Form 13424-A - Low Income Taxpayer Clinic (Litc) Interim And Year-End Report General Information Page 2

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Low Income Taxpayer Clinic (LITC)
Interim and Year-End Report
General Information
Name of clinic
Consultations
For a definition of Consultation, see form instructions.
6
A. Number of consultations conducted with ESL taxpayers
B. Number of consultations conducted with low income taxpayers
C. Total number of consultations (add lines 6A and 6B)
7
Number of technical assistance consultations conducted
Referrals
Number of ESL taxpayers referred for controversy representation (clinics operating a controversy
8
program should leave line 8 blank and skip to line 9)
Number of cases where Taxpayer Advocate Service (TAS) assistance was requested (this item should
9
be completed only by clinics that operate a controversy program)
Tax Returns and Other Documents
10 A. Number of tax returns prepared ancillary to ESL activities
B. Number of tax returns prepared to resolve a controversy
C. Total number of tax returns prepared (add lines 10A and 10B)
11
Number of Individual Taxpayer Identification Number (ITIN) applications prepared
Volunteer Activities
Yes
No
12
Does the organization have a pro bono panel
13
Number of volunteers that provided service to the clinic during the reporting period who are:
A. Attorneys
B. Certified Public Accountants
C. Enrolled Agents
D. Interpreters / Translators
E. Students
F. Others
G. Total number of volunteers (add lines 13A through 13F)
14
Total number of hours of service provided by volunteers
Professional Education Activities
Number of professional education (CPE or CLE) credits available through presentations conducted
15
during the reporting period
16
List the topics covered during CPE or CLE presentations. Attach additional pages as necessary.
F.
A.
B.
G.
C.
H.
D.
I.
E.
J.
13424-A
Department of the Treasury - Internal Revenue Service
Form
(Rev. 4-2012) Catalog Number 53040U

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