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Important
Note:
Forms are to be used as a guide only to assist you. No liability is assumed for errors in substance or form. It is your responsibility to revise the forms to meet current law
requirements and your particular situation. No liability is assumed for improper use of these forms.
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S
CORPORATION - SHAREHOLDER'S CONSENT TO INITIAL ELECTION
The undersigned,
being a shareholder of ________________________, a
______________
corporation, hereby consents to the election of that corporation, made on
Internal
Revenue Service
Form 2553 to which this statement is attached, to be treated as a small business
corporation
under Section 1362(a) of the Internal Revenue Code of 1954.
The name and
address of the corporation are: __________________,
__________________.
The corporation's tax-payer identification number is: ________________.
The undersigned
shareholder's name and address and tax-payer identification number are
as follows:
Name and Address
Taxpayer Identification No.
________________________
________________________
________________________
________________________
The number of
shares owned by the undersigned shareholder, and the date or dates when
the undersigned
shareholder acquired those shares, are as follows:
Number of Shares
Date(s) Acquired
_______
_____________________
_______
_____________________
Dated
______________________
_____________________________
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