Note: Form 2553 begins on the next page.
Where To File Form 2553 after 6/17/19
If the corporation’s principal business, office,
or agency is located in
Use the following address
or fax number
Connecticut, Delaware, District of Columbia,
Georgia, Illinois, Indiana, Kentucky, Maine,
Maryland, Massachusetts, Michigan, New
Hampshire, New Jersey, New York, North Carolina,
Ohio, Pennsylvania, Rhode Island, South Carolina,
Tennessee, Vermont, Virginia, West Virginia,
Wisconsin
Department of the Treasury
Internal Revenue Service
Kansas City, MO 64999
Fax # 855-887-7734
Alabama, Alaska, Arizona, Arkansas, California,
Colorado, Florida, Hawaii, Idaho, Iowa, Kansas,
Louisiana, Minnesota, Mississippi, Missouri,
Montana, Nebraska, Nevada, New Mexico, North
Dakota, Oklahoma, Oregon, South Dakota, Texas,
Utah, Washington, Wyoming
Department of the Treasury
Internal Revenue Service
Ogden, UT 84201
Fax # 855-214-7520
Form 2553
(Rev. December 2017)
Department of the Treasury
Internal Revenue Service
Election by a Small Business Corporation
(Under section 1362 of the Internal Revenue Code)
(Including a late election filed pursuant to Rev. Proc. 2013-30)
You can fax this form to the IRS. See separate instructions.
Go to www.irs.gov/Form2553 for instructions and the latest information.
OMB No. 1545-0123
Note: This election to be an S corporation can be accepted only if all the tests are met under Who May Elect in the instructions, all
shareholders have signed the consent statement, an officer has signed below, and the exact name and address of the corporation
(entity) and other required form information have been provided.
Part I Election Information
Type
or
Print
Name (see instructions)
Number, street, and room or suite no. If a P.O. box, see instructions.
City or town, state or province, country, and ZIP or foreign postal code
A Employer identification number
B Date incorporated
C State of incorporation
D
Check the applicable box(es) if the corporation (entity), after applying for the EIN shown in A above, changed its
name or
address
E Election is to be effective for tax year beginning (month, day, year) (see instructions) . . . . . .
Caution: A corporation (entity) making the election for its first tax year in existence will usually enter the
beginning date of a short tax year that begins on a date other than January 1.
F Selected tax year:
(1)
Calendar year
(2)
Fiscal year ending (month and day)
(3)
52-53-week year ending with reference to the month of December
(4)
52-53-week year ending with reference to the month of
If box (2) or (4) is checked, complete Part II.
G
If more than 100 shareholders are listed for item J (see page 2), check this box if treating members of a family as one
shareholder results in no more than 100 shareholders (see test 2 under Who May Elect in the instructions)
H
Name and title of officer or legal representative whom the IRS may call for more information
Telephone number of officer or legal
representative
I If this S corporation election is being filed late, I declare I had reasonable cause for not filing Form 2553 timely. If this late
election is being made by an entity eligible to elect to be treated as a corporation, I declare I also had reasonable cause for not
filing an entity classification election timely and the representations listed in Part IV are true. See below for my explanation of the
reasons the election or elections were not made on time and a description of my diligent actions to correct the mistake upon its
discovery. See instructions.
Sign
Here
Under penalties of perjury, I declare that I have examined this election, including accompanying documents, and, to the best of my
knowledge and belief, the election contains all the relevant facts relating to the election, and such facts are true, correct, and complete.
Signature of officer
Title
Date
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 18629R
Form 2553 (Rev. 12-2017)
Form 2553 (Rev. 12-2017)
Page 2
Name Employer identification number
Part I
Election Information (continued) Note: If you need more rows, use additional copies of page 2.
J
Name and address of each
shareholder or former shareholder
required to consent to the election.
(see instructions)
K
Shareholder’s Consent Statement
Under penalties of perjury, I declare that I
consent to the election of the above-named
corporation (entity) to be an S corporation
under section 1362(a) and that I have
examined this consent statement, including
accompanying documents, and, to the best
of my knowledge and belief, the election
contains all the relevant facts relating to the
election, and such facts are true, correct,
and complete. I understand my consent is
binding and may not be withdrawn after the
corporation (entity) has made a valid
election. If seeking relief for a late filed
election, I also declare under penalties of
perjury that I have reported my income on all
affected returns consistent with the S
corporation election for the year for which
the election should have been filed (see
beginning date entered on line E) and for all
subsequent years.
L
Stock owned or
percentage of ownership
(see instructions)
Number of
shares or
percentage
of ownership
Date(s)
acquired
M
Social security
number or
employer
identification
number (see
instructions)
N
Shareholder’s
tax year ends
(month and
day)
Signature Date
Form 2553 (Rev. 12-2017)
Form 2553 (Rev. 12-2017)
Page 3
Name Employer identification number
Part II Selection of Fiscal Tax Year (see instructions)
Note: All corporations using this part must complete item O and item P, Q, or R.
O Check the applicable box to indicate whether the corporation is:
1.
A new corporation adopting the tax year entered in item F, Part I.
2.
An existing corporation retaining the tax year entered in item F, Part I.
3.
An existing corporation changing to the tax year entered in item F, Part I.
P
Complete item P if the corporation is using the automatic approval provisions of Rev. Proc. 2006-46, 2006-45 I.R.B. 859, to
request (1) a natural business year (as defined in section 5.07 of Rev. Proc. 2006-46) or (2) a year that satisfies the ownership
tax year test (as defined in section 5.08 of Rev. Proc. 2006-46). Check the applicable box below to indicate the representation
statement the corporation is making.
