Form 8654 Tax Counseling for the Elderly Program Semi-Annual/Annua

Form

Tax Counseling for the Elderly Program
Semi-Annual/Annual Program Report

(April 2013)
1. Report type
Semi-Annual

OMB Number
1545-2222

Department of the Treasury - Internal Revenue Service

8654

TCE

4. Report period (month, day, year)

2. Fiscal year
Annual

From 10 / 01 /

3. Recipient organization name

To

Street address

City

State

/

/
ZIP code

Account/Identifying number

Reimbursement Expenses
(a)
Numbers

(b)
Cost

5. To volunteer tax assistors/quality reviewers
6. To volunteer instructors
7. To volunteer coordinators/administrators
8. Total (ADD lines 5-7)

Administrative Expenses
9. Salaries/Benefits (clerical, administrative or technical staff only)
10. Supplies/Volunteer Recognition—For TCE Program
11. Rent/Utilities/Custodial Services—When additional and necessary for TCE
Program
12. Auditing
13. Daily Site Operations Travel (includes travel of paid staff to monitor sites)
14. Program Publicity Development
15. Interpreter Services
16. Telephone Installation (No WATTS or 800 Lines) or Internet Connectivity
costs
17. Other (postage and/or food costs)
18. Total Administrative Expenses (ADD lines 9 through 17, column (b)). This
figure should not be more than 30% of line 19
19. Program Cost (ADD lines 8 and 18 column (b))
20. Cost of Travel to IRS Office/IRS Training
21. Costs for Electronic Filing Supplies/Services
22. Total Program Cost (ADD lines 19, 20, and 21 column (b))
23. Total amount of TCE federal award
24. Unexpended Balance of TCE federal award (Subtract line 22 from line 23)
25. Refund to IRS (Complete on annual report ONLY)

Catalog Number 64330H

www.irs.gov

Form 8654 (Rev. 4-2013)

Page 2
Account/Identifying Number

Other Information
60+

Other

26. Number of individual federal tax returns prepared (paper)
27. Number of individual federal tax returns prepared (e-file)
28. Total number of individual federal tax returns prepared (paper and e-file)
Add lines 26 and 27.
29. Number of taxpayers assisted—all other (excludes return preparation)
30. Total number of taxpayers assisted (add lines 28 and 29)
31. Number of tax preparation sites

Numbers

a. e-file sites
b. combination of paper and e-file sites
c. Total lines 31a and 31b
32. Attach to this form, a listing of each site’s SIDN (Site Identification Number) that was provided
by the IRS Territory Office, its EFIN (Electronic Filing Identification Number), whether the site
is a combination paper/e-file site, and the volunteer return preparation hours for each site.
Signature of responsible officer

Date

Agency use

IRS Volunteer Income Tax Preparation and Outreach Programs Privacy and Paperwork Reduction Act Notice
Privacy and Paperwork Reduction Act Notice– The Privacy Act of 1974 requires that when we ask for information we tell you our legal right to ask for
the information, why we are asking for it, and how it will be used. We must also tell you what could happen if we do not receive it, and whether your
response is voluntary, required to obtain a benefit, or mandatory. Our legal right to ask for information is 5 U.S.C. 301. The Paperwork Reduction Act
requires that the IRS display an OMB control number on all public information requests. The OMB Control Number for this study is 1545-2222. The time
estimated for participation is 15 minutes. We are asking for this information to assist us in contacting you relative to your interest and/or participation in
the IRS volunteer income tax preparation and outreach programs. The information you provide may be furnished to others who coordinate activities and
staffing at volunteer return preparation sites or outreach activities. The information may also be used to establish effective controls, send
correspondence and recognize volunteers. Your response is voluntary. However, if you do not provide the requested information, the IRS may not be
able to use your assistance in these programs.

Catalog Number 64330H

www.irs.gov

Form 8654 (Rev. 4-2013)

Page 3

Instructions for Form 8654, Tax Counseling for the Elderly Program Semi-Annual/Annual Program Report
Line 1.

Enter the Report Type. If it is a semi-annual report put an X or if it is the annual report put an X in the box.

Line 2.

Enter the Fiscal Year.

Line 3.

