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LABAMA
EPARTMENT OF
EVENUE
Rev. 6/11
Alabama S-Corporation Nonresident Agreement
For the year January 1 – December 31, 20_____, or other tax year beginning ______________________ 20______, ending ______________________ 20_____.
SHAREHOLDER SOCIAL SECURITY NUMBER / FEIN
S CORPORATION FEIN
SHAREHOLDER TAX YEAR
CORPORATION TAX YEAR
NAME
NAME
LEGAL RESIDENCE
ADDRESS
CITY
CITY
STATE OF LEGAL RESIDENCE
ZIP
STATE
ZIP
SHAREHOLDER’S ENTITY TYPE
AGREEMENT
(1) I hereby agree that I will timely file a nonresident income tax return with the Alabama Department of Revenue and include therein
my pro rata share of the income, loss and deductions of the above named entity for any taxable year in which I am a shareholder
and will pay any tax liability due thereon.
(2) I hereby irrevocably appoint the registered agent of the above entity and any agent or officer of the entity present in Alabama as
my agent for service of process of any documents from the Alabama Department of Revenue in connection with my income tax
returns or those of the entity, and that I hereby consent to personal jurisdiction by the State of Alabama in connection with my
income tax returns or those of the entity. In addition, I hereby appoint the following person or firm in Alabama as agent for service
of process: (OPTIONAL)
________________________________________________________________________________________________________
________________________________________________________________________________________________________
(3) This agreement will be binding upon my heirs, representatives, assignees, successors, executors and administrators.
(4) I understand this agreement may not be revoked or cancelled after the due date (with extensions) of the entity’s Alabama return.
__________________________________________________
__________________________________________________
SIGNATURE OF OWNER / SHAREHOLDER
TITLE OR STATUS
(If shares are jointly owned, each owner must execute a separate agreement. If held as trustee or custodian, indicate title or status. If
executed under power of attorney, so state.)
A COPY OF THIS FORM MUST BE ATTACHED TO THE ALABAMA FORM 20S RETURN
EACH YEAR THE AGREEMENT IS IN EFFECT.
ADOR