Member Consent to the Revocation of S Corp Election for
________LLC
Name of LLC: LLC Address: Employer Identification Number: Name of Member: Member's Address: Member's Social Security Number: Amount of Ownership Interest Owned & Dates Acquired: Pursuant to IRC § 1362(d), I, __________ , hereby consent to the revocation of the S corporation election pursuant to IRC § 1362(a) by _______ LLC effective ________. Under penalties of perjury, I declare that the facts presented in this member consent to the revocation of S Corp election are, to the best of my knowledge, true, correct, and complete. __________________ Member ___________ Date
Community Property Ownership add: Name of Member's Spouse: Address of Member's Spouse: Social Security Number of Spouse: Pursuant to IRC § 1362(d), the ownership interests shown above are community property. I hereby consent to the revocation of the S Corp election pursuant to IRC § 1362(a) by ________ LLC, effective ___________________. Married member, no joint ownership, and not community property, add: Name of Member's Spouse: Address of Member's Spouse: Social Security Number of Spouse: The shares shown above are not community property. Nevertheless, if I have any interest in the shares, pursuant to IRC § 1362(d), I hereby consent to the revocation of the S Corp election pursuant to IRC § 1362(a) by _______ LLC, effective ___________. Under penalties of perjury, I declare that the facts presented in this consent to the revocation of S Corp election are, to the best of my knowledge, true, correct, and complete. ____________________ Signature ____________ Date