13978 Projected Operations VITA Grant Application

Form

13978

(March 2022)

Department of the Treasury - Internal Revenue Service

Projected Operations VITA Grant Application

OMB Number
1545-2222

Purpose: This form is to be used by VITA Grant applicants. It should accompany the VITA Grant Application and include estimates
expected for next filing season in the categories shown. Note: At least 90% of the total number of federal returns prepared must meet
the low income threshold.

Period of performance

Name of organization

October 1,

to September 30,

Federal Return Preparation

Number of Returns

1. Federal returns filed electronically
2. Federal returns filed as paper
3. Federal returns filed through MyFreeTaxes
4. Total federal returns prepared (Add lines 1-3)
Return Preparation Site Information (Complete page 2 with site information)

Number of Sites

5. Traditional sites
6. Virtual sites
7. Facilitated self-assistance sites
8. Total proposed sites (Add lines 5-7)
Estimate the number of volunteers and the total hours the volunteers
will work by type of position they will occupy.

Number of Volunteers

Total Volunteer Hours

9. Tax preparers
10. Support
11. Site coordinators
12. Instructors
13. Program administrators
Estimate the number of federal tax returns expected to prepare for each underserved population. Choose only one population as your
primary and one population as your secondary focus.
Underserved Population

Primary (select one)

Secondary (select one)

Number of Returns

14. Elderly
15. Rural
16. Persons with disabilities
17. Limited English proficient
18. Native American
19. Low income (not included in lines 14 -18)
Comments/Remarks

Note: To be completed when applying for entry into the program.
Catalog Number 51503C

www.irs.gov

Form 13978 (Rev. 3-2022)

Page 2
Complete the following table with existing and proposed site information. Provide the EFIN (Electronic Filing Identification Number) and
SIDN (Site Identification Number) for each site. If more space is required to list all the program’s site, please provide the information in
a word or excel document.
Site Name

EFIN

SIDN

City

State

Open All Year
Yes

Catalog Number 51503C

www.irs.gov

No

Form 13978 (Rev. 3-2022)

Page 3

Instructions for Form 13978, Projected Operations VITA Grant Application
Line 1

Record the number of low income federal returns expected to file electronically.

Line 2

Record the number of low income federal returns expected to file as a paper return.

Line 3

Record the number of low income federal returns expected to file through MyFreeTaxes.

Line 4

Record the total low income federal returns expected to file. This is the sum of lines 1 through 3.

Line 5

Record the number of sites planned to operate during the next filing season as traditional site locations.

Line 6

Record the number of sites planned to operate during the next filing season as virtual site locations.

Line 7

Record the number of sites planned to operate during the next filing season Facilitated Self-Assistance (FSA) locations.

Line 8

Record the total number of established and new sites that will operate. This is the sum of lines 5 through 7.

Line 9

Record the number of volunteers whose primary responsibility will be certified tax return preparers and record the total
hours expected to work by all these volunteers.

Line 10

Record the number of volunteers whose primary responsibility will be support personnel such as a greeter and record the
total hours expected to work by all these volunteers.

Line 11

Record the number of volunteers whose primary responsibility will be site coordinators and record the total hours expected
to work by all these volunteers.

Line 12

Record the number of volunteers whose primary responsibility will be instructors and record the total hours expected to
work by all these volunteers.

Line 13

Record the number of volunteers whose primary responsibility will be program administrators and record the total hours
expected to work by all these volunteers.

Line 14

Estimate the total number of federal returns expected to prepare for the low income elderly population.

Line 15

Estimate the total number of federal returns expected to prepare for the low income rural population.

Line 16

Estimate the total number of federal returns expected to prepare for the low income person with disabilities population.

Line 17

Estimate the total number of federal returns expected to prepare for the low income limited English proficient population.

Line 18

Estimate the total number of federal returns expected to prepare for the low income Native American population.

Line 19

Estimate the total number of federal returns expected to prepare for the low income population not included in lines 14
through 18.

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 30 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 51503C

www.irs.gov

Form 13978 (Rev. 3-2022)