Page 4 Part VIlII-IRS-Certified Volunteer Quality Reviewer Section Review the tax return with the taxpayer to ensure: .Taxpayer (and Spouse's) identity was verified with a photo ID The volunteer return preparer/quality reviewer are certified to prepare/review this return and return is within scope of the program. .All questions in Parts I through VI have been answered .All unsure boxes were discussed with the taxpayer and correctly marked yes or no. The information on pages one through three was correctly addressed and entered on the return. Names, SSNs, ITINs, and EINs, were verified and correctly transferred to the return .Filing status was verified and correct. .Personal and Dependency Exemptions are entered correctly on the return All Income (including income with or without source documents) checked yes" in Part IlI was correctly transferred to the tax return. .Adjustments to income, such as student loan interest, IRA contributions, self employment tax, were verified and are correct. .Standard or Itemized Deductions are correct. .All credits are correctly reported All applicable provisions of ACA were considered for each person named on the tax return and were entered correctly Any Shared Responsibility Payments are correct. Withholding shown on Forms W-2, 1099 and Estimated Tax Payments are correctly reported Direct DepositDebit and checking/saving account numbers are correct. .SIDN is correct on the return. The taxpayer(s) was advised that they are responsible for the information on their returrn. Certified Volunteer Preparer's name/initials (optional) Certified Volunteer Quality Reviewer's name/initials (optional) Additional Tax Preparer notes Privacy Act and Paperwork Reduction 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 beneft, 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 retum preparation sites or outreach activitios. The information may also be used to establish offective controls, send correspondence and recognize volunteers. Your response is voluntary. However, if you do not provide the requested information, the IRS may not be able to use your assistance in these programs The Paperwork Reduction Act requires that the IRS display an OMB control number on all public information requests. The OMB Control Number for this study is 1545-1964. Also, i you have any comments regarding the time estimates associated with this study or suggestion on making this process simpler, please write to the Internal Revenue Service, Tax Products Coordinating Committee, SE-W CARMP:TT:SP. 1111 Constitution Ave. Nw, Washington, DC 20224 Catalog Number 52121E www.irs.gov Form 13614-C (Rev. 10-2017)