Free CT-6 (Fill-in) - New York

CT-6
(7/08)
Employer identification number

New York State Department of Taxation and Finance

Election by a Federal S Corporation to be Treated As a New York S Corporation
This election is to be effective for the tax year beginning (mm-dd-yy) For office use only

Legal name of corporation

Mark an X in the box if federal election is pending.................. Telephone number

Date received

Mailing address

DBA or trade name (if any)

(
Mailing name (if different from legal name)

)

State of incorporation Date of incorporation

c/o
Number and street or PO box

Date began business in New York State

City

State

ZIP code

Number of shares issued and outstanding

The federal election to treat the corporation as an S corporation is effective for the tax year beginning

Total number of shareholders

Number of shareholders who are nonresidents of New York State

Indicate the month and day your tax year ends Shareholders' unanimous consent and individual affirmation: By signing below each shareholder of the above corporation elects to include all amounts required by Tax Law, Article 22, section 660, in computing his or her New York taxable income and certifies that the personal information given below is to the best of his or her knowledge and belief true, correct, and complete. See instructions if a continuation sheet or a separate consent statement is needed.
A Name and address of each shareholder
(include ZIP code)

B Social security number or employer identification number

C Stock owned Number of Date shares acquired

D Shareholder's signature (see instructions) For this election to be valid, all shareholders must signify consent by signing below.

Certification: I certify that this election and any attachments are to the best of my knowledge and belief true, correct, and complete. Authorized person Paid preparer use only
Signature of authorized person E-mail address of authorized person Telephone number ( ) Address City Official title Date ID number State Date ZIP code

Firm's name (or yours if self-employed) Signature of individual preparing this election E-mail address of individual preparing this election

See instructions for where to file.