Form 14335 Contact Information for VITA and TCE Grant Programs

Form

14335

(March 2022)

Department of the Treasury - Internal Revenue Service

Contact Information for VITA and TCE Grant Programs

Recipient name

OMB Number
1545-2222

Federal Award Identifier

Address

Days of operation

Hours of operation

See the Instructions and Definitions provided on the reverse.
Primary Contact Information
Primary contact name
Phone number

Title
Extension

Cell phone number

Email address

May the IRS share the Primary Contacts information with other grant recipients and non-grant recipients
involved in the VITA or TCE program

Yes

No

Yes

No

Yes

No

Yes

No

Alternate Contact Information
Alternate contact name
Phone number

Title
Extension

Cell phone number

Email address

May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients
involved in the VITA or TCE program

Authorized Organization Representative Information
Authorized Organization Representative

Title

Phone number

Cell phone number

Extension

Email address

May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients
involved in the VITA or TCE program

Federal Tax Matters Contact Information
Federal Tax Matters contact name

Title

Phone number

Cell phone number

Extension

Email address

Financial/PMS Contact Information
Financial/PMS contact name

Title

Phone number

Cell phone number

Extension

Other Contact Information

Explain role

Other contact name

Title

Phone number

Extension

Cell phone number

Email address

Email address

May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients
involved in the VITA or TCE program
Catalog Number 59717U

www.irs.gov

Form 14335 (Rev. 3-2022)

Other Contact Information

Explain role

Other contact name

Title

Phone number

Extension

Cell phone number

Email address

May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients
involved in the VITA or TCE program

Other Contact Information

Explain role

Other contact name

Title

Phone number

Extension

Cell phone number

Yes

No

Yes

No

Email address

May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients
involved in the VITA or TCE program

Instructions for Form 14335, Contact Information for VITA and TCE Grant Programs
Instructions: List those individuals that we may contact with questions concerning your grant. Refer to the following definitions.
Designate only one primary contact. Designate at least one alternate contact. We are asked occasionally to share contact information
with other grant recipients and non-grant recipients involved or interested in the VITA or TCE program. Please indicate whether we may
share your information.
Definitions:
1. Primary — Manages the day-to-day operations of your organization's program and is responsible for ensuring its requirements
are met.
2. Alternate — Knowledgeable of the grant and its requirements and assists or directs the primary contact.
3. Authorized Organization Representative — Authorized to act for the organization and to assume the obligations imposed by the
Federal laws, regulations, requirements, and conditions that apply to grant applications or grant awards.
4. Federal tax matters — Authorized to discuss your organization's federal tax matters with IRS. This individual is only contacted
when questions arise concerning your organization's filing of its federal returns or paying of federal taxes, penalties or interest.
5. Financial/PMS — Responsible for the financial aspects of the grant. This includes responsibility for requesting disbursement and
required reporting in the Payment Management System.
6. Other — Provides assistance in the absence of those designated a role or that share responsibility for a role. Please explain their
role in the space provided.

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 59717U

www.irs.gov

Form 14335 (Rev. 3-2022)