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Dollar Election Under Section 985
Form 8819 OMB No. 1545-0123
(Rev. September 2017) ▶ File Form 8819 separately from your income tax return. See instructions.
Department of the Treasury
Internal Revenue Service ▶ Go to www.irs.gov/Form8819 for the latest information.
Name of corporation making election Employer identification number

Number, street, and room or suite no. (If a P.O. box, see instructions.) Tax year for which dollar election is
effective
City or town, state, and ZIP code

1 Check the applicable box to indicate who is making the dollar election under
Regulations section 1.985-1(b)(2)(ii)(B)(2):
a A noncontrolled section 902 corporation to elect the U.S. dollar as its (or its QBU branch’s) functional currency.
b The majority domestic corporate shareholders of a noncontrolled section 902 corporation to elect the U.S. dollar as the
corporation’s (or the corporation’s QBU branch’s) functional currency.

2a Name of noncontrolled section 902 corporation (do not complete if same as filer above) b Country of organization or creation

c Country where the principal place of business of the noncontrolled section 902 corporation is located and country of each of
its QBU branches. Attach additional sheets if necessary.

3 Enter the information requested below (see instructions). Attach additional sheets if necessary.

(d) Percent of stock
(a) Name of shareholder (b) Address (street number, P.O. (c) Identifying number owned in each class
box, city or town, state, and ZIP code)
Common Preferred 1 Preferred 2

4 Enter the names, addresses, and identifying numbers of all persons that are related to the noncontrolled section 902
corporation who are eligible QBUs (within the meaning of Regulations section 1.985-2(b)(1)) or that have a branch that is an
eligible QBU. Attach additional sheets if necessary.
Name Address Identifying number

5 Enter the name, address, and identifying number of every domestic corporate shareholder notified of the dollar election as
required by Regulations section 1.985-2(c)(3)(i). Attach additional sheets if necessary.
Name Address Identifying number

Under penalties of perjury, I declare that I have examined this form and to the best of my knowledge and belief, it is true, correct, and complete.

Signature Title (if any) Date (MM/DD/YYYY)
For Paperwork Reduction Act Notice, see instructions. Cat. No. 10850K Form 8819 (Rev. 9-2017)

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Form 8819 (Rev. 9-2017) Page 2

Future Developments Specific Instructions
For the latest information about developments related to Address. Include the suite, room, or other unit number
Form 8819 and its instructions, such as legislation after the street address. If the post office does not deliver
enacted after they were published, go to mail to the street address and the filer has a P.O. box,
www.irs.gov/Form8819. show the box number instead of the street address.
Line 3. If the box on line 1a is checked, enter the name,
General Instructions address, identifying number, and percentage of stock
Section references are to the Internal Revenue Code owned (as defined in section 902(b)) in each class of
unless otherwise noted. stock for each domestic corporate shareholder.
If the box on line 1b is checked, enter the name,
Purpose of Form
address, identifying number, and the percentage of stock
Form 8819 is filed by or on behalf of a noncontrolled owned (within the meaning of section 958(a)) in each
section 902 corporation (defined in section 904(d)(2)(E)) class of stock for each domestic corporate shareholder
operating in a hyperinflationary environment that elects (as described in section 902(a)) making the election.
the U.S. dollar as its (or its qualified business unit (QBU)
branch’s) functional currency. Paperwork Reduction Act Notice. We ask for the
information on this form to carry out the Internal Revenue
Who Must File
laws of the United States. You are required to give us the
• If an election is made by a noncontrolled section 902 information. We need it to ensure that you are complying
corporation, Form 8819 must be filed by an authorized with these laws and to allow us to figure and collect the
officer or director of the corporation. right amount of tax.
• If the election is made on behalf of a noncontrolled You are not required to provide the information
section 902 corporation or branch of a noncontrolled requested on a form that is subject to the Paperwork
foreign corporation, Form 8819 must be filed by each of Reduction Act unless the form displays a valid OMB
the majority domestic corporate shareholders (as defined control number. Books or records relating to a form or its
in Regulations section 1.985-2(c)(3)). instructions must be retained as long as their contents
Signature. If there is not enough space for all required may become material in the administration of any Internal
filers to sign Form 8819, attach a sheet showing each Revenue law. Generally, tax returns and return
additional signature, that person’s title, if any, and the information are confidential, as required by section 6103.
date signed. The attachment must be signed under The time needed to complete and file this form will vary
penalties of perjury. depending on individual circumstances. The estimated
burden for business taxpayers filing this form is approved
When and Where To File under OMB control number 1545-0123.
File Form 8819 within 180 days after the end of the tax If you have comments concerning the accuracy of
year for which the dollar election is made. Send it to the these time estimates or suggestions for making this form
following address. simpler, we would be happy to hear from you. You can
Internal Revenue Service send us comments from www.irs.gov/FormComment. Or
P.O. Box 409101 you can write to the Internal Revenue Service, Tax Forms
Ogden, UT 84409 and Publications, 1111 Constitution Ave. NW, IR-6526,
Washington, DC 20224. Don’t send the form to this
office. Instead, see When and Where To File, earlier.

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