HITS Consumer Claim

CLAIM FORM
For HITS TAX & BOOKKEEPING SERVICES, LLC
RESTITUTION

Please print legibly and keep a copy for your records.

Name(Required)

First Middle Last

Current Mailing Address(Required)

Street Address City State ZIP Code

Address Used for Relief Program(Required)

Street Address City State ZIP Code

Programs Applied For

NC HOPE (rent/eviction assistance)

NCHAF (homeowner assistance)

Internet

Phone #(Required)

e-mail Address(Required)

Signature(Required)

Date(Required)

Your signature on this form is your sworn statement that you were a client of and may be entitled to restitution from HITS Tax & Bookkeeping Services, LLC.

HITS Consumer Claim

CLAIM FORM For HITS TAX & BOOKKEEPING SERVICES, LLC RESTITUTION

PLEASE COMPLETE THIS CLAIM FORM BY JULY 31, 2024

CLAIM FORM
For HITS TAX & BOOKKEEPING SERVICES, LLC
RESTITUTION

PLEASE COMPLETE THIS CLAIM FORM
BY JULY 31, 2024