Pre-CAP/CAP Application Form

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Overview

Selection Criteria
Taxpayer to Complete

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Sheet 1: Selection Criteria

Compliance Assurance Process (CAP) Selection Criteria

·         Taxpayers must have assets of $10 million or more;

·         The taxpayer must be a publicly-held entity with a legal requirement to prepare and submit Forms 10K, 10Q, 8K, or 20F or other disclosure type forms to the SEC or equivalent regulatory body. Privately-held entities will be eligible if they are able to provide to the Service certified, audited financial statements or equivalent documentation on a quarterly basis;

·         Taxpayers must not be in litigation with the Service and not under investigation by the IRS or any Federal or State agency which would limit access to current corporate tax records or could result in a material tax item;

·         Taxpayer must not have entered into a listed transaction as defined in Form 8886 for any open tax year or filed year under examination or in Appeals.

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Sheet 2: Taxpayer to Complete

Pre-CAP and CAP Application Form
								OMB # :1545-1800
Taxpayer Name per Tax Return:
Address per Tax Return:
EIN:
Check if Applying for: Pre-CAP ________ CAP ________
Fiscal Year Ending:
Pre-CAP and CAP Applicant Questions								Yes	No
1	Did the taxpayer report total assets on the prior US income tax return equal to or exceeding $10,000,000?							c	c
2a	Is the taxpayer publicly-held with a legal requirement to prepare and submit Forms 10K, 10Q, 8K, or 20F or other disclosure type forms to the SEC or equivalent regulatory body?							c	c
2b	If no in 2a, does the taxpayer prepare certified, audited financial statements or equivalent documentation on a quarterly basis?							c	c
3	Is the taxpayer currently under examination by the Internal Revenue Service?							c	c
4	Is the taxpayer currently in litigation or under investigation by the IRS or any Federal or State agency which would limit access to the current corporate tax records or the investigation could result in a material tax item? If yes, provide a brief explanation in line 7 below.							c	c
5	Has the taxpayer entered into any listed transaction as defined in the Instructions to Form 8886 for any open tax year or filed year under examination or in Appeals? If yes, please attach a copy of Form 8886.							c	c
6	Did the taxpayer recently undergo any changes that would affect the taxpayer's ability to dedicate resources to the CAP program or limit the availability of records?							c	c
7	If necessay, provide brief explanation described in Line 4.
Officer Authorized to Sign Return:
Name:					Title:
Phone Number:					E-mail:
Paperwork Reduction Act Notice.
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 contents may become material in the administration of any Internal Revenue law. Generally, tax returns 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 burden for taxpayers who file this form is 1 hour and 52 minutes.
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 Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send the form to this address.