Form Ftb 638 - California Tax Shelter Resolution Initiative Election To Participate In Notice 2006-1
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1
2STATE OF CALIFORNIA
CALIFORNIA TAX SHELTER RESOLUTION INITIATIVE
FRANCHISE TAX BOARD
ELECTION TO PARTICIPATE IN NOTICE 2006-1
PO BOX 1673
RANCHO CORDOVA CA 95812-1673
TELEPHONE: (916) 845-3752
FAX NUMBER: (916) 845-5267
Once you or your authorized representative completes and signs FTB 638, California Tax Shelter Resolution Initiative -
Election to Participate in Notice 2006-1 , the completed form serves as an agreement between you and the Franchise
Tax Board. Please see the instructions on Side 2 for participation requirements and other information.
Complete this form and file it along with a copy of IRS Form 13750, Election to Participate in
Announcement 2005-80 Settlement Initiative, including all schedules (including, but not limited to, Schedules A
and B), for each transaction for which you are making an Election to Participate under the California Initiative,
no later than March 31, 2006.
Taxpayers who fail to provide the required information with form FTB 638 will not be eligible to participate in the
California Initiative. The Franchise Tax Board may request additional information that must be submitted by the time
provided in those requests, including a California amended return reversing the transaction(s) for which you are making
an Election to Participate under the California Initiative.
1. Name. Provide us with your name and, if you file
2. Your Taxpayer Identification Number. You must provide
a joint tax return, your spouse’s name.
your California Corporation Number, Employer Identifica-
tion Number or Social Security Number. For Privacy Act
Notice, get form FTB 1131.
California Corporation Number: _____________
EIN: _____ - ____________
SSN: _____ - _____ - ______
4. Telephone number
(
) _____ - _______
3. Address (Street, City, State, ZIP code)
5. Fax number
(
) _____ - _______
6. PLEASE SIGN BELOW
I declare, under penalty of perjury of the laws of the State of California, that I examined this form, including any
accompanying statements and attachments, and the information contained therein is true, correct, and complete.
I am properly authorized to execute this form.
_____
I am the taxpayer identified in this form and this declaration is based upon my personal knowledge.
_____
I am the authorized representative of the taxpayer(s) identified in this form and this declaration is based
upon all information I have obtained regarding the matter(s) for which this election is submitted.
Your name (please print) : _________________________ Spouse’s name ( please print ): _______________________
Your signature: _________________________________ Spouse’s signature _______________________________
Date: __________ Telephone number: (___)__________Date: __________ Telephone number: (___)___________
Note: An Election to Participate signed by a representative or an attorney-in-fact must be accompanied by a
completed Power of Attorney (form FTB 3520) authorizing such a signature.
For Privacy Act Notice, get form FTB 1131.
FTB 638 (NEW 01-2006) SIDE 1
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