Federal Free Printable Form 4876-A (Rev. September 2016) for 2017 Federal Election to Be Treated as an Interest Charge DISC

It appears you don't have a PDF plugin for this browser. Please use the link below to download 2016-federal-form-4876-a.pdf, and you can print it directly from your computer.

Election to Be Treated as an Interest Charge DISC
Form 4876-A (Rev. September 2016)

Form 4876-A (Rev. September 2016) Department of the Treasury Internal Revenue Service Part I ▶ Information Election To Be Treated as an Interest Charge DISC OMB No. 1545-0123 about Form 1120-IC-DISC and its separate instructions is at www.irs.gov/form1120icdisc. The corporation named below elects to be treated as an interest charge domestic international sales corporation (IC-DISC) for income tax purposes. All of the corporation’s shareholders must consent to this election. Name of corporation A Employer identification number Number, street, and room or suite no. (or P.O. box if mail is not delivered to street address) B Principal business classification (see instructions) City or town, state, and ZIP code C Tax year of IC-DISC: Must use tax year of shareholder (or shareholder group) with the highest percentage of voting power (see instructions). Enter ending month and day ▶ F Date corporation began doing business E Election is to take effect for the tax year beginning (month, day, year) G Name and address (including ZIP code) of each shareholder (or expected shareholder) at the beginning of the tax year the election takes effect and when the election is filed. D Name of person who may be called for information: (optional) Telephone number: Ha Number of Hb Number of shares of stock shares of stock held on first day held on date of year of election consent is made I Identifying number (see instructions) 1 2 3 4 5 6 7 8 9 10 Total. Enter total shares for all shareholders (include shares of shareholders listed on any attachments) . . . . . . . . . . . . . . . . . . . . Under penalties of perjury, I declare that the corporation named above has authorized me to make this election for the corporation to be treated as an IC-DISC and that the statements made are to the best of my knowledge and belief true, correct, and complete. Date Signature and Title of Officer ▶ Part II , Shareholders’ Consent Statement. Part II may be used instead of attachments. For this election to be valid, each shareholder must sign and date below or attach a separate consent to this form (see instructions). We, the undersigned shareholders, consent to the election of the corporation named above to be treated as an IC-DISC. Our consent is irrevocable and is binding upon all transferees of our shares in this corporation. Signature of shareholder and date. (If consent involves transferred shares, attach a schedule showing the name and address of the holder of the shares at the beginning of the tax year and the number of shares for which the consent is made.) 1 6 2 7 3 8 4 9 5 10 For Paperwork Reduction Act Notice, see page 2. Cat. No. 62075X Form 4876-A (Rev. 9-2016) Page 2 Form 4876-A (Rev. 9-2016) Future Developments For the latest information about developments related to Forms 4876-A and 1120-IC-DISC, such as legislation enacted after they were published, go to www.irs.gov/form1120icdisc. General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A corporation files Form 4876-A to elect to be treated as an interest charge domestic international sales corporation (IC-DISC). Once the election is made, it remains in effect until terminated or revoked. See Regulations section 1.992-2(e). The election applies to each shareholder who owns stock in the corporation while the election is in effect. What Is an IC-DISC? An IC-DISC is a domestic corporation that meets certain conditions regarding its organization and international sales and that elects to be treated as an IC-DISC. The corporation must be organized under the laws of a state or the District of Columbia and meet the following tests. • At least 95% of its gross receipts during the tax year are qualified export receipts. • At the end of the tax year, the adjusted basis of its qualified export assets is at least 95% of the sum of the adjusted basis of all its assets. • It has only one class of stock, and its outstanding stock has a par or stated value of at least $2,500 on each day of the tax year (or, for a new corporation, on the last day to elect IC-DISC status for the year and on each later day). • It keeps separate books and records. • Its tax year must conform to the tax year of the shareholder (or shareholder group) who has the highest percentage of voting power. If two or more shareholders (or shareholder groups) have the same highest percentage of voting power, the IC-DISC’s tax year may be the same as that of any such shareholder (or group). See section 441(h) and its regulations for more information. • Its election to be treated as an IC-DISC is in effect for the tax year. See section 992 and its regulations for details. Also see section 993 and its regulations for definitions of qualified export receipts and qualified export assets. Ineligible organizations. S corporations, certain financial institutions, and other corporations listed in section 992(d) are not eligible for IC-DISC treatment. When To File If it is the corporation’s first tax year, complete and file Form 4876-A within 90 days after the beginning of the tax year. For any tax year that is not the corporation’s first tax year, the election must be made during the 90-day period immediately preceding the first day of that tax year. For the election to be valid, all of the corporation’s shareholders, as of the first day of the tax year the election is to take effect, must consent to it. Where To File File Form 4876-A with the IRS Service Center where the corporation will file its annual return, Form 1120-IC-DISC. Specific Instructions Part I Address. Include the suite, room, or other unit number after the street address. If the post office does not deliver mail to the street address and the corporation has a P.O. box, show the box number instead. Item B—Principal business classification. Use the list of Codes for Principal Business Activity in the Instructions for Form 1120-IC-DISC to enter the corporation’s business code number, principal business activity, and principal product or service. Item C—Tax year change. If a corporation electing to be an IC-DISC has to change its tax year to meet the tax year requirements of section 441(h), the corporation generally does not need IRS consent to make the change. A tax year change by a shareholder requires IRS consent. A subsequent change by the corporation to meet the tax year requirements of section 441(h) may require IRS consent. See section 442 and the regulations under sections 441, 442, and 921 for more information. Also see Rev. Proc. 2002-37, 2002-22 I.R.B. 1030, and Rev. Proc. 2002-39, 2002-22 I.R.B. 1046, as clarified and modified by Notice 2002-72, 2002-46 I.R.B. 843. Columns Ha and Hb. Number of shares of stock. Enter the number of shares of stock held on the first day of the year of election and the number held on the date of consent to make the election. Complete both columns for each shareholder. Column I—Identifying number. The identifying number for an individual is the social security number. For all others, it is the employer identification number. Signature. Form 4876-A must be signed by the president, vice president, treasurer, assistant treasurer, chief accounting officer, or other officer (such as tax officer) authorized to sign for the corporation. Part II Shareholders’ Consent Statement. An election for IC-DISC treatment will be valid only if all shareholders sign either the consent statement in Part II or a separate statement as described below. Several shareholders may combine their consents in one statement. If legally married spouses jointly own the stock or the income from it, both must sign the consent. If tenants in common, joint tenants, or tenants by the entirety own the stock, each person must sign. The legal guardian should sign for a minor; if none has been appointed, the natural guardian should sign. The executor or administrator should sign for an estate, and the trustee should sign for a trust. If the estate or trust has more than one executor, administrator, or trustee, any of them who is authorized to file the returns may sign the consent. For a corporation or partnership, an officer or partner who is authorized to sign the other returns may sign the consent for the IC-DISC election. A foreign person’s consent may be signed by any individual who would be authorized to sign if the person were a U.S. person. Extension. Normally, the consents must be attached to Form 4876-A. If you establish reasonable cause for not filing a consent on time, you may file the consent within an extended period granted by an IRS Service Center. File the consents with the same service center where you filed Form 4876-A. Consent by transferee shareholder. If shares are transferred before a consent is filed, the transferee shareholder may consent to the IC-DISC election as long as the transfer occurs and the consent is filed within the first 90 days of the tax year. The service center may grant an extension beyond that date. If the transfer takes place more than 90 days after the tax year began, an extension can be granted only if the transferor was eligible for one. Separate statement. Any shareholder who does not sign the consent in Part II of Form 4876-A must sign a separate consent statement for the election to be valid. The statement must say: “I, (shareholder’s name), a shareholder of (corporation’s name), consent to the election of (corporation’s name) to be treated as an IC-DISC. The consent so made by me is irrevocable and is binding on all transferees of my shares in (corporation’s name).” In addition, the statement must show (a) the names, addresses, and identification numbers of both the corporation and the shareholder; (b) the number of shares the shareholder owned (or expects to own) at the beginning of the tax year the election takes effect; and (c) the number of shares the shareholder owns when making the consent. For transferred stock, also show the name and address of the person who held the shares at the beginning of the tax year and the number of shares to which this consent applies. Supplemental Form 4876-A. If, between the date the election is filed and the date it takes effect, the corporation issues more shares of stock or the share ownership changes, it must file a supplemental Form 4876-A, with “SUPPLEMENTAL” written across the top of the form. The form must be filed within the first 90 days of the tax year the election takes effect. On the supplemental form, include all the information from the earlier form except for the list of owners contained in Parts I and II. Report only the owners of the new or additional shares in Part I, and in Part II obtain their consents only. Each new shareholder or holder of additional shares must consent to the IC-DISC election for the Supplemental Form 4876-A to be valid. Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to give us the information. We need it to ensure that you are complying with these laws and to allow us to figure and collect the right amount of tax. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103. The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is: Recordkeeping . . . . . 4 hr., 4 min. Learning about the law or the form . . . . . . . . 1 hr., 5 min. Preparing and sending the form to the IRS . . . . . 1 hr., 12 min. If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can send us comments from www.irs.gov/formspubs. Click on “More Information” and then on “Give us feedback.” Or you can write to the Internal Revenue Service, Tax Forms and Publications, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not file your form at this address. Instead, see Where To File, earlier.
Extracted from PDF file 2016-federal-form-4876-a.pdf, last modified September 2016

