Form 972 - Consent Of Shareholder To Include Specific Amount In Gross Income Page 2

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2
Form 972 (Rev. 12-2016)
Page
General Instructions
shareholder agrees to a consent
information. We need it to ensure
dividend and sends a completed
that you are complying with these
Purpose of form. Form 972 is used
Form 972 to the corporation. The
laws and to allow us to figure and
by a shareholder who agrees to
corporation claims the consent
collect the right amount of tax.
report a consent dividend as taxable
dividend deduction on its tax return
You are not required to provide
income in the form of a dividend on
for the fiscal year ending on June
the information requested on a form
the shareholder’s own tax return
30, 2017. The shareholder reports
that is subject to the Paperwork
even though the shareholder
the consent dividend as a taxable
Reduction Act unless the form
receives no actual cash distribution
dividend on its tax return filed for
displays a valid OMB control
of the consented amounts. A
the calendar year ending on
number. Books or records relating to
dividend is a consent dividend only
December 31, 2017.
a form or its instructions must be
if it would have been included in the
Identifying number. Individuals
retained as long as their contents
shareholder’s gross income if it was
enter their social security number.
may become material in the
actually paid. If the shareholder
All others enter their employer
administration of any Internal
agrees to treat the dividend as
identification number.
Revenue law. Generally, tax returns
taxable, the corporation may be able
and return information are
Address. Include the room, suite, or
to claim a consent dividend
confidential, as required by section
other unit number after the street
deduction on its income tax return.
6103.
address. If the Post Office doesn't
Also, the shareholder increases its
deliver mail to the street address
The time needed to complete and
basis in the stock of that corporation
and the shareholder has a P.O. box,
file this form will vary depending on
in the amount of the consent
show the box number instead of the
individual circumstances. The
dividend for which the shareholder is
street address.
estimated burden for individuals is
taxed.
approved under OMB control
Signature. Form 972 must be
Who may file. A shareholder who
number 1545-0074, the estimated
signed by the shareholder. If the
agrees to treat the consent dividend
burden for businesses is approved
shareholder is a partnership, one of
as a taxable dividend must complete
under OMB number 1545-0123, and
the partners must sign. If the
and send Form 972 to the
the estimated burden for all others
shareholder is an estate or trust, the
corporation that will claim the
who file this form is shown below.
fiduciary or officer representing the
consent dividend as a deduction.
estate or trust must sign. For a
Recordkeeping . . 3 hrs., 35 min.
When and where to file. Send the
corporate shareholder, the
Learning about the
completed Form 972 to the
president, vice president, treasurer,
law or the form . . . . . 6 min.
corporation by the due date of the
assistant treasurer, chief accounting
corporation’s tax return for the tax
Preparing the form . . . . 9 min.
officer, or other authorized officer
year the corporation will claim the
If you have comments concerning
(such as tax officer) must sign the
consent dividends as a deduction.
the accuracy of these time estimates
consent.
The corporation must attach Form
or suggestions for making this form
The shareholder’s attorney or
973, Corporation Claim for
simpler, we would be happy to hear
agent may sign this consent if he or
Deduction for Consent Dividends,
from you. You can send us
she is specifically authorized by a
and a copy of each completed Form
comments from
power of attorney which, if not
972 to its income tax return.
Click on
previously filed, must accompany
“More information” and then on
Note: The shareholder must report
Form 972.
“Give us feedback.” Or you can write
the consent dividend as a taxable
to Internal Revenue Service, Tax
dividend in the same tax year the
Paperwork Reduction Act
Forms and Publications Division,
corporation will claim the consent
Notice
1111 Constitution Ave. NW, IR-6526,
dividend deduction. For example,
Washington, DC 20224.
the corporation has a fiscal tax year
We ask for the information on this
that begins on July 1, 2016, and
Do not send the tax form to this
form to carry out the Internal
ends on June 30, 2017. In
office. Instead, see When and where
Revenue laws of the United States.
November 2016, a calendar year
to file on this page.
You are required to give us the

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