Election To Be Treated as a

Possessions Corporation Under Section 936

Form 5712

OMB No. 1545-0215 (Rev. September 2000)

Department of the Treasury

Internal Revenue Service

Do not attach to your tax return—file separately.

The corporation named below elects under section 936(e) of the Internal

Revenue Code to be treated as a possessions corporation for income tax purposes.

Name of corporation a Employer identification number

Number, street, and room or suite no. (If a P.O. box, see instructions) b Date of incorporation

City or town, state, and ZIP code c Place of incorporation

d Business code number e Principal business activity f Principal product or service

h Date corporation began business in a U.S. possession Annual return will be filed for the tax year ending

(enter the month or “unknown”)

g Election takes effect for the tax i

year beginning (month, day, year)

Number of shares of each class

issued and outstanding Description of each class of stock

Submit the following information for each shareholder who owns 10% or more of the issued and outstanding stock of any class:

Name of shareholder Identifying number Address Class of stock Number of shares owned

Under penalties of perjury, I declare that I have been duly authorized by the above-named corporation to make this election and that the statements made are, to the

best of my knowledge and belief, true, correct, and complete.

Signature and title of officer Date

For Paperwork Reduction Act Notice, see instructions on back. Cat. No. 12020I Form 5712 (Rev. 9-2000)
Form 5712 (Rev. 9-2000) Page 2

Generally, an election under section 936(a) may be revoked

during the first 10 years of section 936 status only with the

consent of the Commissioner. After the 10th year, the

Commissioner’s consent is not needed. See section 936(e)(2)

for more details. Requests to revoke the election should be

sent to the Internal Revenue Service, Attn: Director, Prefiling

and Technical Guidance, Large and Mid-Size Business

Division (LM:PFTG), Mint Bldg, 3rd Floor, Room M3-443,

1111 Constitution Ave., NW, Washington, DC 20224.

Instructions

Section references are to the Internal Revenue Code.

Paperwork Reduction Act Notice. We ask for the

information on this form to carry out the Internal Revenue

laws of the United States. You are required to give us the

information. We need it to ensure that you are complying

with these laws and to allow us to figure and collect the right

amount of tax.

Form 5712-A

Use Form 5712-A, Election and Verification of the Cost

Sharing or Profit Split Method Under Section 936(h)(5), to

elect either the cost sharing method or the profit split

method. These methods allow the possessions corporation

to share either its costs or its profits with its affiliates. When

making either election, attach Form 5712-A to Schedule P

(Form 5735). See Form 5712-A for more details.

The time needed to complete and file this form will vary

depending on individual circumstances. The estimated

average time is:

Recordkeeping 4 hr., 32 min.

Learning about the law or

the form 35 min.

Preparing and sending the

form to the IRS 42 min.

Form 5735

For each year the election is in effect, Form 5735,

Possessions Corporation Tax Credit (Under Sections 936 and

30A) must be completed and attached to the corporation’s

income tax return.

If you have comments concerning the accuracy of these

time estimates or suggestions for making this form simpler,

we would be happy to hear from you. You can write to the

Tax Forms Committee, Western Area Distribution Center,

Rancho Cordova, CA 95743-0001. Do not send the form to

this address. Instead, see Where To File above.

Consolidated Returns

A corporation may not join in filing a consolidated return for

any year this election is in effect.

Business Classification

See the Standard Industrial Classification Manual for the

proper code for the product or service. Enter the business

code number, principal business activity, and principal

product or service.

Who Can Elect

Only domestic corporations that are existing credit claimants

can elect to be treated as possessions corporations.

When To File

File Form 5712 by the due date (including extensions) of the

first return to which the election will apply.

Address

If the Post Office does not deliver mail to the street address

and the corporation has a P.O. box, show the box number

instead of the street address.

Where To File

File this form with the Internal Revenue Service Center,

Philadelphia, PA 19255. File it separately from your regular

income tax return.

Identifying Number

For individuals, the identifying number is their social security

number. For all others, it is the employer identification

number.

U.S. Possessions

For purposes of this election, U.S. possessions include

Puerto Rico and the Virgin Islands.

Signature

This form must be signed by the president, vice president,

treasurer, assistant treasurer, chief accounting officer, or any

other corporate officer (such as tax officer) authorized to

sign.

Period of Election

The election applies to the first tax year the election was

made, and each subsequent tax year unless revoked, and for

each tax year the domestic corporation qualifies under

section 936(a).

Purpose of Form

Form 5712 must be completed by domestic corporations

that elect to be treated as possessions corporations under

section 936.

You are not required to provide the information requested

on a form that is subject to the Paperwork Reduction Act

unless the form displays a valid OMB control number. Books

or records relating to a form or its instructions must be

retained as long as their contents may become material in

the administration of any Internal Revenue law. Generally, tax

returns and return information are confidential, as required by

section 6103.

Important. The corporation must be an “ existing credit

claimant” in order to make this election. For details, see

Regulations section 1.936-11 and the Instructions for Form

5735.

Other Forms That May Be Required