Summary of change

Print Form

VITA/TCE Program
(OMB # 1545-2222)
Addition of new forms or documents to be cleared by OMB:
Please provide the following information when verifying whether a VITA/TCE document needs
OMB approval as outlined in the Paperwork Reduction Act.
1) A copy of the document or tool used to solicit information from the participants
volunteering for the VITA/TCE program.
2) A copy of any instructions associated with the documents listed above.
3) Complete answers to the following questions.
4) Projected annual release date of these documents to the public.

Description of Document or tool
Please provide a description of the document and legal justification for need to solicit this
information.
Form 14204, Tax Counseling for the Elderly (TCE) Application Checklist and Cover Sheet - Form found in
Publication 1101, Application Package and Guidelines for Managing a TCE Program, which is used as checklist
for applicants when applying for the grant to ensure they know exactly what is required to be submitted with
their grant application. This form is also used as a contact sheet.

Burden Estimates
Is this document completed by IRS employees, during the normal course of their work?
If yes, are recipients of this document required to reply to the IRS or provide
addition documentation, in response?

____Yes ____No

____Yes ____No

30-50
Estimated number of participants completing this document...................................______________
10 minutes
Estimated amount of time it will take to complete this document............................______________
8.5 hours
Sub-total.......................................................................................................______________
0
Any additional estimated time for recordkeeping or storage of information............______________

Total Estimated Burden............................................................................... 8.5 hours

Projected use and reporting of this document
Once per year
How often will recipients be required to reply/per year?........................................._______________
May 1
What month is this document made available each year?........................................_______________