Note: Form 2553 begins on the next page.

Fax numbers for filing Form 2553 have changed.

The fax number for filing Form 2553 with the Cincinnati Service Center has changed.
The new number is 855-270-4081 (the old number was 859-669-5748).
The fax number for filing Form 2553 with the Ogden Service Center has changed. The
new number is 855-214-7520 (the old number was 801-620-7116).
Form 2553 Election by a Small Business Corporation
(Under section 1362 of the Internal Revenue Code)
(Rev. December 2013) OMB No. 1545-0123
See Parts II and III on page 3.
▶

Department of the Treasury ▶ You can fax this form to the IRS (see separate instructions).
Internal Revenue Service ▶ Information about Form 2553 and its separate instructions is at www.irs.gov/form2553.

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
Name (see instructions) A Employer identification number

Type Number, street, and room or suite no. (If a P.O. box, see instructions.) B Date incorporated
or Print
City or town, state, and ZIP code 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 who the IRS may call for more information I Telephone number of officer
or legal representative

If this S corporation election is being filed late, I declare that I had reasonable cause for not filing Form 2553 timely, and if this
late election is being made by an entity eligible to elect to be treated as a corporation, I declare that I also had reasonable cause
for not filing an entity classification election timely and that 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).

Under penalties of perjury, I declare that I have examined this election, including accompanying documents, and, to the best of my
Sign knowledge and belief, the election contains all the relevant facts relating to the election, and such facts are true, correct, and complete.

Here
▲

Signature of officer Title Date

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 18629R Form 2553 (Rev. 12-2013)
Form 2553 (Rev. 12-2013) Page 2
Part I Election Information (continued) Note. If you need more rows, use additional copies of page 2.

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
L
documents, and, to the best of my knowledge and Stock owned or
belief, the election contains all the relevant facts percentage of ownership
relating to the election, and such facts are true, (see instructions)
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
M
I have reported my income on all affected returns Social security
J consistent with the S corporation election for the number or N
Name and address of each year for which the election should have been filed Number of employer Shareholder’s
shareholder or former shareholder (see beginning date entered on line E) and for all shares or identification tax year ends
required to consent to the election. subsequent years. percentage Date(s) number (see (month and
(see instructions) Signature Date of ownership acquired instructions) day)

Form 2553 (Rev. 12-2013)

Form 2553 (Rev. 12-2013) Page 3
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.

Part III Qualified Subchapter S Trust (QSST) Election Under Section 1361(d)(2)*
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.
Form 2553 (Rev. 12-2013)
Form 2553 (Rev. 12-2013) Page 4
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. 12-2013)