Fillable Form 3115 - Application For Change In Accounting Method printable pdf download

3115

Form

Application for Change in Accounting Method

OMB No. 1545-0152

(Rev. December 2009)

Department of the Treasury

Internal Revenue Service

Identification number (see instructions)

Name of filer (name of parent corporation if a consolidated group) (see instructions)

Principal business activity code number (see instructions)

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

Tax year of change begins (MM/DD/YYYY)

Tax year of change ends (MM/DD/YYYY)

City or town, state, and ZIP code

Name of contact person (see instructions)

Name of applicant(s) (if different than filer) and identification number(s) (see instructions)

Contact person’s telephone number

If the applicant is a member of a consolidated group, check this box

If Form 2848, Power of Attorney and Declaration of Representative, is attached (see instructions for when Form 2848 is

required), check this box .

Check the box to indicate the type of applicant.

Check the appropriate box to indicate the type

of accounting method change being requested.

Individual

Cooperative (Sec. 1381)

(see instructions)

Corporation

Partnership

Controlled foreign corporation

S corporation

Depreciation or Amortization

(Sec. 957)

Insurance co. (Sec. 816(a))

Financial Products and/or Financial Activities of

Financial Institutions

10/50 corporation (Sec. 904(d)(2)(E))

Insurance co. (Sec. 831)

Other (specify)

Qualified personal service

corporation (Sec. 448(d)(2))

Exempt organization. Enter Code section

Caution. To be eligible for approval of the requested change in method of accounting, the taxpayer must provide all information that is relevant to the taxpayer

or to the taxpayer's requested change in method of accounting. This includes all information requested on this Form 3115 (including its instructions), as

well as any other information that is not specifically requested.

The taxpayer must attach all applicable supplemental statements requested throughout this form.

Information For Automatic Change Request

Part I

Enter the applicable designated automatic accounting method change number for the requested automatic change. Enter

Yes No

only one designated automatic accounting method change number, except as provided for in guidance published by the

IRS. If the requested change has no designated automatic accounting method change number, check "Other," and provide

both a description of the change and citation of the IRS guidance providing the automatic change. See instructions.

(a) Change No.

(b) Other

Description

Do any of the scope limitations described in section 4.02 of Rev. Proc. 2008-52 cause automatic consent to be

unavailable for the applicant's requested change? If "Yes," attach an explanation. .

Note. Complete Part II below and then Part IV, and also Schedules A through E of this form (if applicable).

Information For All Requests

Part II

Yes No

Did or will the applicant cease to engage in the trade or business to which the requested change relates, or

terminate its existence, in the tax year of change (see instructions)? . . . . . . . . . . . . . . . . . . .

If “Yes,” the applicant is not eligible to make the change under automatic change request procedures.

4 a Does the applicant (or any present or former consolidated group in which the applicant was a member during the

applicable tax year(s)) have any Federal income tax return(s) under examination (see instructions)?

If “No,” go to line 5.

b Is the method of accounting the applicant is requesting to change an issue (with respect to either the applicant or

any present or former consolidated group in which the applicant was a member during the applicable tax year(s))

either (i) under consideration or (ii) placed in suspense (see instructions)? .

Signature (see instructions)

Under penalties of perjury, I declare that I have examined this application, including accompanying schedules and statements, and to the best of my knowledge and belief,

the application contains all the relevant facts relating to the application, and it is true, correct, and complete. Declaration of preparer (other than applicant) is based on all

information of which preparer has any knowledge.

Filer

Preparer (other than filer/applicant)

Signature and date

Signature of individual preparing the application and date

Name of individual preparing the application (print or type)

Name and title (print or type)

Name of firm preparing the application

3115

For Privacy Act and Paperwork Reduction Act Notice, see the instructions.

Form

(Rev. 12-2009)