Form Rev. October 2014 Department of the Treasury Internal Revenue Service Part I Application To Adopt Change or Retain a Tax Year OMB No. 1545-0134 Information about Form 1128 and its separate instructions is available at www.irs.gov/form1128. C If Yes to line 10b has any Form 1128 been filed for such partnership. Does the applicant or any related entity currently have any accounting method tax year ruling or technical advice request pending with the IRS National Office. Attachment Sequence No* General Information Type or Print Important All filers must complete Part I and sign below. See instructions. Name of filer if a joint return is filed also enter spouse s name see instructions Filer s identifying number Number street and room or suite no. if a P. O. box see instructions Service Center where income tax return will be filed City or town state and ZIP code Filer s area code and telephone number/Fax number Name of applicant if different than the filer see instructions / Applicant s identifying number see instructions Name of person to contact if not the applicant or filer attach a power of attorney Contact person s area code and telephone number/Fax number Check the appropriate box es to indicate the type of applicant see instructions. Individual Partnership Estate 2a Cooperative sec* 1381 a Controlled foreign corporation CFC sec* 957 Passive foreign investment company PFIC sec* 1297 Foreign sales corporation FSC or Interest-charge domestic international sales corporation IC-DISC Other foreign corporation Domestic corporation S corporation Specified foreign corporation SFC sec* 898 Personal service 10/50 corporation sec* 904 d 2 E Trust Approval is requested to check one see instructions Adopt a tax year ending Tax-exempt organization Homeowners Association sec* 528 Other Specify entity and applicable Code section Change to a tax year ending Retain a tax year ending b If changing a tax year indicate the date the present tax year ends see instructions. c If adopting or changing a tax year the first return or short period return will be filed for the tax year and ending beginning Is the applicant s present tax year as stated on line 2b above also its current financial reporting year Yes No If No attach an explanation* Indicate the applicant s present overall method of accounting. Accrual method Cash receipts and disbursements method Other method specify State the nature of the applicant s business or principal source of income. Signature All Filers See Who Must Sign in the 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 it is true correct and complete. Declaration of preparer other than filer is based on all information of which preparer has any knowledge. Date Signature of filer Paid Preparer Use Only Print/Type preparer s name Preparer s signature Sign Here Type or print name and title Check if self-employed Firm s name Firm s EIN Firm s address Phone no.
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