Transcription of Form 1122 (Rev. December 2003)
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Authorization and Consent of Subsidiary CorporationTo Be included in a Consolidated Income Tax Return1122 form (Rev. December 2003 )Department of the TreasuryInternal Revenue ServiceFor the calendar year 20, or other tax year beginning , 20and ending, 20 NameEmployer identification numberNumber, street, and room or suite or town, state, and ZIP codeName of parent corporationEmployer identification numberThe subsidiary corporation named above authorizes its parentcorporation to include it in a consolidated return for the tax yearindicated and for each subsequent year the group must file aconsolidated return under the applicable regulations. If theparent corporation does not file a consolidated return onUnder penalties of perjury, I declare that the subsidiary named above has authorized me to sign this form on its behalf, that I have examined thisform and the information contained herein, and to the best of my knowledge and belief, it is true, correct, and of subsidiary officerForm 1122 (Rev.)
Authorization and Consent of Subsidiary Corporation To Be Included in a Consolidated Income Tax Return Form 1122 (Rev. December 2003) Department of the Treasury
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