Form 13424 - Low Income Taxpayer Clinic (Litc) Application Information Page 3

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Instructions for Form 13424, Low Income Taxpayer Clinic (LITC) Application Information (cont'd)
Please provide a complete response, including zip plus-four code, for the Clinic Street Address, and Clinic Mailing Address. Do not
write “same.” Phone numbers should be formatted as 123-456-7890 x.111. When providing the clinic’s website address, please provide
the direct link to the LITC page if one is available. If no website exists, write “none.”
Please individually list all languages in addition to English in which services can be provided on site. If the clinic uses a telephone or
internet based translation service, state “other languages through interpreter services.”
All applicants are required to identify a Clinic Director, Qualified Expert (QTE), and Qualified Business Administrator (QBA) at the time
of application. For more information on these positions, see Publication 3319, LITC Grant Application and Guidelines. For the clinic
director and QTE, list any applicable licenses and certifications. All applicants are required to identify the sponsoring organization's Tax
Compliance Officer. The Tax Compliance Officer is the individual authorized to speak with the IRS about federal tax compliance matters
involving the sponsoring organization.
13424
Form
(Rev. 4-2016)
Catalog Number 36126D

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