REVOCATION OF “S” CORPORATION ELECTION: Corporation’s statement to District Director of Internal Revenue voluntarily revoking its “S” corporation election

District Director of Internal Revenue

                                                        [Address]

Re:                                                   [Name of corporation]

                                                        [Taxpayer Identification Number]

Revocation of S Corporation Election

Notice is given, pursuant to Section 1372(a) of the Internal Revenue Code, that _________[name of corporation], a _________[state] corporation with offices at _________[address], _________[city], _________[state], revokes its S corporation election filed with you on IRS Form 2553 dated _________.

The number of shares of the corporation’s stock (including non-voting stock) issued and outstanding at the time of this revocation are _________.

The first taxable year for which this revocation is intended to be effective is the corporation’s taxable year beginning _________[date].

Required shareholder consents to this revocation of election are attached.

Dated: _________.

[Signature of authorized corporate officer]

[Typed name and title]