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Form 13614-C

(October 2022)

Department of the Treasury - Internal Revenue Service

Intake/Interview & Quality Review Sheet

 

OMB Number
1545-1964

 

You will need:
• Tax Information such as Forms W-2, 1099, 1098, 1095.
• Social security cards or ITIN letters for all persons on your tax return.
• Picture ID (such as valid driver's license) for you and your spouse.
• Please complete pages 1-4 of this form.
• You are responsible for the information on your return. Please provide
complete and accurate information.
• If you have questions, please ask the IRS-certified volunteer preparer.

Volunteers are trained to provide high quality service and uphold the highest ethical standards.

To report unethical behavior to the IRS, email us at wi.voltax@irs.gov

Part I – Your Personal Information (If you are filing a joint return, enter your names in the same order as last year’s return)

6. Last year, were you:

 

7. Your spouse’s Date of Birth

 

9. Last year, was your spouse:

 

Part II – Marital Status and Household Information

 

(This includes registered domestic partnerships, civil unions, or other formal relationships under state law)

 

2. List the names below of:

• everyone who lived with you last year (other than your spouse)
• anyone you supported but did not live with you last year