Fillable Form 13615 - Volunteer Standards Of Conduct Agreement

Form 13615 - Volunteer Standards Of Conduct Agreement - Vita/tce Programs Page 2

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Volunteer:

By signing this form, I declare that I have completed Volunteer Standards of Conduct Training and have

read, understood, and will comply with the volunteer standards of conduct.

Print full name

Volunteer position(s)

Home street address: city, state and ZIP code

E-mail address

Daytime telephone

Sponsoring partner name/site name

Number of years volunteered (including this year)

Volunteer signature

Date

Privacy Act Notice–The Privacy Act of 1974 requires that when we ask for information we tell you our legal right to

ask for the information, why we are asking for it, and how it will be used. We must also tell you what could happen if

we do not receive it, and whether your response is voluntary, required to obtain a benefit, or mandatory.

Our legal right to ask for information is 5 U.S.C. 301. We are asking for this information to assist us in contacting you

relative to your interest and/or participation in the IRS volunteer income tax preparation and outreach programs. The

information you provide may be furnished to others who coordinate activities and staffing at volunteer return

preparation sites or outreach activities. The information may also be used to establish effective controls, send

correspondence and recognize volunteers. Your response is voluntary. However, if you do not provide the requested

information, the IRS may not be able to use your assistance in these programs. Please note: Sponsoring organizations

may perform background checks on their volunteers.

(Partner Use Only)

Site Coordinator, Sponsoring Partner, Instructor or IRS:

By signing this form, I declare that I have verified the required certifications and proper identification for this

volunteer prior to allowing the volunteer to work at the VITA/TCE site.

Volunteer Certification Levels

Standards

Foreign Students

of Conduct

Inter-

Basic

Intermediate

Advanced Military

COD HSA

(Required

national

for ALL)

Certification Test

Add the letter “P”

for all passing

test scores

Print approving official’s name and title:

Approving official’s signature and date:

(site coordinator, sponsoring partner, instructor, etc.)

13615

Cat. No. 38847H

Form

(Rev. 1-2012)

Form 13615 - Volunteer Standards Of Conduct Agreement - Vita/tce Programs Page 2

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