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CASH Questionnaire 2025
*
1.
Contact Information - if no email, write n/a
(Required.)
Name
Email Address
Phone Number
*
2.
what is the reason for your visit to CASH
(Required.)
Tax Preparation
IRS or NYS letter
Question about a Tax Return
Other Reason
3.
If you have an IRS or NYS tax problem, would you like to speak with someone from the Low Income Taxpayer clinic for potential legal help?
Yes, someone from LITC will reach out to you
No
*
4.
Please check the one that best describes you:
(Required.)
Couple filing joint
Female
Male
Other (please specify)
*
5.
How did you hear about CASH
(Required.)
Radio
Direct Mail/Post Card
Another client of CASH (Family/Friend)
Social Media
Community Organization/ Non-Profit Partner
Other (please specify)
*
6.
Would you like to be a CASH Volunteer? Volunteers are required to utilize an email account.
(Required.)
No
Yes - I can volunteer this year (now)
Yes - I can volunteer next year (Next Tax Year)
7.
Would you be interested in a savings initiative that will help you to evaluate your credit and identity individualized financial goals.
Yes - Financial Empowerment Staff will Follow-up
No - Not Interested
No Answer
8.
Do you and your family have health insurance
Yes
No
No Answer
9.
If yes to question above, are you happy with your Insurance, and is afforable?
Yes
No- someone from Fidelis Care will reach out to you
No Answer
*
10.
Do you have a Bank account
(Required.)
Yes
No
Other (please specify)
Current Progress,
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