Fillable Form 13715 - Volunteer Site Information Sheet printable pdf download

Department of the Treasury — Internal Revenue Service

13715

Form

Volunteer Site Information Sheet

(Rev. August 2010)

Purpose: Information provided on this form is used by our IRS toll-free assistance line to help taxpayers locate the nearest

volunteer tax preparation site and to list sites on irs.gov. Carefully review and update the information below to correct missing

and/or existing information. Return the completed form to your local IRS contact. If the site information changes after

submitting this form, please contact your local IRS contact to provide the updated information immediately.

Site Information

Is the site an appointment only site?

Yes

Site Name:

If yes to the above question, please

provide the phone number for site.

Site Address:

If yes to the above question, please

provide the contact name for site.

City, State:

Is the site a mobile only site?

Yes

Zip Code:

Program Type: VITA, VITA Grant, Military, AARP, TCE

Site Identification

If VITA or TCE Grant, enter name of Grant Orginazation

Number (SIDN)

Federal e-file

Yes

First day open/

State e-file

Yes

Last day open

Is site a Certified Acceptance Agent (CAA) location?

Yes

What languages are

Yes

Is the site open to public?

offered at the site?

Does the site offer Financial Education

Yes

Does site prepare prior year returns?

and Asset Building Services?

Site Operating Hours

Day

Time

Comments (e.g. holiday closures, alternative opening times)

Open

MON

TUE

WED

THUR

FRI

SAT

SUN

Site Coordinator or Contact

Name:

Best Time to Call:

Mailing Address:

Email Address:

Is this a revision of information you

City, State, Zip:

Yes

previously provided for this year?

Phone Number:

Date of this revision:

IRS Use Only

Date Form 13715 Received in Territory Office:

Territory Manager Approval (Signature & Date):

Date SPECTRM Updated:

SEID of employee who updated SPECTRM:

Privacy Act Notice – Our legal right to ask for information is 5 U.S.C. 301 and 26 USC 7801.

The primary purpose of asking for this information is to assist us in providing services to taxpayers at sites supporting IRS volunteer income tax preparation and outreach

programs. We may provide information to volunteers who coordinate activities and staffing at taxpayer assistance sites.

For more information about uses, see the Privacy Act notice for SPEC Total Relationship Management (SPECTRM) in the Federal Register: July 19, 2004 (Volume 69,

Number 137) [Notices] [Pages 43055-43056]

Your response is voluntary. However, if you do not provide all or part of the requested information, the IRS may not be able to provide accurate information regarding the

locations and services at volunteer tax preparation sites.

13715

Form

(Rev. 8-2010)

Catalog Number 43863F

Form 13715 - Volunteer Site Information Sheet

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