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Form 2553 Information
This Form will help us gather all information needed to submit Form 2553 with the IRS
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Email
*
Your email
Full Business Name. (if you're an LLC, please include the business name with the LLC after)
Your answer
Business Address Street:
Your answer
Business City or Town, State, and ZIP
Your answer
Employer Identification Number (The EIN is assigned by the IRS)
Your answer
Date incorporated or LLC was formed
MM
/
DD
/
YYYY
State of incorporation
Your answer
Your full legal name
Your answer
Your telephone number
Your answer
How many shareholders will the S Corp have?
1
2
3
4
5
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Full name(s) of the shareholder(s)
Your answer
Full address of the shareholder(s)
Your answer
Social security number(s) of the shareholder(s)
Your answer
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