S Election Engagement

S Election Engagement for Form 2553

Please complete and submit the form below to be redirected to our engagement agreement which you may then review and sign electronically.

Name of Business Entity*
Employer Identification Number (EIN) of Business Entity*
Date of Incorporation*
State of Incorporation*
State
Date S Election to be Effective*
Name Legal Representative*
First Last
Title of Legal Representative*
Such as CEO or President
Phone*
Email*
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
S Corporation Shareholders
Complete the following fields for each shareholder.
Shareholder #1*
First Last
Shareholder #1's Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Social Security Number*

Social Security Number
Percentage of Ownership (%)*

Percentage of Ownership (%)
Shareholder #2 (Optional)
First Last
Shareholder #2's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Social Security Number

Social Security Number
Percentage of Ownership (%)

Percentage of Ownership (%)
Shareholder #3 (Optional)
First Last
Shareholder #3's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Social Security Number

Social Security Number
Percentage of Ownership (%)

Percentage of Ownership (%)
Additional Shareholders (Optional)
To add additional Shareholders, include the information requested above in the following field for all additional Shareholders:

Beverly Hills Office:
9025 Wilshire Blvd, Suite 301
Beverly Hills, CA 90211

Encino Office:
16030 Ventura Blvd, Suite 490
Encino, CA 91436

Phone: (310) 800-1472
eFax: (310) 496-2565