TO: District Director

Internal Revenue Service

__________(1)____________

Notice is hereby given, pursuant to Section 1362 of the Internal Revenue Code, that ___________(2)_____________, a ______(3)_______ corporation with offices at __________(4)______, hereby revokes its S corporation election, filed with you on _______(5)_________, 19__(6)_. The first taxable year for which this revocation is intended to be effective is the taxable year commencing _______(7)__________, 19_(8)_.

Dated ___________(9)______________, 19_(10)_.

____________(11)_______________

BY:____________(12)____________ as

President of the corporation

SHAREHOLDERS' CONSENT TO REVOCATION OF ELECTION

We, the undersigned, being more than one-half of the shareholders of __________(13)________ at the beginning of the day on which the revocation of S Corporation election to which this consent is attached was filed with the District Director of Internal Revenue at ________(14)___________, hereby consent to such revocation.

Dated _________(15)___________, 19_(16)_.

Number of

Name and Address Shares Owned Signature

________(17)_________ ____(18)____ _____(19)_____

________(20)_________ ____(21)____ _____(22)_____

________(23)_________ ____(24)____ _____(25)______

The information in this document is designed to provide an outline that you can follow when formulating business or personal plans. Due to the variances of many local, city, county and state laws, we recommend that you seek professional legal counseling before entering into any contract or agreement.