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Form 5712 Election To Be Treated as a
(Rev. September 2000) Possessions Corporation Under Section 936 OMB No. 1545-0215
Department of the Treasury Do not attach to your tax return—file separately.
Internal Revenue Service

The corporation named below elects under section 936(e) of the Internal
Revenue Code to be treated as a possessions corporation for income tax purposes.
Name of corporation a Employer identification number

Number, street, and room or suite no. (If a P.O. box, see instructions) b Date of incorporation

City or town, state, and ZIP code c Place of incorporation

d Business code number e Principal business activity f Principal product or service

g Election takes effect for the tax h Date corporation began business in a U.S. possession i Annual return will be filed for the tax year ending
year beginning (month, day, year) (enter the month or “unknown”)

Description of each class of stock Number of shares of each class
issued and outstanding

Submit the following information for each shareholder who owns 10% or more of the issued and outstanding stock of any class:
Name of shareholder Identifying number Address Class of stock Number of shares owned

Under penalties of perjury, I declare that I have been duly authorized by the above-named corporation to make this election and that the statements made are, to the
best of my knowledge and belief, true, correct, and complete.

Signature and title of officer Date
For Paperwork Reduction Act Notice, see instructions on back. Cat. No. 12020I Form 5712 (Rev. 9-2000)

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Form 5712 (Rev. 9-2000) Page 2

Instructions Consolidated Returns
Section references are to the Internal Revenue Code. A corporation may not join in filing a consolidated return for
any year this election is in effect.
Purpose of Form
Business Classification
Form 5712 must be completed by domestic corporations
that elect to be treated as possessions corporations under See the Standard Industrial Classification Manual for the
section 936. proper code for the product or service. Enter the business
Important. The corporation must be an “ existing credit code number, principal business activity, and principal
claimant” in order to make this election. For details, see product or service.
Regulations section 1.936-11 and the Instructions for Form Address
5735.
If the Post Office does not deliver mail to the street address
Who Can Elect and the corporation has a P.O. box, show the box number
instead of the street address.
Only domestic corporations that are existing credit claimants
can elect to be treated as possessions corporations. Identifying Number
When To File For individuals, the identifying number is their social security
number. For all others, it is the employer identification
File Form 5712 by the due date (including extensions) of the number.
first return to which the election will apply.
Signature
Where To File
This form must be signed by the president, vice president,
File this form with the Internal Revenue Service Center, treasurer, assistant treasurer, chief accounting officer, or any
Philadelphia, PA 19255. File it separately from your regular other corporate officer (such as tax officer) authorized to
income tax return. sign.
U.S. Possessions
For purposes of this election, U.S. possessions include Paperwork Reduction Act Notice. We ask for the
Puerto Rico and the Virgin Islands. information on this form to carry out the Internal Revenue
laws of the United States. You are required to give us the
Period of Election information. We need it to ensure that you are complying
The election applies to the first tax year the election was with these laws and to allow us to figure and collect the right
made, and each subsequent tax year unless revoked, and for amount of tax.
each tax year the domestic corporation qualifies under You are not required to provide the information requested
section 936(a). on a form that is subject to the Paperwork Reduction Act
Generally, an election under section 936(a) may be revoked unless the form displays a valid OMB control number. Books
during the first 10 years of section 936 status only with the or records relating to a form or its instructions must be
consent of the Commissioner. After the 10th year, the retained as long as their contents may become material in
Commissioner’s consent is not needed. See section 936(e)(2) the administration of any Internal Revenue law. Generally, tax
for more details. Requests to revoke the election should be returns and return information are confidential, as required by
sent to the Internal Revenue Service, Attn: Director, Prefiling section 6103.
and Technical Guidance, Large and Mid-Size Business The time needed to complete and file this form will vary
Division (LM:PFTG), Mint Bldg, 3rd Floor, Room M3-443, depending on individual circumstances. The estimated
1111 Constitution Ave., NW, Washington, DC 20224. average time is:
Recordkeeping 4 hr., 32 min.
Other Forms That May Be Required Learning about the law or
Form 5712-A the form 35 min.
Preparing and sending the
Use Form 5712-A, Election and Verification of the Cost form to the IRS 42 min.
Sharing or Profit Split Method Under Section 936(h)(5), to
elect either the cost sharing method or the profit split If you have comments concerning the accuracy of these
method. These methods allow the possessions corporation time estimates or suggestions for making this form simpler,
to share either its costs or its profits with its affiliates. When we would be happy to hear from you. You can write to the
making either election, attach Form 5712-A to Schedule P Tax Forms Committee, Western Area Distribution Center,
(Form 5735). See Form 5712-A for more details. Rancho Cordova, CA 95743-0001. Do not send the form to
this address. Instead, see Where To File above.
Form 5735
For each year the election is in effect, Form 5735,
Possessions Corporation Tax Credit (Under Sections 936 and
30A) must be completed and attached to the corporation’s
income tax return.

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