Elections Under Section 338 for 
Form   8023                   Corporations Making Qualified Stock Purchases                                                         OMB No. 1545-0123
(Rev. November 2016)
                                                        ▶  
Department of the Treasury                                 See separate instructions. 
Internal Revenue Service    ▶ Information about Form 8023 and its separate instructions is at www.irs.gov/form8023.

                                           Section A-1—Purchasing Corporation 

1a  Name and address of purchasing corporation                                                   1b  Employer identification number 

                                                                                                 1c  Tax year ending 1d  State or country of incorporation 

                                   Section A-2—Common Parent of the Purchasing Corporation 

2a  Name and address of common parent of purchasing corporation                                  2b  Employer identification number 

                                                                                                 2c  Tax year ending 2d  State or country of incorporation 

                                                   Section B—Target Corporation 

3a  Name and address of target corporation                                                       3b  Employer identification number 

                                                                                                 3c  Tax year ending 3d  State or country of incorporation 

                            Section C—Common Parent of Selling Consolidated Group, Selling Affiliate,   
                                   S Corporation Shareholder, or U.S. Shareholder 
Complete only for a section 338(h)(10) election or if target was a member of a consolidated group or a controlled foreign corporation (CFC)   
or had been a CFC within the preceding five years. 

4a  Name and address of common parent of the selling consolidated group,                         4b  Identifying number(s) 
      selling affiliate, U.S. shareholder(s) of foreign target corporation, or                   
      S corporation shareholder(s) 
                                                                                                 4c  Tax year ending 

                                                   Section D—General Information 
5a  Acquisition date                               5b   What percentage of target corporation stock was purchased: 
                                                   (i)    During the 12-month acquisition period?                          % 
                                                   (ii)   On the acquisition date?                   % 
For Paperwork Reduction Act Notice, see separate instructions.                                   Cat. No. 49972Z                    Form 8023 (Rev. 11-2016) 

Form 8023 (Rev. 11-2016)                                                                                                                                                Page 2 
                                                          Section E—Elections Under Section 338 
6 Check here to make a section 338(h)(10) election for the target corporation listed in Section B on page 1  .         . . . .   . .                             .   .   ▶
7 Check here to make a section 338 election (other than a section 338(h)(10) election) for the target corporation listed in Section B 
  on page 1  .  .        . . . .         . . .            . . . .  . . . .    . . .                . . .   . . . . . . . . . .   . .                             .   .   ▶
8 If the box on line 7 is checked for the target corporation listed in Section B on page 1, check here to make a gain recognition election  for 
  that corporation. See instructions  .      .            . . . .  . . . .    . . .                . . .   . . . . . . . . . .   . .                             .   .  ▶
9 Check here if this form is filed to make a section 338 election for any target corporation in addition to the one listed in Section B 
  on  page 1  . .        . . . .         . . .            . . . .  . . . .    . . .                . . .   . . . . . . . . . .   . .                             .   .   ▶
Purchasing Corporation(s) Signature(s) 
Under penalties of perjury, I state and declare that I am authorized to make the election(s) on lines 6, 7, 8, and 9 on behalf of the purchasing corporation(s). 

▲                                                                                                  ▲

  Signature of authorized person for purchasing corporation(s)           Date                        Title 
Consolidated Selling Group or Selling Affiliate Signature (Section 338(h)(10) Election) 
Under penalties of perjury, I state and declare that I am authorized to make the section 338(h)(10) election on line 6 on behalf of the common parent of the selling 
consolidated group or on behalf of the selling affiliate. 

▲                                                                                                  ▲

  Signature of authorized person for the common parent or selling        Date                        Title 
  affiliate 

S Corporation Shareholder(s) Signature(s) (Section 338(h)(10) Election) 
Under penalties of perjury, I state and declare that I am a shareholder of the S corporation target or that I am authorized to make the section 338(h)(10) election on  line 6 on 
behalf of that shareholder. If more than one shareholder, attach a schedule with other signatures. 

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  Signature of S corporation shareholder                                 Date                        Title 

                                                                                                                           Form  8023  (Rev. 11-2016)