Form 13013 Taxpayer Advocacy Panel (TAP) Membership Application

Department of the Treasury — Internal Revenue Service

Form

13013

Taxpayer Advocacy Panel (TAP)

(February 2009)

OMB No. 1545-1788

Membership Application

Part I a – Personal Information
Last name

First name

Middle initial

County

State

Home address (Street addrsss preferred)
City
ZIP code

Legal resident of State

Home phone no (include area code)

E-mail address
Mobile / Cellular phone no (include area code) Business phone no (include area code)

Employement Status
Currently Employed

Retired (indicate former Employer and Position/Occupation, below)

Other (indicate under Position/Occupation)

Employer

Position held / Occupation

How did you hear about the IRS Taxpayer Advocacy Panel?

Please tell us why you want to be a member of the IRS Taxpayer Advocacy Panel.

All information provided on this Form will remain Confidential.
If you have questions, please call: 1-888-912-1227, or visit our website at: www.improveirs.com
Catalog Number 31517Y

www.irs.gov

Form 13013 (Rev. 02-2009)

Page 2 of 4

Part I b – Panel Membership Requirements
(Note: Current IRS or Treasury employees or former employees who last worked for the IRS or Treasury within three years are
not eligible to serve on the Taxpayer Advocacy Panel).

Yes

No

1. Are you a current IRS or Treasury employee?
2. Are you a former IRS or Treasury employee who last worked for the IRS or Treasury within three
years from December 1st of the current year?
3. Are you a United States citizen?
4. Are you willing to travel overnight to attend multi-day meetings/events? (Note: Panel members will be
reimbursed by the IRS for authorized travel expenses.)
5. Are you willing to serve as a volunteer Panel member for 3 years?
6. Are you willing and able to commit approximately 300-500 hours of volunteer service to the Taxpayer
Advocacy Panel each year?
7. Are you willing to have the IRS check to make sure you are current with your Federal tax filings and
financial obligations?
8. Are you willing to undergo an FBI background check?
9. Are you an agent for another country who is registered or required to register under the Foreign Agent
Registration Act?
10. Are you a lobbyist for a foreign entity who is registered or required to register under the Lobbying
Disclosure Act of 1995?
Part II – Demographic Information
Note: You are not required to provide demographic information. However, if you choose to provide the information, it will help to
ensure that the Panel membership reflects the diversity and representation of the overall population.

Male

Race (select one or more):
American Indian or Alaska Native
Native American Indian/Alaskan Native
Asian
Black
White
Other (Specify):
Asian / Pacific Islander
Native Hawaiian or Other Pacific Islander

Ethnicity:
Race (check one only)
Hispanic
or LatinoHispanic
Black
Not Hispanic or Latino

Gender (check one)
Female

White

Language – Can you read, write or speak the following languages? (check all that apply)
English

Chinese

Korean

Spanish

Vietnamese

Russian

Other (Specify):

Age (check one only)
18-29 years

40-49 years

60-69 years

30-39 years

50-59 years

70-years and older

Household Income / Salary (check one only)
$24,999 or less a year

$35,000 - $49,999

$75,000 - $99,999

$25,000 - $34,999

$50,000 - $74,999

$100,000 or more

All information provided on this Form will remain Confidential.
If you have questions, please call: 1-888-912-1227, or visit our website at: www.improveirs.com
Catalog Number 31517Y

www.irs.gov

Form 13013 (Rev. 2-2009)

Page 3 of 4

Part III – Experience
TAP Members are a diverse group of citizens who work on committees to improve the Federal tax administration system. Please
address each question below in sufficient detail to enable us to assess your experience. Your experience can be both personal and
professional. This information is used to determine your qualifications to be a productive member of the TAP.
1. As a member of the Taxpayer Advocacy Panel you will be assigned to committees responsible for preparing recommendations and
proposals to the IRS. Please provide one or more detailed examples of your experience working as a member of a group. Describe
the group's task, your role in the group, and the outcome of the task.

2. As a member of the Taxpayer Advocacy Panel you will be expected to speak with individuals and groups about the Panel and use
the opportunity to get ideas and suggestions for improving IRS customer service and satisfaction. Please provide one or more
detailed examples of your experience speaking to individuals or groups to communicate information about a program or initiative.

3. As a member of the Taxpayer Advocacy Panel you will present recommendations/proposals from the public to other committee
members. Please provide one or more detailed examples of your experience presenting a position on a particular issue.

4. As a member of the Taxpayer Advocacy Panel you may have to present a position that you do not agree with. Please provide one
or more detailed examples of your experience presenting a position you do not agree with or describe how you might handle this
situation.

5. As a member of the Taxpayer Advocacy Panel you will work on problems and develop solutions to address these problems.
Please provide one or more detailed examples of problems you worked on and what steps you took to resolve the problem.

6. Please provide one or more detailed examples of committees, organizations and groups (both personally and professionally) that
you have been involved in that demonstrate your commitment to volunteerism. Please include the specific contributions you made.

All information provided on this Form will remain Confidential.
If you have questions, please call: 1-888-912-1227, or visit our website at: www.improveirs.com
Catalog Number 31517Y

www.irs.gov

Form 13013 (Rev. 02-2009)

Page 4 of 4

Part III – Experience (Continued)
TAP Members are a diverse group of citizens who work on committees to improve the Federal tax administration system. Please
address each question below in sufficient detail to enable us to assess your experience. Your experience can be both personal and
professional. This information is used to determine your qualifications to be a productive member of the TAP.
Computer Skills (check all that apply)
TAP members are geographically dispersed across the nation so they must rely on current technology to communicate and work on
projects from remote locations. Please indicate your proficiency using the technology below.
Proficiency with navigating the
Internet

Ability to send and receive e-mail with
attached documents

Experience using software for creating or
reviewing documents

Part IV – Certification (You must sign your application to have it considered valid)
I certify that I am a legal resident of the United States of America; I have fulfilled my tax obligations; I have not been involved in criminal
activities; and, to the best of my knowledge and belief, all of my statements herein are true, correct, complete, and made in good faith.

Signature of Applicant

Date

Applicants are encouraged to apply electronically from the IRS TAP website at: www.improveirs.org. Please complete and submit this
application, only if you are unable to electronically apply from the IRS TAP web site. Applications must be received no later than April
30, 2009.
Mail this paper application to:
IRS TAP Office
Room 1314
1111 Constitution Avenue
Washington, DC 20224
You may also fax the application to: 1-202-622-9382

Paperwork Reduction Act Notice
We ask for information on this form to carry out the Internal Revenue laws of the United States. Your response is voluntary. You are not
required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid
OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become
material in the administration of any Internal Revenue law. Generally, tax returns and information are confidential, as required by Code
section 6103.
The time needed to complete this form will vary depending on the individual circumstances. The estimated average time is 90 minutes.
If you have comments concerning the accuracy of this time estimate or suggestions for making this form simpler, please submit your
comments in writing to:
Internal Revenue Service
Tax Products Coordinating Committee
SE:W:CAR:MP:T:T:SP
1111 Constitution Ave., NW
Washington, DC 20224
Do not mail your Application to this address.

All information provided on this Form will remain Confidential.
If you have questions, please call: 1-888-912-1227, or visit our website at: www.improveirs.com
Catalog Number 31517Y

www.irs.gov

Form 13013 (Rev. 02-2009)