15424 Taxpayer Experience Office Speaker Request Form

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Form

15424

(June 2023)

Department of the Treasury - Internal Revenue Service

OMB Number
1545-

Taxpayer Experience Office Speaker Request

Submit the speaker request at least 60 days prior to the event date. Complete all sections and send to: [email protected].

Requester’s Information
Name

Organization

Address (number, street, and room or suite number)

City or town

Telephone number

Alternative telephone number

State

ZIP code

Email address

Event Information
Event title
Time (include time zone)

Date
Location/Platform (i.e., Zoom, Teams, etc.)

Topic(s)/Subject(s)

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Event link/Agenda

Advertisement link

Estimated attendance

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Purpose of event
Background of event

Event Point of Contact (POC)
Event POC telephone number

Alternative telephone number

Event POC email address

Comments

Additional details (select all that apply)
Internal
External
Virtual

Recorded

Attendees charged fees to attend

Underserved

Multilingual

Open to public

Open to media

Federal/State/Local government

Prohibitions (provide explanation in comments section above)

Speaker Information
Speaker request type
Taxpayer Experience Office (TXO) Chief
Executive
Speaker’s role/format
Keynote
Length of speech (30, 60, 90 minutes)
Additional request(s)
Bio
Presentation objectives

Taxpayer Experience Office (TXO) Deputy Chief

Subject matter expert

Other

Solo presenter

Panel

Speaker’s time slot

Picture/Headshot

Other
Final advertisement date

PowerPoint presentation/materials

Presentation outline/summary

Comments

Catalog Number 94102B

www.irs.gov

Form 15424 (6-2023)

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