Note: Form 2553 begins on the next page.

Where To File Form 2553 after 6/17/19

If the corporation’s principal business, office,     Use the following address  
         or agency is located in                         or fax number

Connecticut, Delaware, District of Columbia,       Department of the Treasury 
Georgia, Illinois, Indiana, Kentucky, Maine,       Internal Revenue Service 
Maryland, Massachusetts, Michigan, New             Kansas City, MO 64999  
Hampshire, New Jersey, New York, North Carolina, 
Ohio, Pennsylvania, Rhode Island, South Carolina,    

Tennessee, Vermont, Virginia, West Virginia,       Fax # 855-887-7734
Wisconsin

Alabama, Alaska, Arizona, Arkansas, California,    Department of the Treasury 
Colorado, Florida, Hawaii, Idaho, Iowa, Kansas,    Internal Revenue Service 
Louisiana, Minnesota, Mississippi, Missouri,       Ogden, UT 84201 
Montana, Nebraska, Nevada, New Mexico, North 
Dakota, Oklahoma, Oregon, South Dakota,  Texas,      

Utah, Washington, Wyoming                          Fax # 855-214-7520

                                       Election by a Small Business Corporation
Form   2553                             (Under section 1362 of the Internal Revenue Code) 
(Rev. December 2017)                   (Including a late election filed pursuant to Rev. Proc. 2013-30)              OMB No. 1545-0123
Department of the Treasury             ▶ You can fax this form to the IRS. See separate instructions. 
Internal Revenue Service       ▶ Go to www.irs.gov/Form2553 for instructions and the latest information.
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 or province, country, and ZIP or foreign postal code                      C  State of incorporation 

D   Check the applicable box(es) if the corporation (entity), after applying for the EIN shownA   in   above, changednameits 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. 

        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. 
Sign  
Here    ▲
          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.
                                                     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                  L   
                                           of my knowledge and belief, the election             Stock owned or  
                                           contains all the relevant facts relating to the percentage of ownership  
                                           election, and such facts are true, correct,          (see instructions) 
                                           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                                        M   
                                           affected returns consistent with the S                                          Social security  
                 J                         corporation election for the year for which                                     number or               N   
     Name and address of each              the election should have been filed (see        Number of                            employer      Shareholder’s  
     shareholder or former shareholder     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. 12-2017) 

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)