Form 6729 - Qss Site Review Sheet
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1
2Date of review
Department of the Treasury - Internal Revenue Service
6729
Form
QSS Site Review Sheet
(October 2015)
Site name
SIDN
Reviewer name or SEID
A. Review conducted by
B. Type of review
C. Advanced notice
QSS Reviewer
SPEC Shopper
Other
QSS Review
SPEC Shopping
Other
Announced
Unannounced
Instructions: This form is used to measure the site’s adherence to the Quality Site Requirements (QSR), Volunteer Standards of
Conduct (VSC), and to monitor site operations for Volunteer Income Tax Assistance/Tax Counseling for the Elderly Programs. Do not
enter any information that identifies a specific person in the comments box. NOTE: The term “coordinator” includes both site
coordinators and local coordinators. Questions used to determine how to answer the measurement question are in italics. Comments
are required for answer options which are underlined. The measurement questions for determining if a site review is adhering to a QSR
are in bold. Note: Each met measurement question is valued at 10%. If all ten measurement questions are met, the site is rated at
100%.
QSR # 1: Certification
Comments
1 Are all volunteers certified in Volunteer Standards of Conduct?
Yes
No-not certified
No-unable to verify
2 Are all required volunteers certified in the Intake/Interview and Quality Review Training?
Yes
No
3 Are all volunteers who address tax law issues certified in tax law?
Yes
No-not certified
No-unable to verify
4 Are out-of-scope returns prepared at the site?
Yes
No
5 Did the site meet the components for QSR #1?
Yes
No
6 Did the coordinator complete site/local coordinator training?
Yes
No
QSR # 2: Intake and Interview Process
Comments
7 Are all volunteers using a correct Intake and Interview Process for every return?
Yes
No-Other
No-Not using Form 13614-C
No-Not verifying taxpayer (or spouse) identity
No-Not interviewing the taxpayer
No-Not verifying taxpayer/dependent TINs
No-Not reviewing Form 13614-C
No-Not using Form 14446 (Virtual Site)
8 Is there a process which ensures returns are within scope and volunteer preparers are
assigned returns at their certification level?
Yes
No-Not identifying volunteer/return certification levels
No-Not identifying out-of-scope issues
No-Other
9 Did the site meet the components for QSR #2?
Yes
No
QSR # 3: Quality Review Process
Comments
10 Are quality reviewers using a correct Quality Review Process for every return?
Yes
No-Using an unapproved method
No-Does not quality review all returns
No-Other
No-Incomplete Quality Review Process
11 Are volunteers advising taxpayers of their responsibility for the information listed on their
return?
Yes
No
12 Is there a process which ensures returns are within scope and quality reviewers are
assigned returns at their certification level?
Yes
No-Not identifying reviewer/return certification level
No-Not identifying out-of-scope issues
No-Other
13 Did the site meet the components for QSR #3?
Yes
No
QSR # 4: Reference Materials
Comments
14 Are all required reference materials available at the site?
Yes
No-Publication 17 not available
No-Publication 4012 not available
No-Neither publication is available
6729
Catalog Number 61054K
Form
(Rev. 10-2015)
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