Form 8869
(Rev. December 2020)
Qualified Subchapter S Subsidiary Election
Department of the Treasury
Internal Revenue Service
(Under section 1361(b)(3) of the Internal Revenue Code)
▶
Go to www.irs.gov/Form8869 for instructions and the latest information.
OMB No. 1545-0123
Part I Parent S Corporation Making the Election
1a Name of parent
b Number, street, and room or suite no. If a P.O. box, see instructions.
c City or town, state or province, country, and ZIP or foreign postal code
2 Employer identification number (EIN)
3 Tax year ending (month and day)
4 Service center where last return was filed
5 Name and title of officer or legal representative whom the IRS may call for more information
6 Telephone number of officer or legal
representative
Part II Subsidiary Corporation for Which Election is Made (For additional subsidiaries, see instructions.)
7a Name of subsidiary
b Number, street, and room or suite no. If a P.O. box, see instructions.
c City or town, state or province, country, and ZIP or foreign postal code
8 EIN (if any)
9 Date incorporated
10 State of incorporation
11 Date election is to take effect (month, day, year) (see instructions) . . . . . . . . . . . . . . . . . . .
▶
12 Did the subsidiary previously file a federal income tax return? If “Yes,” complete lines 13a, 13b, and 13c . . . . . . . . .
▶
Yes No
13a Service center where last return was filed 13b Tax year ending date of last
return (month, day, year)
▶
13c Check type of return filed:
Form 1120
Form 1120-S Other
▶
14 Is this election being made in combination with a section 368(a)(1)(F) reorganization described in Rev. Rul. 2008-18, where the subsidiary was
an S corporation immediately before the election and a newly formed holding company will be the subsidiary’s parent? . . . . .
▶
Yes No
15 Was the subsidiary’s last return filed as part of a consolidated return? If “Yes,” complete lines 16a, 16b, and 16c . . . . . . .
▶
Yes No
16a Name of common parent 16b EIN of common parent 16c Service center where consolidated return was filed
Under penalties of perjury, I declare that I have examined this election, including accompanying statements, and to the best of my knowledge and belief, it is true, correct,
and complete.
Signature of officer
of parent corporation
▶
Title
▶
Date
▶
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 28755K
Form 8869 (Rev. 12-2020)
