Form 8023
(Rev. November 2016)
Department of the Treasury
Internal Revenue Service
Elections Under Section 338 for
Corporations Making Qualified Stock Purchases
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See separate instructions.
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Information about Form 8023 and its separate instructions is at www.irs.gov/form8023.
OMB No. 1545-0123
Section A-1—Purchasing Corporation
1a Name and address of purchasing corporation 1b Employer identification number
1c Tax year ending 1d State or country of incorporation
Section A-2—Common Parent of the Purchasing Corporation
2a Name and address of common parent of purchasing corporation 2b Employer identification number
2c Tax year ending 2d State or country of incorporation
Section B—Target Corporation
3a Name and address of target corporation 3b Employer identification number
3c Tax year ending 3d State or country of incorporation
Section C—Common Parent of Selling Consolidated Group, Selling Affiliate,
S Corporation Shareholder, or U.S. Shareholder
Complete only for a section 338(h)(10) election or if target was a member of a consolidated group or a controlled foreign corporation (CFC)
or had been a CFC within the preceding five years.
4a Name and address of common parent of the selling consolidated group,
selling affiliate, U.S. shareholder(s) of foreign target corporation, or
S corporation shareholder(s)
4b Identifying number(s)
4c Tax year ending
Section D—General Information
5a Acquisition date 5b What percentage of target corporation stock was purchased:
(i) During the 12-month acquisition period?
%
(ii) On the acquisition date? %
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 49972Z
Form 8023 (Rev. 11-2016)