VITA Grant Program Budget Plan

• Issuer: Treasury Department
• Section: Treasury Department

Catalog Number 51502R www.irs.gov Form 13977 (Rev. 3-2022)

Form 13977

(March 2022)

Department of the Treasury - Internal Revenue Service

VITA Grant Budget Plan OMB Number

1545-2222

Purpose: This form is to be used by VITA Grant Applicants. It should accompany the completed VITA Grant Application and only

represent the categorical dollar expenses of estimated program expenditures, cash contributions and third party-in-kind contributions

(donated cash, property or services) qualifying as matching funds.

Name of Organization Federal Funds

Proposed Expenditures Matching Funds

Proposed Expenditures

1. Fringe Benefits

2. Training Travel Reimbursement (Site Coordinator, Instructors,

Volunteers)

3. Travel Reimbursement (Site operation)

4. Food - Limited to $500 for Volunteers

5. Salary Costs (Clerical, Site Administration, Instructor)

6. General Office Supplies

7. Audit Services

8. Publicity for VITA Program

9. Volunteer Services Check if Simplified Method Used

10. Volunteer Recognition

11. Interpreter Services

12. Space Rental (Includes Utilities, Insurance and Custodial Services)

13. Other (Provide details in Comments/Remarks section below)

14. Technology - Computers and Printers

15. Network Cards and Internet Connectivity

16. IT Support

17. Installation of Phone Lines for E-File and Tax Preparation

18. Financial Education Asset Building Services

19. Indirect Cost Rate 10% de minimis rate

OR

20. Total Estimated Program Cost (Add All Lines)

21. Corporate Felony Conviction Yes No

22. Related Party Transaction Yes No

23. Sub-Awards of $1,000 or more Yes No

Comments/Remarks