YOUR SIGNATURE HERE
SPOUSE'S SIGNATURE HERE
TAXPAYER'S REPRESENTATIVE
SIGN HERE
(Date signed)
(Date signed)
BY
(Authorized Official Signature and Title - See Instructions)
(Date signed)
CORPORATE
NAME
CORPORATE
OFFICER(S)
SIGN HERE
(Division Executive Name - See Instructions) (Division Executive Title - See Instructions)
INTERNAL REVENUE SERVICE SIGNATURE AND TITLE
(Date signed)
(Date signed)
(Date signed)
www.irs.gov
In reply refer to:
Department of the Treasury-Internal Revenue Service
Consent to Extend the Time to Assess Income Tax
Estimated Future Common Expense Allowance for Real Estate Sales Under Contract
For income tax purposes, the Commissioner of Internal Revenue has tentatively allowed
(Name(s))
taxpayer(s) of
(Number, Street, City or Town, State, ZIP Code)
The amount of federal income tax due on any return(s) filed by or for the taxpayer(s) for the tax year(s) ended
assessed at any time before and up to one year after a return is filed for tax year ended
may be
to consider the allocable share of the estimated cost of future common improvements as part of the cost or other basis of
certain real estate sold or otherwise disposed of under contract. As a provision of this tentative allowance, the above
taxpayer(s) and the Commissioner of Internal Revenue agree that:
.
Form 921
(Rev. July 2001)
Catalog Number 16974D Form 921 (Rev. 07 -2001)
Taxpayer Identification
Number(s)
Real Estate Project covered by this consent agreement:
A return filed before the expected project completion date shall be considered filed on the day prescribed above without
regard to extensions. This consent agreement to extend the time to assess tax is limited to the assessment of
deficiencies attributable to the use of the alternative cost method with respect to the real estate project described above.
If a notice of tax deficiency is sent to the taxpayer(s) by certified or registered mail on or before the date above, the time
to assess income tax under this consent agreement is further extended by the assessment suspension period, plus 60
days.
(Tax Year of Expected Project Completion)
THIS CONSENT AGREEMENT DOES NOT DEPRIVE THE TAXPAYER(S) OF ANY
APPEAL RIGHTS TO WHICH THEY WOULD OTHERWISE BE ENTITLED.
(Name/Title/Taxpayer Identification Number)
(Name/Title/Taxpayer Identification Number)
(See back of form for signature instructions)
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Catalog Number 16974D
Form 921 (Rev. 07-2001)
Instructions for Internal Revenue Service Employees
The signature and title line must be signed and dated by the appropriate authorized official within your division.
SMALL BUSINESS/SELF-EMPLOYED DIVISION
Enter the name and title of your business unit executive (e.g., Area Director; Director, Compliance Policy; or Director,
Compliance Services). Secure signature of authorized division official.
WAGE AND INVESTMENT DIVISION
Enter the name and title of your business unit executive (e.g., Area Director or Director, Field Compliance Services).
Secure signature of authorized division official.
LARGE AND MID-SIZE BUSINESS ENTITIES DIVISION
Enter the name and title of your business unit executive (e.g., Director, Field Compliance). Secure signature of
authorized division official.
TAX EXEMPT AND GOVERNMENT ENTITIES DIVISION
Enter the name and title of your business unit executive (e.g., Director, Exempt Organizations; Director, Employee
Plans; Director, Federal, State and Local Governments; Director, Indian Tribal Governments; or Director, Tax Exempt
Bonds). Secure signature of authorized division official.
APPEALS DIVISION
Enter the name and title of your business unit executive (e.g., Director, Appeals Operating Unit). Secure signature of
authorized division official.
Instructions for Taxpayer(s)
Please sign and return the original and copy of Form 921, Consent to Extend the Time to Assess Income Tax, to apply
for an extension in accordance with Revenue Procedure 92-29 and its successors. Your signature(s) must match the
name(s) as it appears on this form.
If the taxpayer named on this consent form is a corporation, the officer(s) duly authorized to sign on behalf of the entity
must sign the consent. Include the name of the corporation and signature/ title of the corporate officer(s).
If this consent form includes tax years where a joint return was filed, the signature of both husband and wife is required.
One spouse may sign as agent for the other, if acting under an authorized power of attorney.
If you're an attorney or agent for the taxpayer(s), you may sign the consent form provided the action is specifically
authorized by a power of attorney. If you haven't filed a power of attorney, please include it with this form.
If you're acting as a fiduciary (executor, administrator, trustee, etc.) you must include a completed Form 56, Notice
Concerning Fiduciary Relationship, if you haven't already filed one.
If you're an entity subject to the unified audit and litigation procedures for TEFRA (Tax Equity and Fiscal
Responsibility Act) partnerships, you must use Form 921-P. If you're an entity not subject to the TEFRA
requirements (namely S-Corporations, partnerships, limited liability companies, trusts, syndicates, pools, etc.), you must
use Form 921-I.