13614-C
Intake/Interview and Quality Review Sheet (Khmer Version)
Form 13614-C (km) is the Khmer version of Form 13614-C, the Intake/Interview and Quality Review Sheet of the IRS Volunteer Income Tax Assistance (VITA) and Tax Counseling for the Elderly (TCE) program. The IRS lists it as the Khmer Version. Its questions are written in Khmer script, while form numbers such as W-2 and 1099-R appear in Latin letters.
The edition is dated October 2025 and its questions are about 2025. It asks the taxpayer to complete pages 1 to 5 and to bring tax information such as Forms W-2, 1099, 1098 and 1095, Social Security cards or ITIN letters for every person on the return, and a photo ID such as a valid driver's license for you and your spouse. A certified volunteer completes the columns set aside for the volunteer.
After the sheet, the PDF includes Form 15080 (km), a Khmer consent for Global Carry Forward of return data. The English edition is Form 13614-C. You can fill out this PDF free in your browser on this page and download it without an account.
Names, mailing address and phones, living or working in two or more states in 2025, status questions such as legally blind, visa, IPPIN and digital assets, refund and payment choices, IRS letters in another language, the $3 campaign fund, marital status and a household table.
Boxes for 2025 wages, tips, retirement and disability payments, Social Security or railroad retirement, unemployment, state refunds, interest and dividends, sales of stocks, bonds or real estate, alimony, rentals, gambling winnings and self-employment pay.
Itemized expenses, student loan interest, child care, retirement contributions, educator supplies, alimony paid, education, a home sale, an HSA, Marketplace insurance, energy-efficient home items, a new vehicle, cancelled debt, disaster losses and IRS letters.
Questions on English ability, disability, U.S. armed forces veteran status and race or ethnicity, which the form says are only for statistics, then the Privacy Act and Paperwork Reduction Act notice.
A page for additional notes and comments, then Form 15080 (km), the Khmer consent that lets TaxSlayer LLC share return data with a VITA/TCE site next season.
The list at the top names Forms W-2, 1099, 1098 and 1095, Social Security cards or ITIN letters for all persons on the return, and photo ID for you and your spouse.
Fill in your details and your spouse's, answer the status questions, choose a refund method such as direct deposit or a check by mail, or a payment method such as IRS.gov direct pay, and give your marital status as of December 31, 2025.
Name everyone who lived with you last year, except your spouse, and anyone you supported who did not live with you, with date of birth (mm/dd/yy), relationship and months in your home in 2025.
On pages 2 and 3, check only the boxes that apply to you or your spouse. The columns on the right are for the certified volunteer.
The form says you are not required to answer the page 4 questions. Form 15080 (km) says you do not need to complete it to use the return preparation services.
The form says you are responsible for the information on your return, to give complete and correct information, and to ask the IRS-certified volunteer preparer if you have questions.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The sheet is used with the IRS-certified volunteer at the VITA or TCE site. The only IRS address it prints is for comments on the time estimates.
The form prints no deadline. Its questions refer to 2025.
The privacy notice says providing the information is voluntary, but if it is not provided the IRS volunteers may not be able to help prepare and file the return.
The form says to email the IRS at [email protected] to report unethical behavior.
If signed, Form 15080 (km) lets TaxSlayer LLC make your return data available to the VITA/TCE volunteer site you choose next filing season. It says the consent is valid until November 30, 2027.
Form 15080 (km) gives the Treasury Inspector General for Tax Administration (TIGTA) at 1-800-366-4484 for return information disclosed or used without authorization.
13614-C
297 fields, 6 pages
15080
5 fields, 1 page
15080
5 fields, 1 page
W-2
568 fields, 11 pages
1099-R
257 fields, 9 pages
5695
167 fields, 4 pages
A taxpayer who reads Khmer answers the questions, and an IRS-certified volunteer at the VITA or TCE site completes the volunteer columns.
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The PDF is in Khmer. The IRS lists it as the Khmer Version of Form 13614-C. This page describes it in English.
It prints Rev. 10-2025 and is dated October 2025. Its questions refer to 2025, and marital status is asked as of December 31, 2025.
The checklist says to complete pages 1 to 5. Columns marked for the certified volunteer are left to the volunteer.
No. The form says those answers are for statistical purposes only, are not part of your tax return, are not sent to the IRS with your return, and are not required.
A Khmer consent to share your return data for Global Carry Forward through TaxSlayer LLC. The form says it is optional and, if signed, valid until November 30, 2027.