Enter the recipient’s organization name, street address, city, state, zip code, and the account/identifying number. The account/
identifying number is the Employer Identification Number (EIN).
Enter the report period (month, day and year) on the To lines (e.g. if this is the semi-annual report because your program is in
operation after 4/30 your “to line” will be 5/31 – If this is your annual report enter the date in the “to line” your program ended).
Enter the number of volunteer tax assistors/quality reviewers on line 5(a), the number of volunteer instructors on line 6(a), and
the number of volunteer coordinators/administrators on line 7(a). Enter the total number of volunteer tax assistors/quality
reviewers, volunteer instructors, and volunteer coordinators/administrators on line 8(a). DO NOT count any volunteer twice,
even if he/she serves in two or more capacities.
Enter the final amount of reimbursement for volunteer tax assistors/quality reviewers, volunteer instructors and volunteer
coordinators/administrators on the appropriate line in column (b). DO NOT include expenses for any volunteer twice (i.e., if an
individual serves as a volunteer coordinator as well as a tax assistors/quality reviewers all of his/her expenses should be
estimated on line 7, only). Include reimbursements made to volunteers for actual expenses incurred or stipends provided to
volunteers. Either method is permitted and both stipends and actual reimbursements can be used by a grantee simultaneously
as long as records are kept on both and the total is placed under lines 5-8. Please note: Stipends must be designated on
expected out-of-pocket expenses not on time engaged in volunteer service.

Line 4.
Line 5-8.

Line 9.

Line 11.

Enter the number of clerical, administrative or technical personnel you will pay in the Numbers Column and the dollar amount in
the Cost Column.
Supplies include pencils, pens, paper, etc. These are supplies for the TCE Program other than those directly attributable for efile. Include purchase of recognition items not to exceed $10 purchased for volunteers on this line.
Enter the rent, utilities and/or custodial services costs for the TCE Program.

Line 12.

Enter the cost for audit services for the TCE Program.

Line 13.

Enter travel of program sponsors or expenses incurred by program administrators or coordinators who are paid staff to monitor
sites.
Enter the final cost for the development of publicity (i.e., public service announcements, posters, brochures) and other publicity
materials.
Enter the final cost for interpreter services.

Line 10.

Line 14.
Line 15.
Line 16.

Line 18.

Enter the final cost of installing temporary telephone lines at “telephone answering sites”, or internet connectivity costs to
provide e-file services.
Enter the final cost for all postage, including postage used for the fulfillment of orders for program materials. In addition, enter
the final cost of food that was expended for volunteers at TCE sites that was deemed necessary, reasonable, allocable, and
allowable under OMB guidelines and the total expenses for food may not exceed $500.
Total the administrative expenses (add lines 9-17 in the Cost Column (b)). This figure should not be more than 30% of line 19.

Line 19.

Enter the program cost by adding lines 8 and 18 in the Cost Column (b).

Line 20.

Enter the costs incurred for attending a meeting at the IRS office or with IRS personnel. Provide lodging receipts, taxi receipts,
air fare, meals and incidental expenses, gas receipts, etc. Include travel expenses for attendance at train-the-trainer tax law or
site coordinator training. Do not include expenses for daily site operation travel, these are now captured on line 13.

Line 21.

Line 22.

Cost for diskettes, paper, printer cartridges, toner, cable locks, memory, network cards, external media, and anything else
directly attributable to e-file expenses. Computers and printers (with unit cost not to exceed $1,000) can be purchased to
support e-file using grant funds. You should also include costs associated with computer repair of equipment used for tax
preparation services.
Enter the total program costs (add lines 19-21 in the Cost Column (b)).

Line 23.

Enter the total amount of the TCE federal award.

Line 17.

Line 24.

Enter the unexpended balance of the TCE federal award (subtract line 22 from line 23).

Line 25.
Line 26.

An entry needs to be made on this line for any monies that were withdrawn from the Payment Management System (PMS) for
activities that did not occur.
List the number of individual paper federal tax returns prepared for taxpayers 60+ and all other taxpayers.

Line 27.

List the number of individual e-file federal tax returns prepared for taxpayers 60+ and all other taxpayers.

Line 28.

Add figures from lines 26 and 27 and insert that total in line 28.

Line 29.

List the number of taxpayers assisted—All other (exclude return preparation) for taxpayers 60+ and all other taxpayers.

Line 30.

Add figures from lines 28 and 29 and insert that total in line 30.

Line 31.

List the number of tax preparation sites for e-file sites, the combination of paper and e-file sites, and the total of lines 31a and
31b on line 31c.
Provide the site name, Site Identification Number (SIDN), Electronic Filing Identification Number (EFIN), type of site i.e., e-file or
combo, and the volunteer return preparation hours for each site. The volunteer return preparation hours are the actual hours the
volunteers work and not the hours of operation.

Line 32.

The Form 8654, Semi-Annual/Annual Program Report should be prepared as cumulative, reflecting expenditures for the
entire year. A Semi-Annual Report is required to be completed ONLY if program is in operation after April 30th. The
Semi-Annual Report is due by 6/30. The Annual Report must be submitted by 12/31 or 90 days after the completion of
your program, whichever is earlier.
Catalog Number 64330H

www.irs.gov

Form 8654 (Rev. 4-2013)