Free Form 13715 (Rev. 8-2007) - Federal

Form 13715 Rev. August 2007

Department of the Treasury -- Internal Revenue Service

SPEC Volunteer Site Information Sheet

Purpose: Information from this form is used by our IRS toll-free assistance line to help taxpayers locate the nearest volunteer tax preparation site. Please carefully review and update the information below to correct missing and/or existing information. Once complete, return to your local IRS contact. Once this form is submitted, if the site information changes, immediately contact your local SPEC contact person.

SITE General Information
Site Name: Site Address: City, State, ZIP: County: Site ID Number (SIDN) First day open/ Last day open Languages Offered at Site Is the site an Appointment only Site? Appointment Phone Number Name of Site Contact for Appointments Program Type: VITA, Military, AARP, TCE Federal e-file State e-file Yes Yes Yes No No No Yes No

/ Schedule

Is the site open to public?

Day
Open

Time
Close

Comments (e.g. holiday closures, alternative opening times)

MON TUE WED THUR FRI SAT SUN Site Coordinator or Contact
Name: Mailing Address: City, State ZIP: Phone Number: Best Time to Call: Email Address: Is this a revision of information you previously provided for this year? Date of this revision Yes No AM PM

IRS Use Only
Date Form 13715 Received in Territory Office Territory Manager Approval (Signature & Date) Date STARS Updated SEID of employee who updated STARS
Privacy Act 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. We may provide information to volunteers who coordinate activities and staffing at taxpayer assistance sites. For more information about uses, see the Privacy Act notice for the Taxpayer Assistance Reporting System (STARS) in the Federal Register: July 19, 2004 (Volume 69, Number 137) [Notices] [Pages 43055-43056] Your response is voluntary. However, if you do not provide all or part of the requested information, the IRS may not be able to provide accurate information regarding the locations and services at volunteer tax preparation sites.

Catalog Number 43863F

Form 13715 (8-2007)