Page 2
Instructions For Completing Form 4913
This form should be used by IRS employees only. SPEC Partners should use Form 13315 and SPEC volunteers
should use Form 13206. All employees who participate in Wage & Investment (W&I) educational activities should
complete Form 4913 immediately following the activity. SPEC Territory Managers and Management Assistants
should only complete Form 4913 if they directly participate in a SPEC activity. SPEC Territory Managers will timely
input Form 4913 into STARS.
Note: The Balanced Measures & Diagnostics Data Dictionary defines many of the terms used on this form.
Lines 01-03
General—Enter employee name, SEID, territory name, Office Code and the date of the activity.
Lines 04-07 Program Activity:
Taxpayers Reached—Record the number of taxpayer contacts for Compliance, EITC,
E-Services and All Other Outreach activities. The number of taxpayer contacts is based on a
reasonable correlation between the tax law information provided in the outreach event and the
targeted audience. The targeted audience is the estimated number of participants who will benefit
from the message being delivered (i.e., EITC information given to low income taxpayers).
Targeted audience information should be obtained before the outreach event.
Number of Volunteers Assisting Direct Activities—Record the number of volunteers
assisting employees with direct activities.
Number of Sessions—For Outreach activities, count each event or training session where
assistance is offered to more than one taxpayer as one site. For a volunteer who travels to many
different locations (such as nursing homes, schools or home visits) to provide a one-day
assistance, count as one site.
NOTE: Media events are considered leveraged activities and should not be included on this form.
Refer to SETR Code 00970 definitions for:
•
Compliance
•
EITC
•
E-Services
•
Other
Line 09 Description of Activity—Include a brief description of the event, targeted audience, and the
method used for the outreach. (i.e., 300,000 EITC Form XXXX were issued to low income
taxpayers that attended a seminar for low income housing).
Line 10 To be completed by the IRS Territory Office only—Enter the date the activity was entered
into STARS and the SEID of the individual performing the data input.
Form 4913 (Rev. 3-2006)
