Department of the Treasury-Internal Revenue Service                       In reply refer to
  Form 921-I                  Consent Fixing Period of Limitation on Assessment of 
  (April 2015)                                         Income and Profits Tax                                             Taxpayer Identification 
                                                                                                                          Number(s)
                             (S-Corporations, Partnerships, Limited Liability Companies, Trusts, Syndicates, Pools, Etc.) 
                                Estimated Future Expense Allowance for Real Estate Sales Under Contract
For income or profits tax purposes, the Commissioner of Internal Revenue has tentatively allowed

                                                        (Entity Name)
a                                                       with identifying numbers                                          , whose address is
(S-Corporation, Partnership, Limited Liability Company,                          (Taxpayer Identification Number)
Trust, Syndicate, Pool, Etc.)
                                                                                                                          , to consider in whole
                                (Number, Street, City or Town, State, ZIP Code)
or in part the allocable share of the estimated cost of future common improvements as part of the cost or other basis of 
certain real estate sold or otherwise disposed of under contract.
Real Estate Project covered by this consent agreement:

As a provision of this tentative allowance, the undersigned taxpayer,

                                                        (Name of Investor)
a                                                of the entity named above and the Commissioner of Internal Revenue agree that:
(Shareholder, Partner, Member, Beneficiary, Etc.)
The amount of federal income or profits tax due on any return filed by or for the taxpayer for tax year(s) ended

                                                                                                                          may be assessed
at any time before and up to one year after a return is filed for tax year ended                                                                  .
                                                                                 (Ending Date for Tax Year of Expected Project Completion)
A return filed before the expected project completion date shall be considered filed on the day prescribed above without 
regard to extensions. This consent agreement to extend the time to assess tax is limited to the assessment of deficiencies 
attributable to the use of the alternative cost method with respect to the real estate project described above. If a notice of 
tax deficiency is sent to the taxpayer by certified or registered mail on or before the date above, the time to assess income 
tax under this consent agreement is further extended by the assessment suspension period, plus 60 days.
             THIS CONSENT AGREEMENT DOES NOT DEPRIVE THE TAXPAYER(S) OF ANY  
               APPEAL RIGHTS TO WHICH THEY WOULD OTHERWISE BE ENTITLED
Your name (type or print)                               Your signature                                                         Date signed

Spouse’s name (type or print)                           Spouse’s signature                                                     Date signed

Taxpayer's representative’s name (type or print)        Taxpayer’s representative’s signature                                  Date signed

Entity name (S-Corporation, Partnership, Limited Liability Company, Trust, Syndicate, Pool, Etc.)

Entity officer’s name and title (type or print)                                Entity officer’s signature                      Date signed

Entity officer’s name and title (type or print)                                Entity officer’s signature                      Date signed

                                      INTERNAL REVENUE SERVICE SIGNATURE AND TITLE
IRS Official’s name - See Instructions (type or print)  IRS Official’s Title - See Instructions

IRS Official’s Signature - See Instructions                                                                                    Date signed

Catalog Number 31727W           (See back of form for signature instructions)    www.irs.gov                              Form 921-I (Rev. 4-2015)

                                                                                                                      Page 2

                                         Instructions for Taxpayer(s)
This form should be used by investors in the electing S-Corporation, Partnership, Limited Liability Company, Trust, 
Syndicate, Pool, etc.  that are not subject to unified audit and litigation procedures for TEFRA (Tax Equity &Fiscal 
Responsibility Act) partnerships.  
  
Please sign and return the original and copy of Form 921-I , Consent Fixing Period of Limitation On Assessment of 
Income and Profits Tax,  to apply for an extension according to Revenue Procedure 92-29 and its successors.  
  
Form 921 must be signed by each partner/shareholder/beneficiary or their authorized representative.  If you’re an 
individual and this consent form includes tax years where a joint return was filed, the signature of both husband and wife 
is required. One spouse may sign as agent for the other, if acting under an authorized power of attorney.  
  
If you’re an attorney or agent for the taxpayer(s), you may sign the consent form provided the action is specifically 
authorized by a power of attorney. If you haven’t filed a power of attorney, please include it with this form. If you’re acting 
as a fiduciary (executor, administrator, trustee, etc.) you must include a completed Form 56, Notice ConcerningFiduciary 
Relationship, if you haven't already filed one.  
  
If the investor is a corporation or a multiple-owned entity, the shareholder/partner/member/ beneficiary/officer(s) duly 
authorized to sign on behalf of the entity must sign the consent. Include the name and entity type and the name, 
signature, name and title of the officer(s)/signer(s). It isn't necessary to affix a seal, unless the entity is required by charter 
or by law of jurisdictions to affix the seal in the execution of instruments.  
  
Investors in electing entities that fall under TEFRA requirements must use Form 921-P.

                            Instructions for Internal Revenue Service Employees
Complete the delegated IRS official’s name and title of the employee who is signing the form on behalf of the IRS. 
 
An IRS official delegated authority under Delegation Order 25-2 must sign and date the consent. (IRM 1.2.52.3) 

Catalog Number 31727W                                   www.irs.gov                                  Form 921-I (Rev. 4-2015