Form 13980 - Business Results Vita Grant Program Year End Report - 2009

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Department of the Treasury– Internal Revenue Service
13980
Form
Business Results
(June 2008)
VITA Grant Program Year End Report
Purpose: This form is to be used by VITA Grant Program grantees. It should accompany the completed VITA Grant
Program Year End Narrative due September 30 and should represent the grantees performance for the below grant
period in the categories listed.
Grant Period: October 1,
Name of Partner:
through June 30,
Federal Return Preparation
Number of Returns
1. Total low income federal returns filed electronically
2. Total low income federal returns filed as paper returns
3. Total low income federal returns prepared (Add lines 1 & 2)
Return Preparation Site Information
Number of Sites
4. Total established sites - fixed location
5. Total established sites - ad hoc location
6. Total new sites - fixed location
7. Total new sites - ad hoc location
8. Total sites operated (Add lines 4 through 7)
9. Total sites offering paper only return preparation
10. Total sites offering electronic filing
11. Total tax preparation software packages provided by the IRS
Quality Review Method Used at Sites
Number of Sites
12. Total sites using peer review
13. Total sites using designated review
Volunteers
Volunteers and Total Volunteer Hours
14. Total number of all volunteers
15. Total number of all volunteer hours
Volunteer Certification - Record the number of volunteers certified at each training level
Number of
shown in items 17-23. Volunteers with multiple certification levels should be shown in
Volunteers
each level they are certified. Volunteers not certified should be recorded on line 16.
16. Volunteers not certified
17. Volunteer certified in VITA/TCE Basic
18. Volunteer certified in VITA/TCE Intermediate
19. Volunteer certified in VITA/TCE Advanced
20. Volunteer certified in VITA/TCE International
21. Volunteer certified in VITA Military
22. Volunteer certified in VITA Foreign Student
23 Volunteer certified in VITA Puerto Rico
Underserved Population - Indicate the number of federal tax returns prepared for each
Number of Returns
underserved population.
24. Low income elderly
25. Low income rural
26. Low income disabled
27. Low income limited English proficient
28. Low income Native American
29. Low income (not included in Lines 24-28)
Dollars Generated
Dollars
30. Total EITC refund dollars generated by low income federal returns filed
31. Total refund dollars generated by low income federal returns filed
Signature
Signature Of Responsible Official
Date
13980
Catalog Number 51539E
Form
(Rev. 6-2008)

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