Form 13715 Volunteer Site Information Sheet

Department of the Treasury - Internal Revenue Service

13715

Form
(October 2021)

OMB Number
1545-2222

Volunteer Site Information Sheet

Purpose: The IRS toll-free assistance line and the VITA Site Locator Tool on irs.gov use the information you provide on this form to help
taxpayers locate the nearest volunteer tax preparation site. Fill-in the information below carefully and ensure it is accurate and complete.
Return the completed form to your local IRS contact. If the site information changes after submitting this form, please provide your local
IRS contact with the updated information immediately.

Site Information

D
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A
F
T

Date (MMDDYYYY)

10. Is the site a mobile only site

Yes

No

11. Does site prepare prior year returns

Yes

No

1. Site name

12. Does the site offer Certifying Acceptance Agent (CAA) service

Yes

No

Yes

No

2. Site address

13. Does the site use an Alternative Filing Method for return preparation
If "Yes", select one and type additional methods if applicable

Revised form

Yes

No

3. City, state,
Zip code

14. What service systems are used to support virtual return preparation for this site? Select
all that apply.

4. Site Identification
Number (SIDN)

DocuSign

5. Program type
6. First day open/
Last day open

/

Get Your Refund

Google docs

TaxSlayer taxpayer customer portal

TaxSlayer taxpayer scanned documents

Zoom or other video conferencing system

Other system (write in)

7. Languages
offered

8. Is the site open to public

Yes

No

9. Is the site an appointment only site

Yes

No

C
O
P
Y MON

Fax machines and/or phone calls

If "Yes", provide
contact name and
phone number

15. Does your VITA/TCE site offer voter registration assistance to taxpayers

Yes

No

16. Does the site offer Financial Education and Asset Building Services
If "Yes", Relationship Manager is required to complete Form 14099 SPEC Financial Education & Asset Building Partner Assessment Tool

Yes

No

17. Does the site Prepare Non-Resident Alien/Foreign Student/Scholar
Returns

Yes

No

18. Has Form 15272, VITA/TCE Security Plan, or equivalent been
submitted to the Territory Office

Yes

No

19a. Federal e-file

Yes

No

Yes

No

19b. State e-file

Site Operating Hours

Day

Time
Open

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

TUE
WED
THUR
FRI
SAT
SUN
Site Coordinator or Contact
Name

Phone number

Best time to call
AM

Address (street, city, state, zip code)

PM

Email address

IRS Use Only
Date Form 13715 received in Territory Office

SPECTRM updated (employee SEID) and date

Territory Manager or Designee approval (sign and date certifying the information on this form matches the data in SPECTRM)
Privacy Act and Paperwork Reduction Notice – Our authority to ask for this information is 5 U.S.C. 301 and 26 USC 7801 and 7803. 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. The time estimated for participation
is 30 minutes. Your response is voluntary. However, if you do not provide the requested information, the IRS may not be able to promote your assistance in these programs. We
may not conduct or sponsor a collection of information subject to the Paperwork Reduction Act without displaying the OMB control number. We may provide this information to
volunteers who coordinate activities and staffing at taxpayer assistance sites, and we may disclose this information to the media and the public. For more information about these
and other routine uses, see the Privacy Act notices for Stakeholder Relationship Management and Subject Files and Volunteer Records (10.004 and 10.555) in the Federal
Register: September 8, 2015 (Volume 80, Number 173) [Pages 54073-54074]

Catalog Number 43863F

www.irs.gov

Form 13715 (Rev. 10-2021)

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