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   REV-976 (TR) 12-19

                                                                                                  ELECTION NOT TO BE TAXED AS 
                                                                                                  A PENNSYLVANIA S CORPORATION
              PO BOX 280901 
              HARRISBURG PA 17128-0901 

                                                                                                                                                                                                                       Corporation is not subject to PA corporate 
                                                                                                                                                                                                                  net income tax; election is for PA resident 
START                                                                                                                                                                                                             shareholder purposes only.
Ü                                                                                                                                                                                                                 Revenue ID 

                                                                                                                                                                                                                  Federal Employer Identification Number (FEIN) 

                                                                                                                                                                                                                  Pennsylvania Department of State Entity Number 

                                                                                                                                                                                                                       Election is to be first effective for: 
                                                                                                                                                                                                                  Tax year beginning:               MMDDYYYY  
        Please fill in Corporate Name, Address, City, State and ZIP Code above. 
                                                                                                                                    Election is for this corporation and its qualified subchapter S subsidiaries 
              as identified on the included schedule showing the names and                                                                                                                                        Tax year ending:                    MMDDYYYY
              Revenue ID numbers of all subsidiaries.
(A)Name and address of each shareholder, member or partner having an                                                            (B)Social Security                                                                (C)         (D)     We, the undersigned  
 interest in the corporation’s stock without regard to the manner in which                                                                                    Number or Federal                                   Percentage        shareholders, consent to the  
                                                                                                                                                                Employer                                               of       election of the corporation not  
 the stock is owned. If additional space is needed, complete a separate                                                                                       Identification                                           Stock          to be taxed as a  
 schedule and include it with this form.                                                                                                                        Number                                                 Owned Pennsylvania S corporation.
                                                                                           You must provide your Social Security number so the department may 
 establish your identity and cross-reference other tax systems, as is 
 authorized under federal law, 42 U.S.C. § 405 (c).
Name                                                                                                                                                                                                                          Signature/Date   MMDDYYYY
Street                                                   City                                     State          ZIP Code 
                                                                                                                                                                                                                              Please Sign after printing.
Name                                                                                                                                                                                                                          Signature/Date   MMDDYYYY
Street                                                   City                                     State          ZIP Code 
                                                                                                                                                                                                                              Please Sign after printing.
Name                                                                                                                                                                                                                          Signature/Date   MMDDYYYY
Street                                                   City                                     State          ZIP Code 
                                                                                                                                                                                                                              Please Sign after printing.
Name                                                                                                                                                                                                                          Signature/Date   MMDDYYYY
Street                                                   City                                     State          ZIP Code 
                                                                                                                                                                                                                              Please Sign after printing.
Name                                                                                                                                                                                                                          Signature/Date   MMDDYYYY
Street                                                   City                                     State          ZIP Code 
                                                                                                                                                                                                                              Please Sign after printing.
Name                                                                                                                                                                                                                          Signature/Date   MMDDYYYY
Street                                                   City                                     State          ZIP Code 
                                                                                                                                                                                                                              Please Sign after printing.
Name                                                                                                                                                                                                                          Signature/Date   MMDDYYYY
Street                                                   City                                     State          ZIP Code 
                                                                                                                                                                                                                              Please Sign after printing.
Name                                                                                                                                                                                                                          Signature/DateMMDDYYYY
Street                                                   City                                     State          ZIP Code      
                                                                                                                                                                                                                              Please Sign after printing.
 
                                                                                                                                                                                                                  Total = _____ 100%
The corporate statement must be signed by an authorized officer of the corporation. The                                                                        NAME OF CORPORATE OFFICER                     TELEPHONE NUMBER 
above-named corporation hereby elects not to be taxed as a Pennsylvania S corporation 
under Section 401 of the Tax Reform Code of 1971.                                                                                                             Á SIGNATURE AND TITLE 
Under penalties of perjury, I declare that I have examined this Election Not To Be                                                                                                                                           Please Sign after printing.
Taxed As A Pennsylvania S Corporation, and to the best of my knowledge and                                                                                     SOCIAL SECURITY NUMBER                             DATE
belief it is true, correct and complete.                                                                                                                                                                                                       MMDDYYYY

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                                                                    Pennsylvania Department of Revenue 

                                                                    Instructions for REV-976 
REV-976 IN (TR) 12-19                           Election Not to be Taxed as a Pennsylvania S Corporation  

