S-Corporation Election

Name*

First Last

Legal Business Name*

Physical Business Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Fax

Email*

Is your Mailing Address different than Business?*

Yes

No

Mailing address

Street Address Address Line 2 City State ZIP Code

Employer Identification Number (EIN)*

State of Incorporation*

Date of Incorporation*

Date S Corporation election is effective*

Typically the date of incorporation.

Note

The beginning of the tax year is the date of incorporation and requires a short tax year in year one. As an example, if the entity incorporates August 10, the first tax year would run from August 10 through December 31. Our service is offered to corporations that select a calendar year (ending December 31) as the tax year-end. Corporations electing a tax year with a different end date need to file their S Corporation election with the help of their attorney, accountant or on their own.

Name of Officer or Legal Rep*

First Last

This is the person the IRS may call for information

Title of Officer or Legal Rep*

Phone*

Shareholder #1 Name*

First Last

Shareholder #1's Address*

Street Address Address Line 2 City State ZIP Code

Shareholder #1's Social Security Number*

Please do not add dashes to number.

Number of Shares or Percent of Ownership*

Do you wish to add another Shareholder?*

Yes

No

Shareholder #2's Name

First Last

Shareholder #2's Address

Street Address Address Line 2 City State ZIP Code

Shareholder #2's Social Security Number

Please do not add dashes to number.

Number of Shares or Percent of Ownership

Do you wish to add another Shareholder?

Yes

No

Shareholder #3's Name

First Last

Shareholder #3's Address

Street Address Address Line 2 City State ZIP Code

Shareholder #3's Social Security Number

Please do not add dashes to number.

Number of Shares or Percent of Ownership

Note

Upon receipt of the completed form and fees, the appropriate IRS form will be prepared and returned to you for signature. Once returned, Allen Corporation Supply will submit the form direct to the IRS. When your S Corporation election has been approved by the IRS in approximately 60 days, they will mail the verification direct to the business entity at the top of this questionnaire. If you do not hear back within the 60 days, please notify Allen Corporation Supply so we can follow up on your behalf. This S-Corporation election is being filed at your specific request and direction. Allen Corporation Supply is not responsible for maintaining the good standing of the entity in any way, nor are we responsible for any aspect of the entity’s existence or operation other than its initial formation or registration.

Note

Note

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