13424-C Low Income Taxpayer Clinic (LITC) Advocacy Information R

Department of the Treasury - Internal Revenue Service

Form 13424-C

OMB Number
1545-1648

Low Income Taxpayer Clinic (LITC)
Advocacy Information Report

(April 2016)
Name of clinic

Grant year

Part I. Systemic Advocacy Submissions
Complete this section to list systemic issues related to low income or ESL taxpayers submitted during the reporting period to the
Systemic Advocacy Management System (SAMS) https://www.irs.gov/Advocate/Systemic-Advocacy-Management-System-SAMS
Issue number

Submitter

Date submitted

Submitter

Date submitted

Submitter

Date submitted

Brief description of the issue

Issue number
Brief description of the issue

Issue number
Brief description of the issue

Part II. Published Materials
Complete this section to list written materials published during the reporting period to educate low income or ESL taxpayers about tax
issues or to bring awareness to the public about the LITC program or tax issues that affect low income or ESL taxpayers.
Format

Book

Law review

Magazine

Newspaper

Website

Other

Author's name

Date published

Title of article

Publication or website

Brief description of the article

Format

Book

Law review

Magazine

Newspaper

Website

Other

Author's name

Date published

Title of article

Publication or website

Brief description of the article

Format

Book

Law review

Magazine

Newspaper

Website

Other

Author's name

Date published

Title of article

Publication or website

Brief description of the article

Catalog Number 54942J
For Paperwork Reduction Act Notice, see Publication 3319.

www.irs.gov

Form 13424-C (Rev. 4-2016)

Page 2

Part III. Television and Radio Appearances
Complete this section to list television and radio appearances made during the reporting period to educate low income or ESL
taxpayers about tax issues or to bring awareness to the public about the LITC program or tax issues that affect low income or ESL
taxpayers.
Airing dates of segment

Number of potential listeners or viewers

Discussion topic

Presenter

Brief description of the topic

Airing dates of segment

Number of potential listeners or viewers

Discussion topic

Presenter

Brief description of the topic

Airing dates of segment

Number of potential listeners or viewers

Discussion topic

Presenter

Brief description of the topic

Part IV. Public Service Announcements
Complete this section to list public service announcements aired during the reporting period to educate low income or ESL taxpayers
about tax issues or to bring awareness to the public about the LITC program or tax issues that affect low income or ESL taxpayers.
Number of times segment aired

Number of potential listeners or viewers

Discussion topic

Presenter

Brief description of the topic

Number of times segment aired

Number of potential listeners or viewers

Discussion topic

Presenter

Brief description of the topic

Number of times segment aired

Number of potential listeners or viewers

Discussion topic

Presenter

Brief description of the topic

Catalog Number 54942J

www.irs.gov

Form 13424-C (Rev. 4-2016)

Page 3

Instructions for Form 13424-C, Low Income Taxpayer Clinic (LITC) Advocacy Information Report
Note: Interim and Year-End Reports, including this form (Form 13424-C), may be released under the Freedom of Information Act
(FOIA). In response to a FOIA request, the LITC Program Office will release these reports after appropriate redactions to ensure
confidentiality of taxpayer information.

Purpose
This form is used to report information about certain advocacy work the clinic performed during the reporting period. This form is used
to report all systemic advocacy issues submitted, written materials published, television and radio appearances made, and public
service announcements aired during the reporting period.
The Program Office uses the information reported on this form and the other reporting forms to determine the scope of services
provided by clinics. Data is also aggregated to provide program-wide statistical information about services provided to low income and
English as a Second Language (ESL) taxpayers. Please be careful to follow the instructions for this form and to report all information
completely and accurately. If additional room is necessary to provide details about the activities reported on this form, include such
details in the program narrative.

Reporting Requirements
All clinics must complete this form. See Publication 3319 for additional information.
Reporting Period
Clinics are required to report on LITC activities twice for each grant year. The grant year is January 1 through December 31 for the year
in which a grant award is received. An Interim Report is required to report activities conducted for the period from January 1 through
June 30; a Year-End Report is required to report activities conducted for the entire grant year, the period from January 1 through
December 31. Check the appropriate box at the beginning of the form indicating for which period the report is being completed.
Note: For purposes of this Form 13424-C, clinics are not required to repeat information included in the Interim Report on the
Year-End Report. Report advocacy work performed between January 1 and June 30 on the Interim Report, and report
advocacy work performed between July 1 and December 31 on the Year-End Report.

Specific Instructions
Systemic Advocacy Submissions
Report in this section all systemic issues that relate to low income or ESL taxpayers that were submitted to the Systemic Advocacy
Management System (SAMS) during the reporting period. Include the SAMS issue number, the name of the individual who made the
submission, the date of each submission, and a brief description of the issue described in the submission. The SAMS site is available at
www.irs.gov/uac/Systemic-Advocacy-Management-System (SAMS).
Published Materials
Report in this section all written materials published during the reporting period to educate low income or ESL taxpayers or to bring
awareness to the public about the LITC program or tax issues that affect low income or ESL taxpayers. Include the posting of
educational materials to a website or the distribution of educational materials via social media. Check the appropriate box to indicate
the format of the publication. If the publication was released in multiple formats (i.e., in a magazine and on a website) check one box
and list the other formats in the Program Narrative on Form 13424-N, line 2.ix. Include the author’s name, the publication date, the title
of the publication or website, the title of the work, and a brief description of the work.
Television and Radio Appearances
Report in this section all television and radio appearances produced by or featuring clinic staff and broadcast during the reporting period
to educate low income or ESL taxpayers or to bring awareness to the public about the LITC program or tax issues that affect low
income or ESL taxpayers. If the broadcast was released in multiple formats or on multiple channels, list the other formats in the
Program Narrative on Form 13424-N, line 2.ix. Include the airing dates of each segment, a reasonable estimate of the number of
listeners or viewers, the topic of the discussion or on-air piece, the names of any clinic representatives involved in the appearances,
and a brief description of the topic discussed on-air.
Public Service Announcements
Report all public service announcements produced by or featuring clinic staff and broadcast during the reporting period written to
educate low income or ESL taxpayers or to bring awareness to the public about the LITC program or tax issues that affect low income
or ESL taxpayers. Include the number of times each segment aired, a reasonable estimate of the number of listeners or viewers, the
topic of the discussion or on-air piece, the names of any clinic representatives involved in the appearances, and a brief description of
the topic discussed on-air.

Catalog Number 54942J

www.irs.gov

Form 13424-C (Rev. 4-2016)