Form 976 Claim for Deficiency Dividends Deductions by a Personal

Form

976

Claim for Deficiency Dividends Deductions by a
Personal Holding Company, Regulated Investment
Company, or Real Estate Investment Trust

(Rev. March 2001)

Department of the Treasury
Internal Revenue Service

OMB No. 1545-0045

(Under Section 547 or 860 of the Internal Revenue Code)

Name of personal holding company, regulated investment company, or real estate investment trust

Employer identification number

Number, street and room or suite no. (If a P.O. box, see instructions.)

City or town, state, and ZIP code

1
2
3a
b
4
5
a
b

Amount of tax deficiency
/
/
/
/
/
/
Last day of tax year:
:
:
.
Amount paid
/
/
Date paid
.
Amount unpaid
How was the deficiency established?
Tax Court Decision—Attach a copy.
Court Judgment—Attach a copy. If established by a final judgment in a suit against the
United States for refund:
/
/
(1) Date the claim for refund was filed
.
/
/
(2) Date the suit was brought
.

1
3a
4

Closing agreement under section 7121.
If a personal holding company, agreement under section 547(c)(3)—Attach a copy of a
properly executed Form 2198.
If a regulated investment company or real estate investment trust, agreement under
e
section 860(e)(3)—Attach a copy of the agreement.
/
/
6 Deficiency determination date (see instructions)
.
/
/
. (Attach a certified copy of the
7 Date the deficiency dividend was distributed.
resolution of the board of directors or other authority authorizing the payment of the deficiency dividend.)
c
d

8

Deficiency dividend was distributed as follows:
a Cash
b Other property (attach description):
(1) Fair market value
(2) Adjusted basis
9a Amount claimed as a deduction for deficiency dividends
b For a regulated investment company or real estate investment trust, enter the amount of line
9a designated as capital gain dividends
10 Only personal holding companies must complete line 10.
(b) Class of stock and number of
shares of each class of stock held at
date of payment of deficiency dividend

(a) Name and address of each shareholder

Sign
Here
Paid
Preparer’s
Use Only

8a
8b(1)
8b(2)
9a
9b
(c) Amount of deficiency dividend
paid to each shareholder on each
class of stock

Under penalties of perjury, I declare that I have examined this claim, including accompanying schedules and statements, and to the best of my knowledge
and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

䊳

Signature of officer

Preparer’s
signature

䊳

Firm’s name (or yours,
if self-employed),
address and ZIP Code

Date
Date

䊳

For Paperwork Reduction Act Notice, see back of form.

䊳

Title

Check if
self-employed

SSN or PTIN
䊳

EIN
Phone no. (
Cat. No. 17061B

)
Form

976

(Rev. 3-2001)

Form 976 (Rev. 3-2001)

