Form 13768 - Electronic Tax Administration Advisory Committee Membership Application
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1
2Electronic Tax Administration Advisory Committee Membership Application
Please complete this application and return it to one of the following addresses by Monday, March 15, 2010.
Please note: Members of the ETAAC may not be federally registered lobbyists.
Internal Revenue Service
e-mail Address: etaac@irs.gov
ETA and Refundable Credits
ETAAC Analyst (C4-213)
-or-
SE:W:ETARC:S:RM
5000 Ellin Road (M/S C4-470)
Lanham, MD 20706
You may also fax your application to: 202.283.2845
PART I
Maiden name or other name(s) used and date(s) (required for FBI check)
Name
Home Address
Home telephone number
Zip Code
City
State
Date of birth (required for FBI check)
City and State of Birth (required for FBI check)
Business name
Job title
Business address
City
State
ZIP Code
Business telephone number
Business FAX number
E-mail address
PART II – Desired Skills and Qualifications
Please submit a short (one or two page) statement, including recent examples, addressing your specific skills and
qualifications as they relate to the following:
1. Experience in electronic tax administration including e-commerce, e-gov, and e-filing, payment and
communication options.
2. Experience in strategic planning and/or change management.
3. Experience in systems management and improvement.
4. Experience in implementing customer service initiatives.
5. Experience in sales or marketing to individual and small business consumers.
6. Experience in public policy development.
7. Hands-on experience resolving major issues in key market segments.
8. Experience in the development of effective communication networks within the tax community.
9. Experience establishing strategic partnerships with external groups, including Federal and state entities.
10. Ability to formulate, develop, and present proposals for the ETAAC and Commissioner's consideration.
PART III
Please attach a copy of your resume, to include prior Treasury and/or IRS employment, please state position(s),
title(s), and dates of employment. In addition, please list professional credentials, membership in professional
organizations, and local liaison activities with IRS, if applicable.
13768
Form
(Rev. 1-2010)
Catalog Number 47884W
Department of the Treasury – Internal Revenue Service
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