Form 921-I - Consent Fixing Period Of Limitation On Assessment Of Income And Profits Tax Page 2
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2Instructions for Taxpayer(s)
This form should be used by investors in the electing S-Corporation, Partnership, Limited Liability Company, Trust,
Syndicate, Pool, etc. that are not subject to unified audit and litigation procedures for TEFRA (Tax Equity &
Fiscal Responsibility Act) partnerships.
Please sign and return the original and copy of Form 921-I, Consent Fixing Period of Limitation On Assessment of
Income and Profits Tax, to apply for an extension according to Revenue Procedure 92-29 and its successors.
Form 921 must be signed by each partner/shareholder/beneficiary or their authorized representative. If you're
an individual and this consent form includes tax years where a joint return was filed, the signature of both husband
and wife is required. One spouse may sign as agent for the other, if acting under an authorized power of attorney.
If you're an attorney or agent for the taxpayer(s), you may sign the consent form provided the action is specifically
authorized by a power of attorney. If you haven't filed a power of attorney, please include it with this form. If you're
acting as a fiduciary (executor, administrator, trustee, etc.) you must include a completed Form 56, Notice Concerning
Fiduciary Relationship, if you haven't already filed one.
If the investor is a corporation or a multiple-owned entity, the shareholder/partner/member/ beneficiary/officer(s) duly
authorized to sign on behalf of the entity must sign the consent. Include the name and entity type and the name,
signature, title, and taxpayer identification number of the officer(s)/signer(s). It isn't necessary to affix a seal, unless
the entity is required by charter or by law of jurisdictions to affix the seal in the execution of instruments.
Investors in electing entities that fall under TEFRA requirements must use Form 921-P.
Instructions for Internal Revenue Service Employees
The signature and title line must be signed and dated by the appropriate authorized official within your division.
SMALL BUSINESS/SELF-EMPLOYED DIVISION
Enter the name and title of your business unit executive (e.g., Area Director; Director, Compliance Policy; or Director,
Compliance Services). Secure signature of authorized division official.
WAGE AND INVESTMENT DIVISION
Enter the name and title of your business unit executive (e.g., Area Director or Director, Field Compliance Services).
Secure signature of authorized division official.
LARGE AND MID-SIZE BUSINESS ENTITIES DIVISION
Enter the name and title of your business unit executive (e.g., Director, Field Compliance). Secure signature of
authorized division official.
TAX EXEMPT AND GOVERNMENT ENTITIES DIVISION
Enter the name and title of your business unit executive (e.g., Director, Exempt Organizations; Director, Employee
Plans; Director, Federal, State and Local Governments; Director, Indian Tribal Governments; or Director, Tax Exempt
Bonds). Secure signature of authorized division official.
APPEALS DIVISION
Enter the name and title of your business unit executive (e.g., Director, Appeals Operating Unit). Secure signature of
authorized division official.
Catalog Number 31727W
921-I (
Form
Rev. 9-2001)
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