Catalog Number 61054K
6729 (Rev. 10-2018)
Form 6729
(October 2018)
Department of the Treasury - Internal Revenue Service
QSS Site Review Sheet
Date of review
Site name SIDN Reviewer name or SEID
A. Review conducted by
QSS Reviewer SPEC Shopper Other
B. Type of review
QSS Review SPEC Shopping Other
C. Advanced notice
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
QSR # 1: Certification Comments
Are all volunteers certified in Volunteer Standards of Conduct?
Yes No-not certified No-unable to verify
Are all required volunteers certified in Intake/Interview and Quality Review?
Yes No
Are all volunteers who address tax law issues certified in tax law?
Yes No-unable to verifyNo-not certified
4 Did the site meet the components for QSR #1?
Yes No
5 Did the coordinator complete coordinator training?
Yes No
QSR # 2: Intake/Interview & Quality Review Process Comments
Are all volunteers using a correct Intake/Interview & Quality Review Process for every
No-Not using Form 13614-C
No-Not interviewing the taxpayer
No-Incomplete Form 13614-C
No-Not using Form 14446 (Virtual Site)
No-Does not quality review all returns
No-Incomplete Quality Review Process
No-Using an unapproved Quality Review
7 Is there a process which ensures returns are within scope and volunteer preparers and
quality reviewers are assigned returns at their certification level?
No-Not identifying out-of-scope issues
No-Not identifying volunteer/return certification levels
No-Not identifying reviewer/return certification level
8 Are volunteers advising taxpayers of their responsibility for the information listed on their
Yes No
9 Did the site meet the components for QSR #2?
Yes No
QSR # 3: Confirming Photo Identification and Taxpayer Identification Numbers Comments
10 Are volunteers using photo identification to confirm taxpayers' identities?
Yes-Photo ID's checked or exception applies
No-Not using photo identification
No-Spouse/Taxpayer not present/No Power of Attorney
11 Are volunteers confirming Taxpayer Identification Numbers (TIN) for everyone listed on the
Yes No
12 Did the site meet the components for QSR #3?
Yes No
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Catalog Number 61054K
6729 (Rev. 10-2018)
QSR # 4: Reference Materials Comments
13 Are all required reference materials available at the site?
No-Publication 4012 not available
No-Publication 17 not available
No-Neither publication is available
14 Is there a process which ensures all volunteer alerts are reviewed by all IRS tax law-certified
Yes No
QSR # 5: Volunteer Agreement Comments
Are all Forms 13615 signed and dated by the volunteer and approving official?
No-Not signed/dated by volunteer
No-Not signed/dated by approving official
No-Unable to verify
No-Form 13206 does not certify Forms 13615
Were any violations to the Volunteer Standards of Conduct (VSC) identified?
No violations identified
Yes-Violation to VSC 1
Yes-Violation to VSC 2
Yes-Violation to VSC 3
Yes-Violation to VSC 4
Yes-Violation to VSC 5
Yes-Violation to VSC 6
17 Did the site meet the components for QSR #5?
Yes No
18 Is Publication 4836, VITA/TCE Free Tax Programs (VolTax), properly displayed at the site?
Yes No
QSR # 6: Timely Filing
Are timely filing requirements met?
No-Not transmitting timely
No-Not retrieving acknowledgments timely
No-Not notifying taxpayers of rejects timely
No-Form 8879 not signed
QSR # 7: Civil Rights Comments
20 Is the current Civil Rights poster displayed at the first point of contact?
Yes No
QSR # 8: Site Identification Number Comments
21 Is the site using the correct Site Identification Number (SIDN)?
Yes No
QSR # 9: Electronic Filing Identification Number Comments
Is the site using the correct Electronic Filing Identification Number (EFIN)?
Yes No
QSR # 10: Security Comments
Is there a process which identifies every volunteer who prepares, reviews, or changes a tax
Yes No
Are adequate security measures taken to protect electronic equipment?
Yes No
Is taxpayer information safeguarded and properly disposed?
Yes No
If Section 7216 is applicable, are consent notices properly secured?
Yes-Consent notices properly secured
No-Consent notices not properly secured
N/A-Consent notices are not required
27 Did the site meet the components for QSR #10?
Yes No
28 Are all volunteers wearing or displaying their name to taxpayers they assist?
Yes No
Site Operations Comments
29 Is the site operating information correct in SPECTRM?
Yes No
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Catalog Number 61054K
6729 (Rev. 10-2018)
Adherence to Quality Site Requirements Comments
30 What is the overall Quality Site Requirement Adherence Rating?
Measurement of this question is
based on the answers to questions
4, 9, 12, 13, 17, 19-22, and 27.