1. Natural Business Year
I represent that the corporation is adopting, retaining, or changing to a tax year that qualifies
as its natural business year (as defined in section 5.07 of Rev. Proc. 2006-46) and has attached a statement showing
separately for each month the gross receipts for the most recent 47 months. See instructions. I also represent that the
corporation is not precluded by section 4.02 of Rev. Proc. 2006-46 from obtaining automatic approval of such adoption,
retention, or change in tax year.
2. Ownership Tax Year
I represent that shareholders (as described in section 5.08 of Rev. Proc. 2006-46) holding more
than half of the shares of the stock (as of the first day of the tax year to which the request relates) of the corporation have the
same tax year or are concurrently changing to the tax year that the corporation adopts, retains, or changes to per item F, Part
I, and that such tax year satisfies the requirement of section 4.01(3) of Rev. Proc. 2006-46. I also represent that the corporation
is not precluded by section 4.02 of Rev. Proc. 2006-46 from obtaining automatic approval of such adoption, retention, or
change in tax year.
Note: If you do not use item P and the corporation wants a fiscal tax year, complete either item Q or R below. Item Q is used to
request a fiscal tax year based on a business purpose and to make a back-up section 444 election. Item R is used to make a regular
section 444 election.
Q Business Purpose—To request a fiscal tax year based on a business purpose, check box Q1. See instructions for details
including payment of a user fee. You may also check box Q2 and/or box Q3.
1. Check here
if the fiscal year entered in item F, Part I, is requested under the prior approval provisions of Rev. Proc.
2002-39, 2002-22 I.R.B. 1046. Attach to Form 2553 a statement describing the relevant facts and circumstances and, if
applicable, the gross receipts from sales and services necessary to establish a business purpose. See the instructions for
details regarding the gross receipts from sales and services. If the IRS proposes to disapprove the requested fiscal year, do
you want a conference with the IRS National Office?
Yes
No
2. Check here
to show that the corporation intends to make a back-up section 444 election in the event the
corporation’s business purpose request is not approved by the IRS. See instructions for more information.
3. Check here
to show that the corporation agrees to adopt or change to a tax year ending December 31 if necessary
for the IRS to accept this election for S corporation status in the event (1) the corporation’s business purpose request is not
approved and the corporation makes a back-up section 444 election, but is ultimately not qualified to make a section 444
election, or (2) the corporation’s business purpose request is not approved and the corporation did not make a back-up
section 444 election.
R Section 444 Election—To make a section 444 election, check box R1. You may also check box R2.
1. Check here
to show that the corporation will make, if qualified, a section 444 election to have the fiscal tax year
shown in item F, Part I. To make the election, you must complete Form 8716, Election To Have a Tax Year Other Than a
Required Tax Year, and either attach it to Form 2553 or file it separately.
2. Check here
to show that the corporation agrees to adopt or change to a tax year ending December 31 if necessary
for the IRS to accept this election for S corporation status in the event the corporation is ultimately not qualified to make a
section 444 election.
Form 2553 (Rev. 12-2017)
Form 2553 (Rev. 12-2017)
Page 4
Name Employer identification number
Part III
Qualified Subchapter S Trust (QSST) Election Under Section 1361(d)(2)* Note: If you are making more than
one QSST election, use additional copies of page 4.
Income beneficiary’s name and address Social security number
Trust’s name and address Employer identification number
Date on which stock of the corporation was transferred to the trust (month, day, year) . . . . . . . .
In order for the trust named above to be a QSST and thus a qualifying shareholder of the S corporation for which this Form 2553 is
filed, I hereby make the election under section 1361(d)(2). Under penalties of perjury, I certify that the trust meets the definitional
requirements of section 1361(d)(3) and that all other information provided in Part III is true, correct, and complete.
Signature of income beneficiary or signature and title of legal representative or other qualified person making the election
Date
* Use Part III to make the QSST election only if stock of the corporation has been transferred to the trust on or before the date on
which the corporation makes its election to be an S corporation. The QSST election must be made and filed separately if stock of the
corporation is transferred to the trust after the date on which the corporation makes the S election.
Part IV Late Corporate Classification Election Representations (see instructions)
If a late entity classification election was intended to be effective on the same date that the S corporation election was intended to be
effective, relief for a late S corporation election must also include the following representations.
1 The requesting entity is an eligible entity as defined in Regulations section 301.7701-3(a);
2 The requesting entity intended to be classified as a corporation as of the effective date of the S corporation status;
3
The requesting entity fails to qualify as a corporation solely because Form 8832, Entity Classification Election, was not timely
filed under Regulations section 301.7701-3(c)(1)(i), or Form 8832 was not deemed to have been filed under Regulations section
301.7701-3(c)(1)(v)(C);
4
The requesting entity fails to qualify as an S corporation on the effective date of the S corporation status solely because the
S corporation election was not timely filed pursuant to section 1362(b); and
5a
The requesting entity timely filed all required federal tax returns and information returns consistent with its requested
classification as an S corporation for all of the years the entity intended to be an S corporation and no inconsistent tax or
information returns have been filed by or with respect to the entity during any of the tax years, or
b
The requesting entity has not filed a federal tax or information return for the first year in which the election was intended to be
effective because the due date has not passed for that year’s federal tax or information return.
Form 2553 (Rev. 12-2017)