Page 2
QSR # 5: Volunteer Agreement (continued)
Comments
9 Did the site meet the components for QSR 5?
Yes
No
10 Is Publication 4836, VITA/TCE Free Tax Programs (VolTax), properly displayed? (Explain
your process for ensuring volunteers and taxpayers know how to report unethical issues.)
Yes
No
Comments
QSR # 6: Timely Filing
11 Are timely filing requirements met? (Explain your process for transmitting returns,
obtaining acknowledgements, and correcting rejects. Explain how taxpayers sign their
tax return.)
Yes
No-Not retrieving acknowledgments timely
No-Not transmitting timely
No-Not notifying taxpayers of rejects timely
No-Form 8879 not signed
No-Other (use if more than one "No" applies)
QSR # 7: Civil Rights
Comments
12 Is a current Civil Rights poster displayed at the first point of contact? (Explain your
process for ensuring volunteers and taxpayers know how to report Civil Rights issues
identified at your site.)
Yes
Yes-Using Publication 4454
No
QSR # 8: Site Identification Number
Comments
13 Does the site use the correct SIDN? (What SIDN are you using?)
Yes
No
QSR # 9: Electronic Filing Identification Number
Comments
14 Does the site use the correct EFIN? (What EFIN are you using?)
Yes
No
QSR # 10: Security
Comments
15 Is there a process to identify everyone who prepares, reviews, or changes a tax return?
(Explain the process to identify who prepares, reviews, corrects, or makes changes to a tax
return.)
Yes
No
16 Are adequate security measures taken to protect equipment and safeguard taxpayer data?
(Explain measures taken to protect equipment and dispose of taxpayer data.)
Yes
No-Taxpayer data not properly disposed
No-Equipment not secured
No-Taxpayer data not safeguarded
17 If Section 7216 is applicable, are consent notices properly secured and maintained? (Do you
or your partner collect taxpayer information, which is used for anything other than preparing
tax returns?)
Yes-Consent notices properly secured
N/A-Consent notices are not required
No-Consent notices not properly secured
18 Did the site meet the components for QSR 10?
Yes
No
19 Do all volunteers wear or display their name to the taxpayers they assist? (Explain your
process for identifying volunteers to taxpayers.)
Yes
No
Site Operations
Comments
20 Is the site operating information correct in SPECTRM? (What are your site operating days and
hours?)
Yes
No
21 Are volunteer preparers and quality reviewers correctly addressing the virtual VITA/TCE
question in TaxSlayer?
Yes
No
Adherence to Quality Site Requirements
Comments
22 What is the overall Quality Site Requirement adherence rating?
The adherence rate is calculated
by awarding 10 points for each of
the measurement questions
marked "Yes". The measurement
questions are 1, 3-5, 9, 11-14, and
18.
6729-D
Catalog Number 66908D
Form
(Rev. 10-2017)