Free Form 13315 (Rev. 8-2008) - Federal

Form 13315 Rev. (8-2008)

Department of the Treasury ­ Internal Revenue Service

Partner Outreach Activities
(See instructions on reverse)

Please use this form to record outreach activity. 1. Beginning Date: 2. Partner Name: Ending Date: 3. Number of Volunteers:

4. Type of outreach activity conducted. If multiple messages were delivered during a single activity a separate Form 13315 must be completed for each activity. Program Compliance Outreach EITC E-Services All Other Outreach 5. How many taxpayers did you reach during this activity? 6. Description of Activity and how the targeted audience was determined. Media Contacts Non-Media Contacts

Estimated total taxpayers reached by partner. Multiply by Outreach Market Segment % X Equals = Targeted Audience 7. Contact Name: Contact Number: To be completed by the IRS Territory Office Only: 8. STARS Transaction Number: Date Input:
Cat. No. 34687B

Input By (Name & SEID)
Form 13315 (Rev. 8-2008)

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Instructions for Completing Form 13315
All Partners who participate in the Internal Revenue Service (IRS) Stakeholder Partnerships, Education and Communication (SPEC) outreach activities are asked to report their accomplishments to their local territory office via email, telephone, fax or Form 13315 immediately following the activity. SPEC Territory Managers, or their designee, should enter this data into STARS, in the month the event occurred for timely transmission.
Line 1 -- Enter activity beginning and ending date. Line 2 -- Enter the name of the Partner (e.g. organization, individual, newspaper, radio station, etc.) responsible for initiating, arranging and/or delivering the event. Line 3 -- Enter the number of volunteers participating in the outreach activity. Record volunteers only once per fiscal year. If volunteers participate in more than one outreach activity, then please only report the volunteer once to SPEC and not each time they participate in an event. Line 4 -- Select from the list of activities the type of outreach being conducted. Note: The "All Other" should only be used when identified by headquarters to track special initiatives. Line 5 -- Enter the number of taxpayers contacted through this outreach activity. Please distinguish between Media and Non-media events. 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 listeners, subscribers, seminar participants, or the television audience, etc., 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, if possible. Line 6 -- Provide a brief description of the outreach activity (e.g. newspaper article, radio broadcast, flyer, presentation, etc.) and the resources used to target theaudience. Outreach Market Segment % is calculated by dividing market segment by the total population. Examples A: (1) 16,000 low income taxpayers reside within a zip code which has 40,000 total W&I taxpayers. 16,000/40,000 = 40% low income market segment. Example B: A partner agrees to distribute EITC information to 10,000 taxpayers within a single zip code. The SPEC relationship manager uses SPEC research database to determine the low income market segment within the zip code is 40%. The total count reported on Form 13315 would be 4,000 taxpayers reached. Note: When multiple messages are delivered a separate Form 13315 must be completed for each activity not to exceed 100% of the total audience. Estimated total taxpayers reached 10,000 Multiply by Outreach Market Segment X 40% Target Audience = 4,000 Line 7 -- Enter Contact Name and Contact Phone Number. Enter the name of the person identified to represent the partner. Line 8 -- Enter the transaction number from the STARS input screen. Note: This number will provide easy access to 13315s that were previously entered in STARS.
Privacy Act Notice-- The Privacy Act of 1974 requires that when we ask for information we tell you our legal right to ask for the information, why we are asking for it, and how it will be used. We must also tell you what could happen if we do not receive it, and whether your response is voluntary, required to obtain a benefit, or mandatory. Our legal right to ask for information is 5 U.S.C. 301. We are asking for this information to assist us in contacting you relative to your interest and/or participation in the IRS volunteer income tax preparation and outreach programs. The information you provide may be furnished to others who coordinate activities and staffing at volunteer return preparation sites or outreach activities The information may also be used to establish effective controls, send correspondence and recognize volunteers.

Cat. No. 34687B

Form 13315 (Rev. 8-2008)