More about the Federal Form 4876-A Other TY 2016

We last updated the Election to Be Treated as an Interest Charge DISC in May 2017, so this is the latest version of Form 4876-A, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form 4876-A directly from TaxFormFinder. You can print other Federal tax forms here.


eFile your Federal tax return now

eFiling is easier, faster, and safer than filling out paper tax forms. File your Federal and Federal tax returns online with TurboTax in minutes. FREE for simple returns, with discounts available for TaxFormFinder users!

File Now with TurboTax

Other Federal Other Forms:

TaxFormFinder has an additional 774 Federal income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 8962 Premium Tax Credit
Form 12277 Application for Withdrawal of Filed Form 668(Y), Notice of Federal Tax Lien (Internal Revenue Code Section 6323(j))
Form W-4V Voluntary Withholding Request
Form 433-D Installment Agreement
Form 8283 Noncash Charitable Contributions

Download all  tax forms View all 775 Federal Income Tax Forms


Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form 4876-A from the Internal Revenue Service in May 2017.

Show Sources >

Historical Past-Year Versions of Federal Form 4876-A

We have a total of four past-year versions of Form 4876-A in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2016 Form 4876-A

Form 4876-A (Rev. September 2016)

Election to be Treated as an Interest Charge DISC 2015 Form 4876-A

Form 4876-A (December 2009)

Election to be Treated as an Interest Charge DISC 2012 Form 4876-A

Form 4876-A (December 2009)

Election to be Treated as an Interest Charge DISC 2011 Form 4876-A

Form 4876-A (December 2009)


TaxFormFinder Disclaimer:

While we do our best to keep our list of Federal Income Tax Forms up to date and complete, we cannot be held liable for errors or omissions. Is the form on this page out-of-date or not working? Please let us know and we will fix it ASAP.

** This Document Provided By TaxFormFinder.org **
Source: http://www.taxformfinder.org/federal/form-4876-a