Download:
pdf |
pdfForm 13715
(Rev. March 2013)
OMB Number
1545-2222
Volunteer Site Information Sheet
Purpose: Information provided on this form is used by our IRS toll-free assistance line to help taxpayers locate the nearest volunteer tax
preparation site and to list sites on irs.gov. Review the information below carefully. Update and/or correct missing or existing information.
Return the completed form to your local IRS contact. If the site information changes after submitting this form, please provide your
local IRS contact with the updated information immediately.
Site Information
Site Name:
Is the site an appointment only site?
Site Address:
If yes to the above question, please provide the phone number for site.
City, State:
Zip Code:
Site Identification
Number (SIDN)
Yes
No
If yes to the above question, please provide the contact name for site.
Does the site use the Virtual Delivery Method for return preparation?
Intake Site
Preparation Site
Both
If “Yes”
Yes
No
Is the site a mobile only site?
Yes
No
Federal e-file
Yes
No
State e-file
Yes
No
Does the site offer Certifying Acceptance Agent (CAA) service?
Yes
No
Is the site open to public?
Yes
No
Does the site offer Financial Education and Asset Building Services?
Yes
No
Program Type: FSA, VITA, VITA Grant, Military, AARP, TCE
First day open/
Last day open
If VITA or TCE Grant, enter name of Grant Organization
/
What languages
are offered at
the site?
Does site prepare prior year returns?
Yes
No
Site Operating Hours
Day
Time
Open
Comments (e.g. holiday closures, alternative opening times)
Close
MON
TUE
WED
THUR
FRI
SAT
SUN
Site Coordinator or Contact
Name:
Mailing Address:
Best Time to Call:
AM
PM
Email Address:
City, State, Zip:
Is this a revision of information you
previously provided for this year?
Phone Number:
Date of this revision:
Yes
No
IRS Use Only
Date Form 13715 Received in Territory Office:
Territory Manager Approval (Signature & Date):
Date SPECTRM Updated:
SEID of employee who updated SPECTRM:
Privacy Act and Paperwork Reduction Notice – Our legal right to ask for information is 5 U.S.C. 301 and 26 USC 7801.
The primary purpose of asking for this information is to assist us in providing services to taxpayers at sites supporting IRS volunteer income tax preparation and outreach
programs. The time estimated for participation is 30 minutes. We may provide information to volunteers who coordinate activities and staffing at taxpayer assistance sites.
Your response is voluntary. However, if you do not provide the requested information, the IRS may not be able to promote your assistance in these programs.
For more information about uses, see the Privacy Act notice for SPEC Total Relationship Management (SPECTRM) in the Federal Register: July 19, 2004 (Volume 69,
Number 137) [Notices] [Pages 43055-43056]
Form 13715 (3-2013) Catalog Number 43863F Department of the Treasury Internal Revenue Service www.irs.gov
File Type | application/pdf |
File Title | Form 13715 (Rev. 3-2013) |
Subject | Volunteer Site Information Sheet |
Author | SE:W:CAR:SPEC:PPD:E |
File Modified | 2013-07-31 |
File Created | 2013-07-31 |