Department of the Treasury - Internal Revenue Service
Consent Fixing Period of Limitation On Assessment of
Income and Profits Tax
(S-Corporation, Partnerships, Limited Liability Company, Trusts, Syndicates, Pools, Etc.)
For Allowance of Estimated Future Expense Liabilities Under Contract for Sale of Real Estate
a
, whose address is
(S-Corporation, Partnership, Limited Liability Company, Trust, Syndicate, Pool, Etc.)
, the undersigned taxpayer,
of the said
a
(Shareholder, Partner, Member,
Beneficiary, Tax Matters Partner)
and the Commissioner of Internal Revenue, hereby consent and agree as follows:
That the amount of any income or profits tax due under any return or returns made by or on behalf of the above-named
taxpayer for the taxable year (or years)
under existing acts, or under prior revenue acts, may be assessed at any time on or before
except that if a notice of a deficiency in tax is sent to said taxpayer by certified or registered mail on or before said date,
then the time for making any assessment as aforesaid shall be extended beyond the said date by the number of days
during which the making of an assessment is prohibited and for 60 days thereafter.
Form 921-A
(Revised January 2001)
In consideration of the tentative allowance, in whole or in part, by the Commissioner of Internal Revenue, for income or
profits tax purposes of the estimated cost of future improvements as apart of the cost or other basis of certain real estate
sold or otherwise disposed of under contract by
Cat. No. 16976Z Form 921-A (Rev. 1-2001)
,
,
(Signature instructions are on the back of this form)
BY
(Authorized Official Signature and Title - see instructions)
(Date signed)
(Division Executive Name - see instructions) (Division Executive Title - see instructions)
INTERNAL REVENUE SERVICE SIGNATURE AND TITLE
In reply refer to:
Taxpayer Identification Number
,
(Number, Street, City or Town, State, ZIP Code)
(S-Corporation, Partnership, Limited Liability
Company, Trust, Syndicate, Pool, Etc.)
YOUR SIGNATURE HERE
SPOUSE'S SIGNATURE
TAXPAYER'S REPRESENTATIVE
SIGN HERE
(Title) (Date signed)
(Title)
(Date signed)
ENTITY
NAME
ENTITY
OFFICER(S)
SIGN HERE
(Date signed)
(Date signed)
(Date signed)
(S-Corporation, Partnership, Limited Liability Company, Trust, Syndicate, Pool, Etc.)
(Shareholder, Partner, Member,
Beneficiary, Tax Matters Partner)
(Shareholder, Partner, Member,
Beneficiary, Tax Matters Partner)
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