8869 Qualified Subchapter S Subsidiary Election

8869

Form
(Rev. December 2020)
Department of the Treasury
Internal Revenue Service

Part I

Qualified Subchapter S Subsidiary Election
▶ Go

to www.irs.gov/Form8869 for instructions and the latest information.

Parent S Corporation Making the Election

1a Name of parent

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OMB No. 1545-0123

(Under section 1361(b)(3) of the Internal Revenue Code)

2 Employer identification number (EIN)

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

3 Tax year ending (month and day)

c City or town, state or province, country, and ZIP or foreign postal code

4 Service center where last return was filed
6 Telephone number of officer or legal
representative

Name and title of officer or legal representative whom the IRS may call for more information

Part II

Subsidiary Corporation for Which Election is Made (For additional subsidiaries, see instructions.)

7a Name of subsidiary

8 EIN (if any)

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

9 Date incorporated

c City or town, state or province, country, and ZIP or foreign postal code

10 State of incorporation

11 Date election is to take effect (month, day, year) (see instructions)

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12 Did the subsidiary previously file a federal income tax return? If “Yes,” complete lines 13a, 13b, and 13c

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13a Service center where last return was filed

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13b Tax year ending date of last
return (month, day, year) ▶

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13c Check type of return filed:
Form 1120-S

Yes

No

Form 1120
Other ▶

14 Is this election being made in combination with a section 368(a)(1)(F) reorganization described in Rev. Rul. 2008-18, where the subsidiary was
an S corporation immediately before the election and a newly formed holding company will be the subsidiary’s parent?
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Yes

No

15 Was the subsidiary’s last return filed as part of a consolidated return? If “Yes,” complete lines 16a, 16b, and 16c .

Yes

No

16a Name of common parent

16b EIN of common parent

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16c Service center where consolidated return was filed

Under penalties of perjury, I declare that I have examined this election, including accompanying statements, and to the best of my knowledge and belief, it is true, correct,
and complete.

Signature of officer
of parent corporation ▶
For Paperwork Reduction Act Notice, see separate instructions.

Title ▶

Date ▶
Cat. No. 28755K

Form 8869 (Rev. 12-2020)