Instructions
Section references are to the Inter nal Revenue Code.
Purpose of form. File Form 976 for a personal holding
company, regulated investment company, or real estate
investment trust that is claiming a deficiency dividend
deduction under section 547 or 860. If the deficiency
dividend deduction is granted, taxpayers will be granted
relief, in whole or in part, from the payment of a tax
deficiency. If the deficiency has already been paid, the
taxpayers must file an amended return to claim a credit or
refund.
When and where to file. File Form 976 within 120 days after
the deficiency determination date (defined below). A personal
holding company must file Form 976 with the IRS office
where the determination of personal holding company status
was made. A regulated investment company or a real estate
investment trust must file Form 976 with either the IRS office
or the Internal Revenue Service Center where the company
or trust filed its income tax return for the tax year for which
the determination applies.
If the deficiency determination is from an agreement with
the delegate (under section 547(c)(3) or 860(e)(3)) any claim
resulting from the deficiency dividend deduction may be filed
with that IRS office.
Deficiency dividends. Deficiency dividends must be
distributed no later than 90 days after the deficiency
determination date and prior to filing Form 976.
The deficiency dividend must be of such a nature as
would have permitted its inclusion in the computation of the
deduction for dividends paid under section 561 for the tax
year for which the tax liability exists, if it had been distributed
during that year.
Deficiency determination date. The deficiency
determination date is as follows:
● For a decision of the Tax Court, the date the decision
becomes final under section 7481.
● For a judgment, decree, or order by a court, the date the
judgment, decree, or order becomes final.
● For a closing agreement made under section 7121, the
date the agreement is approved by the Commissioner.
● If an agreement was made by the IRS and the taxpayer
under section 547(c)(3) (Form 2198) (see below) or section
860(e)(3) and the signed copy of the agreement is sent to the
taxpayer by registered mail, the determination date is the
date of the registration. If the agreement is sent by certified
mail, the determination date is the date of the postmark on
the sender’s receipt. But if the dividend is paid before the
registration or postmark date, and on or after the date the
agreement is signed by the delegate of the Commissioner,
the determination date is the date the agreement was
signed.
Form 2198. Form 2198, Determination of Liability for
Personal Holding Company Tax—Section 547(c)(3) of the
Internal Revenue Code, is used as the agreement required by
section 547(c)(3). The form is jointly signed by a delegate of
the Commissioner of Internal Revenue and a qualified officer
of the personal holding company to establish the personal
holding company’s tax liability.
Claim for credit or refund. If the allowance of the deficiency
dividend deduction results in an overpayment of tax, the
taxpayer must file an amended income tax return in

Page

2

addition to Form 976 to obtain a credit or refund of the
overpayment.
Corporate acquisitions. When the assets of one corporation
are acquired by another corporation in a distribution or
transfer described in section 381(a), see sections 381(c)(17)
and 381(c)(23) for special rules for claiming a deficiency
dividend deduction.
Address. Include the suite, room, or other unit number after
the street address. If the Post Office does not deliver mail to
the street address and the taxpayer has a P.O. box, show the
box number instead of the street address.
Signature. The return must be signed and dated by the
president, vice president, treasurer, assistant treasurer, chief
accounting officer, or any other officer (such as tax officer)
authorized to sign. A receiver, trustee, or assignee must sign
and date any return filed on behalf of the company or trust.
If an officer completed Form 976, the Paid Preparer’s
space under “Signature of officer” should remain blank. If
someone prepares Form 976 and does not charge the
corporation, that person should not sign the return. Certain
others who prepare Form 976 should not sign. For example,
a regular, full-time employee, such as a clerk, secretary, etc.,
should not sign.
Generally, anyone who is paid to prepare Form 976 must
sign the return and fill in the other blanks in the Paid
Preparer’s Use Only area of the return.
The preparer required to sign the return must complete
the required preparer information and:
● Sign it, by hand, in the space provided for the preparer’s
signature (signature stamps or labels are not acceptable) and
● Give a copy of Form 976 to the taxpayer in addition to the
copy filed with the IRS.
Paperwork Reduction Act Notice. We ask for the
information on this form to carry out the Internal Revenue
laws of the United States. You are required to give us the
information. We need it to ensure that you are complying
with these laws and to allow us to figure and collect the right
amount of tax.
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books
or records relating to a form or its instructions must be
retained as long as their content may become material in the
administration of any Internal Revenue law. Generally, tax
return and return information are confidential, as required by
section 6103.
The time needed to complete and file this form will vary
depending on individual circumstances. The estimated
average time is:
Recordkeeping
5 hr., 44 min.
Learning about the law or the form
53 min.
Preparing, copying, assembling, and
sending the form to the IRS
1 hr., 2 min.
If you have comments concerning the accuracy of these
time estimates or suggestions for making this form simpler,
we would be happy to hear from you. You can write to the
Tax Forms Committee, Western Area Distribution Center,
Rancho Cordova, CA 95743-0001. Do not send this form to
this office. Instead, see When and where to file above.