Form 13094 Recommendation for Juvenile Employment with the Internal

Department of the Treasury - Internal Revenue Service

Form

13094

OMB Number
1545-1746

Recommendation for Juvenile Employment
with the Internal Revenue Service

(April 2018)

Name of applicant (print/type)

The individual listed above is seeking employment with the Internal Revenue Service. The position is one of public trust
that requires access and handling of taxpayer receipts and taxpayer information.
Check the appropriate box below with your recommendation for the individual listed on this form
To the best of my knowledge, this individual is of good character and should be able to perform the duties entrusted to
them in a public trust position that requires them to handle taxpayer receipts and taxpayer information.
I cannot recommend this individual for a public trust position that requires them to handle taxpayer receipts and
taxpayer information.
I do not know this individual well enough to recommend for a public trust position that requires them to handle
taxpayer receipts and taxpayer information.
Name of person making recommendation (print/type)

Telephone number

Address

State

City

Relationship to applicant

ZIP code

Number years known applicant

Signature

Date

Note: Form should be completed by a person who has personal knowledge of the applicant's character and
trustworthiness. If the applicant is attending school or has graduated, this form must be completed and signed by the
current or former school official (i.e., principal, guidance counselor or teacher). If the applicant is not in school and is
currently employed or unemployed, the form must be completed and signed by a current or former employer. If the
applicant is not in school and has never been employed, the form must be completed by an adult/authority figure (i.e.,
neighbor, religious, family doctor, etc.). An IRS Employment representative will contact the individual providing the
recommendation to verify the information on the form.
Date

IRS verification signature

5 CFR 736.102
You may designate in the box provided that you do not wish to have your identity disclosed. However, the IRS may be
compelled to disclose your identity in response to a valid Privacy Act request that is made by the individual to whom the
record pertains.
I do not wish to have my identity disclosed.
Privacy Act and Paperwork Reduction Act Notice
We are requesting this information under 5 U.S.C. 301 for the purpose of acquiring your recommendation for the individual listed on this form. Providing
the information is voluntary. Not providing any or all of the information will not have an effect on you from the IRS. Generally, the person you are
providing information about will be able to obtain a copy of the information you provide through a Privacy Act request made to the IRS. The information
may be provided to the Office of Personnel Management, Equal Employment Opportunity Commission, and the General Accounting Office for the
purpose of properly administering Federal personnel systems. The estimated average time to complete this form is 5 minutes. 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. Send
comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Internal
Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Please
do not send the completed form to this address.

Previous versions of this form cannot be used after January 1, 2008.
Catalog Number 32129W

www.irs.gov

Form 13094 (Rev. 4-2018)