Form 13715 (Rev. 9-2017)
Catalog Number 43863F www.irs.gov Department of the Treasury - Internal Revenue Service
Form 13715
(September 2017)
Volunteer Site Information Sheet
OMB Number
1545-2222
Purpose: Information provided on this form is used by our IRS toll-free assistance line and is posted to the VITA Site Locator Tool on irs.gov to
help taxpayers locate the nearest volunteer tax preparation site. Review the information below carefully. Update and/or correct missing or existing
information. 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
Site Name:
Site Address:
City, State:
Zip Code:
Site Identification
Number (SIDN)
First day open/
Last day open
/
What languages
are offered at
the site?
Does site prepare prior year returns? Yes No
Is the site open to public? Yes No
Is the site an appointment only site? Yes No
If yes to the above question, please provide the phone number for site.
If yes to the above question, please provide the contact name for site.
Federal e-file Yes No State e-file Yes No
Does the site use the Virtual Delivery Method for return preparation?
If “Yes”
Yes No
Is the site a mobile only site? Yes No
Does the site Prepare Non-Resident Alien/Foreign Student/Scholar
Returns?
Yes No
Does the site offer Certifying Acceptance Agent (CAA) service? Yes No
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
Program Type: FSA, VITA, VITA Grant, Military, AARP, TCE
Site Operating Hours
Day Time Comments (e.g. holiday closures, alternative opening times)
Open Close
MON
TUE
WED
THUR
FRI
SAT
SUN
Site Coordinator or Contact
Name:
Mailing Address:
City, State, Zip:
Phone Number:
Best Time to Call: AM PM
Email Address:
Is this a revision of information you
previously provided for this year?
Yes No
Date of this revision:
IRS Use Only
Date Form 13715 Received in Territory Office:
Date SPECTRM Updated:
SEID of employee who updated SPECTRM:
I certify the information provided on this form match the data in SPECTRM.
Territory Manager Approval (Signature & Date):
Privacy Act and Paperwork Reduction 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. The time estimated for participation is 30 minutes. We may provide information to volunteers who coordinate activities and staffing at taxpayer assistance sites.
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.
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]
