Grant Period Request
Boxes for a new application (single year or multi-year) or a non-competitive continuation (second or third year), and the grant amount requested, shown as maximum $100,000.
13424
Low Income Taxpayer Clinic (LITC) Application Information
- Agency
- IRS
- Revision
- Rev. 4-2018
- Fillable fields
- 73
- Pages
- 3
- Official source
- IRS form page
- Checked
- October 21, 2026
Form 13424: Low Income Taxpayer Clinic (LITC) Application Information
Form 13424, Low Income Taxpayer Clinic (LITC) Application Information, is part of an organization's application for an LITC grant. The instructions on the form say it reports basic information about the applicant, including the amount and period of the grant requested, contact information for the sponsoring organization, the name and location of the clinic where services are provided, and key clinic staff members.
It is completed by organizations, not by taxpayers seeking help from a clinic. The instructions say all organizations submitting a Full Grant Application or a Non-Competitive Continuation (NCC) Request complete it, and point to Publication 3319 for the application process. The LITC Program Office uses the information to correspond with clinics and to publicize clinic locations to taxpayers in IRS publications and online.
This page hosts the April 2018 revision. You can fill out Form 13424 free in your browser on this page and download the result without an account.
What's on Form 13424
Applicant Information
Legal name of the sponsoring organization, the contact's name and title, phone, fax and email, and the applicant's mailing address.
Clinic Information
Clinic name, public and toll-free phone numbers, fax, website, languages served in addition to English, and the clinic street and mailing addresses.
Clinic Director
Name, telephone and email, with licenses or certifications: attorney, CPA, enrolled agent or other.
QTE and QBA
Name, telephone and email for the Qualified Tax Expert, with licenses or certifications, and for the Qualified Business Administrator.
Tax Compliance Officer
Name, title, telephone and email of the person the applicant identifies as its Tax Compliance Officer.
How to fill out Form 13424
- 1
Grant period
Check single year or multi-year for a new application, or second or third year for an NCC Request. The instructions say IRC section 7526 allows grants for a period of up to three years.
- 2
Grant amount
Enter the total funding requested for the grant year, rounded to whole dollars. The instructions say the maximum that may be awarded for any grant year is $100,000.
- 3
Applicant information
Use the exact name registered with SAM and a full mailing address with ZIP plus four. The instructions show phone numbers formatted as 123-456-7890 x.111.
- 4
Clinic information
Enter the clinic name used in its public materials and both addresses in full. The instructions say not to write same, to give the direct LITC web page or none, and to list each language.
- 5
Clinic staff
Identify the Clinic Director, QTE and QBA, and list licenses and certifications for the director and QTE. Publication 3319 describes these positions.
- 6
Tax Compliance Officer
Name the Tax Compliance Officer. The instructions say an applicant must be in full compliance with its federal tax responsibilities when applying and throughout the grant year.
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How it is submitted and used
Submitted with the application
The form goes with the organization's Full Grant Application or NCC Request. The instructions point to Publication 3319, Section IV, Application and Submission Process.
Complete responses
The instructions say a complete response means an entry is provided for each field.
Public release
Forms submitted with a Full Grant Application or NCC Request may be released under the Freedom of Information Act, after redactions to protect the confidentiality of taxpayer information.
If a grant is awarded
The award is payable to the organization in the Applicant Information section, and the clinic information is used exactly as entered to prepare Publication 4134.
Related forms
Who completes Form 13424?
Organizations applying for or continuing an LITC grant complete it as part of the Full Grant Application or NCC Request. The LITC Program Office uses the information.
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Questions about Form 13424
Is Form 13424 for taxpayers who need help from a clinic?
No. It is completed by organizations applying for a Low Income Taxpayer Clinic grant. The instructions say all organizations submitting a Full Grant Application or an NCC Request complete it.
What is the largest grant amount on the form?
The form shows a maximum of $100,000, and the instructions say that is the maximum funding that may be awarded for any grant year.
Can a first-time applicant request a multi-year grant?
The instructions say applicants that have never been awarded an LITC grant are not eligible for a multi-year grant and may only request a single year grant.
What name goes on the applicant line?
The instructions say the applicant name must match exactly the name used to register with the System for Award Management (SAM).
Can the form be released to the public?
The instructions say forms submitted with a Full Grant Application or NCC Request may be released under the Freedom of Information Act after appropriate redactions.
Where does the clinic information appear?
If a grant is awarded, the instructions say the clinic details are used exactly as entered to prepare Publication 4134, Low Income Taxpayer Clinic List.