                                                               the PA Department of Revenue. The PA-40ESR (F/C) 
         GENERAL INFORMATION                                   form can be downloaded from the department’s website 
Federal subchapter S corporations are no longer required       at www.revenue.pa.gov or ordered by telephone at 
to file the REV-1640, Pennsylvania S Corporation Election      1-888-P      ATAXES (728-2937). 
and Shareholders’ Consent, in order to be granted 
Pennsylvania S corporation status. Effective for tax years               QUALIFIED SUBCHAPTER 
beginning after Dec. 31, 2005, any corporation with a valid 
                                                                                   S SUBSIDIARIES 
federal subchapter S corporation election will automatically                                                              
be a Pennsylvania S corporation. Any federal subchapter S      If a qualified subchapter S subsidiary and/or parent of a 
corporation that does not desire to be a Pennsylvania S        qualified subchapter S subsidiary, does not desire to be 
corporation must file REV-976, Election Not to be Taxed as     taxed as a Pennsylvania S corporation, the parent must 
a Pennsylvania S Corporation, on or before the due date or     file REV-976 for itself and all qualified subchapter S sub-
extended due date of the RCT-101, PA Corporate Net             sidiaries. The corporation must include a schedule with the 
Income Tax Report, for the first tax period in which the elec- election identifying the name, address, Revenue ID and 
tion is to be in effect. This election must be signed by 100   federal employer identification number of each qualified 
percent of the shareholders of the S corporation and once      subchapter S subsidiary owned by the corporation and 
made cannot be revoked for five years. RCT-101 is due 30       doing business in Pennsylvania. 
days after the federal return. 
  CAUTION: In cases where the taxpayer must file 
  short period federal returns in relation to making the            PA RESIDENT SHAREHOLDERS 
                                                                    OF SUBCHAPTER S CORPORATIONS 
election, the RCT-101 and REV-976 are due on the 30th           
day following the due date of the applicable federal return.                IN ANOTHER STATE
                                                                                                                          
In the case of a federal subchapter S corporation not          Any federal subchapter S corporation that does not make this 
required to file RCT-101, does not do business in PA and is    election, and which does not do business nor is registered 
not registered to do business in PA, REV-976 must be filed     to do business in PA but has a PA resident shareholder, will 
30 days after the due date of the federal return (the due      be taxed as a Pennsylvania S corporation and will be 
date of RCT-101 if the corporation is required to file this    required to file PA-20S/PA-65. In addition, each resident 
report).                                                       shareholder will be subject to Pennsylvania personal 
  NOTE: Subchapter S corporations are only required to         income tax on each shareholder’s pro rata share of the S 
  file RCT-101 for tax years when they have built-in gains.    corporation income, whether distributed or not. 
Any federal subchapter S corporation doing business in 
Pennsylvania or registered to do business in PA that does                   FILING THE ELECTION                           
not make this election will be taxed as a Pennsylvania S       For a federal subchapter S corporation conducting busi-
corporation and will be required to file PA-20S/PA-65, PA S    ness in Pennsylvania that is required to file RCT-101: The 
Corporation/Partnership Information Return. In addition,       due date for filing REV-976 is the due date or the extended 
each resident shareholder is subject to Pennsylvania per-      due date of RCT-101 for the first year for which the election 
sonal income tax on each shareholder’s pro rata share of       is to be in effect. 
the S corporation income, whether distributed or not. Each 
nonresident shareholder is subject to tax on the sharehold-    For a federal subchapter S corporation that is not required 
er’s personal income from sources within PA. Filing the        to file RCT-101, (does not do business in PA and is not 
RCT-101 is not required unless the corporation has federal     registered to do business in PA): The due date for filing 
taxable built-in gains.                                        REV-976 is 30 days after the due date or the extended due 
                                                               date of the federal return. These corporations must check 
Partnership returns and Pennsylvania S corporations with       the box indicating “Corporation is not subject to PA 
taxable PA-sourced income are jointly liable with their non-   Corporate Net Income Tax; election is for PA resident 
resident partners and shareholders for payment of tax on       Shareholder purposes only”. 
such income to the extent allocable to the nonresidents.  
Partnerships and S corporations are authorized and required    The REV-976 must be signed by 100 percent of the share-
to withhold this tax from its nonresident owners and remit     holders on the date of the election and sent via Fax or 
the tax to the PA Department of Revenue. The department        Email to: 
accepts through the MeF Fed/State program the electronic       Fax:717-787-3708 
payment of the quarterly estimated withholding tax for non-    Email:ra-btftregisfax@pa.gov 
resident owners filed with the PA65ES. Payments may be 
remitted with the PA-40ES (F/C) found on the department's           DO NOT SEND WITH THE PA CORPORATE 
website with a check or money order made payable to                         NET INCOME TAX REPORT

www.revenue.pa.gov                                                                                       REV-9761
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