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pdfDepartment of the Treasury - Internal Revenue Service
13715
Form
(October 2021)
OMB Number
1545-2222
Volunteer Site Information Sheet
Purpose: The IRS toll-free assistance line and the VITA Site Locator Tool on irs.gov use the information you provide on this form to help
taxpayers locate the nearest volunteer tax preparation site. Fill-in the information below carefully and ensure it is accurate and complete.
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
Date (MMDDYYYY)
10. Is the site a mobile only site
Yes
No
11. Does site prepare prior year returns
Yes
No
1. Site name
12. Does the site offer Certifying Acceptance Agent (CAA) service
Yes
No
Yes
No
2. Site address
13. Does the site use an Alternative Filing Method for return preparation
If "Yes", select one and type additional methods if applicable
Revised form
Yes
No
3. City, state,
Zip code
14. What service systems are used to support virtual return preparation for this site? Select
all that apply.
4. Site Identification
Number (SIDN)
DocuSign
5. Program type
6. First day open/
Last day open
/
Fax machines and/or phone calls
Get Your Refund
Google docs
TaxSlayer taxpayer customer portal
TaxSlayer taxpayer scanned documents
Zoom or other video conferencing system
Other system (write in)
7. Languages
offered
8. Is the site open to public
Yes
No
9. Is the site an appointment only site
Yes
No
If "Yes", provide
contact name and
phone number
15. Does your VITA/TCE site offer voter registration assistance to taxpayers
Yes
No
16. Does the site offer Financial Education and Asset Building Services
If "Yes", Relationship Manager is required to complete Form 14099 SPEC Financial Education & Asset Building Partner Assessment Tool
Yes
No
17. Does the site Prepare Non-Resident Alien/Foreign Student/Scholar
Returns
Yes
No
18. Has Form 15272, VITA/TCE Security Plan, or equivalent been
submitted to the Territory Office
Yes
No
19a. Federal e-file
Yes
No
Yes
No
19b. State e-file
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
Phone number
Best time to call
AM
Address (street, city, state, zip code)
PM
Email address
IRS Use Only
Date Form 13715 received in Territory Office
SPECTRM updated (employee SEID) and date
Territory Manager or Designee approval (sign and date certifying the information on this form matches the data in SPECTRM)
Privacy Act and Paperwork Reduction Notice – Our authority to ask for this information is 5 U.S.C. 301 and 26 USC 7801 and 7803. 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. 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. We may not conduct or sponsor a collection of information subject to the Paperwork
Reduction Act without displaying the OMB control number. We may provide this information to volunteers who coordinate activities and staffing at taxpayer
assistance sites, and we may disclose this information to the media and the public. For more information about these and other routine uses, see the Privacy
Act notices for Stakeholder Relationship Management and Subject Files and Volunteer Records (10.004 and 10.555) in the Federal Register: September 8,
2015 (Volume 80, Number 173) [Pages 54073-54074]
Catalog Number 43863F
www.irs.gov
Form 13715 (Rev. 10-2021)
File Type | application/pdf |
File Title | Form 13715 (Rev. 10-2021) |
Subject | Volunteer Site Information Sheet |
Author | SE:W:CAR:SPEC:PS&A |
File Modified | 2021-10-13 |
File Created | 2021-10-13 |