Contact Information for VITA and TCE Grant
14335
OMB Number
Form
1545-2222
Programs
(Rev. March 2014)
Recipient name
Federal Award Identifier
Address
Days of operation
Hours of operation
See the Instructions and Definitions provided on the reverse.
Primary Contact Information
Primary contact name
Title
Phone number
Extension
Cell phone number
Email address
Yes
May the IRS share the Primary Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
No
Alternate Contact Information
Alternate contact name
Title
Phone number
Extension
Cell phone number
Email address
Yes
May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
No
Authorized Organization Representative Information
Authorized Organization Representative
Title
Phone number
Extension
Cell phone number
Email address
Yes
May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
No
Federal Tax Matters Contact Information
Federal Tax Matters contact name
Title
Phone number
Extension
Cell phone number
Email address
Financial/PMS Contact Information
Financial/PMS contact name
Title
Phone number
Extension
Cell phone number
Email address
Other Contact Information
Explain role:
Other contact name
Title
Phone number
Extension
Cell phone number
Email address
Yes
May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
No
14335
Form
(Rev. 3-2014) Catalog Number 59717U
Department of the Treasury - Internal Revenue Service