Form 13979 - Vita Grant Program Interim / Year End Budget Report - 2009
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4Department of the Treasury – Internal Revenue Service
13979
Form
VITA Grant Program
(June 2008)
Interim / Year End Budget Report
Purpose: This form is to be used by VITA Grant Applicants and should be submitted on or before April 30th
(Interim) and September 30th (Year End) to the IRS SPEC Grant Program Office. It should represent dollar
expenses paid for program expenditures for the period October 1 through March 31 (Interim) or October 1 through
June 30 of the grant period (Year End).
Report Type
Recipient Partner Name:
Interim
Year End
Street Address
City
State Zip Code
Report Period
(Mo/Day/Year)
From:
To:
VITA Grant
Matching Funds
Expense Type
Expenditures
Expenditure
Reimbursement Expenses
Cost (A)
Cost (B)
1. VITA Grant Orientation Conference
2. Training Travel Reimbursement (Site Coordinator, Instructors,
Volunteers)
3. Volunteer Travel Reimbursement (Site operation)
4. Total Reimbursement Expenses (ADD Lines 1 - 3)
Administrative Expense
Cost (A)
Cost (B)
5. Salary Costs (Clerical, Site Administration, Instructor)
6. General Office Supplies
7. Audit Services
8. Publicity for VITA Tax Preparation Program
9. Volunteer Services
10. Volunteer Recognition
11. Interpreter Services
12. Space Rental (Includes Utilities, Insurance and
Custodial Services)
13. Total Administrative Expenses (ADD Lines 5 - 12)
Technology Expenses
Cost (A)
Cost (B)
14. Hardware - Computers and Printers
15. Software
16. Network Cards and Internet Connectivity
17. IT Support
18. Installation of Phone Lines for E-File and Tax Preparation
19. Actual Cost of E-Filing Supplies
20. Total Technology Expenses (ADD Lines 14 - 19)
Total Program Cost
Cost (A)
Cost (B)
21. Total Program Cost (ADD Lines 4, 13 and 20)
Federal Award
22. Total Amount of Federal Grant Award Withdrawn
23. Unexpended Balance of Federal Grant Withdrawn (Subtract
Line 21 from 22)
Comments / Remarks
Signature
Signature Of Responsible Official
Date
13979
Catalog Number 51538T
Form
(Rev. 6-2008)
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