail address.

If you have questions, call Tax Insight at 608 831-1040. Close this window when finished to return to the Tax Insight, LLC website.

Further registration information:

  • Special Accommodations

If you need special accommodations or have special requests, please make note on your registration form.

  • Cancellation Policy

To cancel a registration and receive a refund, you must contact Tax Insight at least7 days before a scheduled tax course. We deduct a $10 cancellation fee from the amount refunded.There are no refunds for cancellations less than 7 days before a course.

  • Transfer Policy

You may transfer to a different location up to 7 days before a course. There is no transfer fee.

  • Substitution Policy

You may make substitutions at any time at no charge. We appreciate advance notice of substitutions to speed on-site registration.