Form 921-A - Consent Fixing Period Of Limitation On Assessment Of Income And Profits Tax
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1
2In reply refer to:
Department of the Treasury - Internal Revenue Service
Consent Fixing Period of Limitation On Assessment of
921-A
Form
Income and Profits Tax
(Revised January 2001)
Taxpayer Identification Number
(S-Corporation, Partnerships, Limited Liability Company, Trusts, Syndicates, Pools, Etc.)
For Allowance of Estimated Future Expense Liabilities Under Contract for Sale of Real Estate
In consideration of the tentative allowance, in whole or in part, by the Commissioner of Internal Revenue, for income or
profits tax purposes of the estimated cost of future improvements as apart of the cost or other basis of certain real estate
sold or otherwise disposed of under contract b
y
,
a
, whose address is
(S-Corporation, Partnership, Limited Liability Company, Trust, Syndicate, Pool, Etc.)
, the undersigned taxpayer,
(Number, Street, City or Town, State, ZIP Code)
of the said
a
(S-Corporation, Partnership, Limited Liability
(Shareholder, Partner, Member,
Company, Trust, Syndicate, Pool, Etc.)
Beneficiary, Tax Matters Partner)
and the Commissioner of Internal Revenue, hereby consent and agree as follows:
That the amount of any income or profits tax due under any return or returns made by or on behalf of the above-named
taxpayer for the taxable year (or years)
,
under existing acts, or under prior revenue acts, may be assessed at any time on or before
,
except that if a notice of a deficiency in tax is sent to said taxpayer by certified or registered mail on or before said date,
then the time for making any assessment as aforesaid shall be extended beyond the said date by the number of days
during which the making of an assessment is prohibited and for 60 days thereafter.
YOUR SIGNATURE HERE
(Date signed)
SPOUSE'S SIGNATURE
(Date signed)
TAXPAYER'S REPRESENTATIVE
SIGN HERE
(Date signed)
ENTITY
NAME
(S-Corporation, Partnership, Limited Liability Company, Trust, Syndicate, Pool, Etc.)
(Shareholder, Partner, Member,
(Title)
(Date signed)
ENTITY
Beneficiary, Tax Matters Partner)
OFFICER(S)
SIGN HERE
(Shareholder, Partner, Member,
(Title)
(Date signed)
Beneficiary, Tax Matters Partner)
INTERNAL REVENUE SERVICE SIGNATURE AND TITLE
(Division Executive Name - see instructions)
(Division Executive Title - see instructions)
BY
(Authorized Official Signature and Title - see instructions)
(Date signed)
(Signature instructions are on the back of this form)
921-A
Cat. No. 16976Z
Form
(Rev. 1-2001)
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