Form 8023 Elections Under Section 338 for Corporations Making Qual

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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8023, PAGE 1 of 2
MARGINS: TOP 13 mm (1⁄2"), CENTER SIDES.
PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216 mm (81⁄2")
279 mm (11")
PERFORATE:
NONE
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

8023

Form
(Rev. February 2006)

Department of the Treasury
Internal Revenue Service

Action

Date

O.K. to print
Revised proofs
requested

Elections Under Section 338 for
Corporations Making Qualified Stock Purchases
䊳

Signature

OMB No. 1545-1428

See separate instructions.

Section A-1—Purchasing Corporation
1a Name and address of purchasing corporation

1b Employer identification number

1c Tax year ending

1d State or country of incorporation

Section A-2—Common Parent of the Purchasing Corporation
2a Name and address of common parent of purchasing corporation

2b Employer identification number

2c Tax year ending

2d State or country of incorporation

Section B—Target Corporation
3a Name and address of target corporation

3b Employer identification number

3c Tax year ending

3d State or country of incorporation

Section C—Common Parent of Selling Consolidated Group, Selling Affiliate,
S Corporation Shareholder, or U.S. Shareholder
Complete only for a section 338(h)(10) election or if target was a member of a consolidated group or a controlled foreign corporation (CFC)
or had been a CFC within the preceding five years.
4a Name and address of common parent of the selling consolidated group,
selling affiliate, U.S. shareholder(s) of foreign target corporation, or
S corporation shareholder(s)

4b Identifying number(s)

4c Tax year ending

Section D—General Information
5a Acquisition date

5b What percentage of target corporation stock was purchased:
(i) During the 12-month acquisition period?
(ii) On the acquisition date?
%

For Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 49972Z

%

Form

8023

(Rev. 2-2006)

2
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8023, PAGE 2 of 2
MARGINS: TOP 13 mm (1⁄2"), CENTER SIDES.
PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216 mm (81⁄2")
279 mm (11")
PERFORATE:
NONE
DO
NOT PRINT
— DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form 8023 (Rev. 2-2006)

Page

2

Section E—Elections Under Section 338
䊳

6

Check here to make a section 338(h)(10) election for the target corporation listed in Section B on page 1

7

Check here to make a section 338 election (other than a section 338(h)(10) election) for the target corporation listed in Section B on
䊳
page 1

8

If the box on line 7 is checked for the target corporation listed in Section B on page 1, check here to make a gain recognition election
䊳
for that corporation (see instructions)

9

Check here if this form is filed to make a section 338 election for any target corporation in addition to the one listed in Section B on
䊳
page 1

Purchasing Corporation(s) Signature(s)
Under penalties of perjury, I state and declare that I am authorized to make the election(s) on lines 6, 7, 8, and 9 on behalf of the purchasing corporation(s).

䊳

Signature of authorized person for purchasing corporation(s)

Date

䊳

Title

Consolidated Selling Group or Selling Affiliate Signature (Section 338(h)(10) Election)
Under penalties of perjury, I state and declare that I am authorized to make the section 338(h)(10) election on line 6 on behalf of the common parent of the selling
consolidated group or on behalf of the selling affiliate.

䊳

Signature of authorized person for the common parent or selling
affiliate

Date

䊳

Title

S Corporation Shareholder(s) Signature(s) (Section 338(h)(10) Election)
Under penalties of perjury, I state and declare that I am a shareholder of the S corporation target or that I am authorized to make the section 338(h)(10) election on
line 6 on behalf of that shareholder. If more than one shareholder, attach a schedule with other signatures.

䊳

Signature of S corporation shareholder

Date

䊳

Title

Form

Printed on recycled paper

8023

(Rev. 2-2006)