Fillable Contact Information for VITA and TCE Grant Programs Form 14335 March 2014

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Contact Information for VITA and TCE Grant Programs Form 14335 March 2014

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Form 14335
(Rev. March 2014)
Contact Information for VITA and TCE Grant
Programs
OMB Number
1545-2222
Form 14335 (Rev. 3-2014) Catalog Number 59717U
www.irs.gov Department of the Treasury - Internal Revenue Service
Recipient name
Address
Federal Award Identifier
Days of operation Hours of operation
See the Instructions and Definitions provided on the reverse.
Primary Contact Information
Primary contact name Title
Phone number Extension Cell phone number Email address
May the IRS share the Primary Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
Yes
No
Alternate Contact Information
Alternate contact name Title
Phone number Extension Cell phone number Email address
May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
Yes
No
Authorized Organization Representative Information
Authorized Organization Representative Title
Phone number Extension Cell phone number Email address
May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
Yes
No
Federal Tax Matters contact name
Federal Tax Matters Contact Information
Title
Phone number Extension Cell phone number Email address
Financial/PMS Contact Information
Financial/PMS contact name Title
Phone number Extension Cell phone number Email address
Other Contact Information
Explain role:
Other contact name Title
Phone number Extension Cell phone number Email address
May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
Yes
No
Form 14335
(Rev. March 2014)
Contact Information for VITA and TCE Grant
Programs
OMB Number
1545-2222
Form 14335 (Rev. 3-2014) Catalog Number 59717U
www.irs.gov Department of the Treasury - Internal Revenue Service
Other Contact Information
Explain role:
Other contact name Title
Phone number Extension Cell phone number Email address
May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
Yes
No
Other Contact Information
Explain role:
Other contact name Title
Phone number Extension Cell phone number Email address
May the IRS share the Alternate Contacts information with other grant recipients and non-grant recipients involved in the
VITA or TCE program
Yes
No
Instructions and Definitions
Instructions: Please list those individuals that we may contact with questions concerning your grant. Refer to the
following definitions. Designate only one primary contact. Designate at least one alternate contact. We are
asked occasionally to share contact information with other grant recipients and non-grant recipients involved or
interested in the VITA or TCE program. Please indicate whether we may share your information.
Definitions:
1. Primary—Manages the day-to-day operations of your organization's program and is responsible for ensuring
its requirements are met.
2. Alternate—Knowledgeable of the grant and its requirements and assists or directs the primary contact.
3. Authorized Organization Representative—Authorized to act for the organization and to assume the
obligations imposed by the Federal laws, regulations, requirements, and conditions that apply to grant
applications or grant awards.
4. Federal tax matters—Authorized to discuss your organization's federal tax matters with IRS. This individual
is only contacted when questions arise concerning your organization's filing of its federal returns or paying
of federal taxes, penalties or interest.
5. Financial/PMS—Responsible for the financial aspects of the grant. This includes responsibility for
requesting disbursement and required reporting in the Payment Management System.
6. Other—Provides assistance in the absence of those designated a role or that share responsibility for a role.
Please explain their role in the space provided.
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Contact Information for VITA and TCE Grant Programs Form 14335 March 2014

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Completed 23 May 2019

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