INTERNAL REVENUE SERVICE

RETURN OF INFORMATION AND AUTHORIZATION AND CONSENT OF
SUBSIDIARY CORPORATION INCLUDED IN A CONSOLIDATED
INCOME TAX RETURN

U. 8, TREASURY DEPARTMENT UNITED STATES 1 9 49

For Calendar Year 1949
, 1949, and ending

1949, and ending .

Or fiscal year beginning -

Or for period beginning .

If the return is for calen- PRINT PLAINLY CORPORATION’S NAME AND BUSINESS ADDRESS Serial
dar year 1949, file it on or — -
before March 15, 1950, ‘| ---------------------——-----n=-- === Date Received
If the return is for a
fiscal year, file it on or| _ . _. _. _.
before the 15th day of the} ” (Street and number)
third month following the
lose of the fiscal year. —_

(Name of subsidiar

(City or town, postal zone number) (State)

(1) Date incorporated —.. _.. Under laws of State of —_____.
(2) Capital stock outstanding at beginning of taxable year: (a) Com., $.-- (b) Pref., $_..-— _

(8) Kind of business ———----_-_------------------- Active or inactive

(4) Name of common parent corporation a _- - a
(Give name of corporation which filed the consolidated income tax return for the entire affiliated group)

(5) Address of common parent corporation

(6) Internal revenue district in which consolidated return is filed —
(Give distriet or city and State)
The above-named subsidiary corporation hereby authorizes the above-named common parent corporation

(or in the event of its failure, the Commissioner or the collector) to make a consolidated income tax return
on its behalf for the taxable year for which this form is filed, and for each taxable year thereafter that a con-
solidated return must be made under the provisions of the consolidated income tax regulations.

The above-named subsidiary corporation, in consideration of the privilege of joining in the making of a
consolidated return with the above-named common parent corporation, hereby consents to and agrees to be
bound by the provisions of the above-mentioned regulations. This consent is applicable to the taxable year for
which this form is filed and to each taxable year thereafter that a consolidated return must be made under
the provisions of the consolidated income tax regulations.

DECLARATION
We, the undersigned, president (or vice president or other principal officer) and treasurer (or assistant
treasurer or chief accounting officer) of the above-named subsidiary corporation, each for himself declares
under the penalties of perjury that the above-named subsidiary has authorized him to sign this form on its
behalf, and that this form has been examined by him and the information contained herein is, to the best of
his knowledge and belief, a true, correct, and complete return of information, made in good faith, pursuant to
the Internal Revenue Code and the regulations issued thereunder.

(President or other principal officer) (State title)
(Treasurer, Assistant Treasurer, or Chief Accounting Officer) “(State tite)
CORPORATE
SEAL
INSTRUCTIONS

Two duplicate originals of this form must be prepared by each subsidiary corporation. Each form must
be signed under the corporate seal. One of these forms shall be forwarded to the common parent corporation
to be filed with the consolidated income tax return; and the other filed, at or before the time the consolidated
income tax return is filed, in the office of the collector for the district prescribed for the filing of a separate
return by the subsidiary.

(Forward this form to the common parent corporation to be filed with the consolidated return)
16508561 _U. §. GOVERNMENT PRINTING OFFICE




INTERNAL REVENUE SERVICE
RETURN OF INFORMATION AND AUTHORIZATION AND CONSENT OF
SUBSIDIARY CORPORATION INCLUDED IN A CONSOLIDATED
INCOME TAX RETURN

U. 8, TREASURY DEPARTMENT UNITED STATES 1 9 49

For Calendar Year 1949

Or fiscal year beginning .....
Or for period beginning

If the return is for calen-
dar year 1949, file it on or
before March 15, 1950.

If the return is for a
fiscal year, file it on or _ _ oe
before the 15th day of the (Street and number)
third month following the
close of the fiscal year.

"(Name of subsidiary)

..-_ Under laws of State of
(2) Capital stock outstanding at beginning of taxable year: (a) Com., $.
(8) Kind of business —.
(4) Name of common parent corporation -...

(Give name of corporation which filed the consolidated income tax return for the entire affiliated group)
(5) Address of common parent corporation ~

(1) Date incorporated _...

(b) Pref., §.

... Active or inactive _.

(6) Internal revenue district in which consolidated return is filed __.

(Give district or city and State

The above-named subsidiary corporation hereby authorizes the above-named common parent corporation
(or in the event of its failure, the Commissioner or the collector) to make a consolidated income tax return
on its behalf for the taxable year for which this form is filed, and for each taxable year thereafter that a con-
solidated return must be made under the provisions of the consolidated income tax regulations.

The above-named subsidiary corporation, in consideration of the privilege of joining in the making of a
consolidated return with the above-named common parent corporation, hereby consents to and agrees to be
bound by the provisions of the above-mentioned regulations, This consent is applicable to the taxable year for
which this form is filed and to each taxable year thereafter that a consolidated return must be made under
the provisions of the consolidated income tax regulations.

DECLARATION
We, the undersigned, president (or vice president or other principal officer) and treasurer (or assistant
treasurer or chief accounting officer) of the above-named subsidiary corporation, each for himself declares
under the penalties of perjury that the above-named subsidiary has authorized him to sign this form on its
behalf, and that this form has been examined by him and the information contained herein is, to the best of
his knowledge and belief, a true, correct, and complete return of information, made in good faith, pursuant to
the Internal Revenue Code and the regulations issued thereunder.

(State title)

(State title)

CORPORATE
‘SEAL

INSTRUCTIONS
Two duplicate originals of this form must be prepared by each subsidiary corporation. Each form must
be signed under the corporate seal. One of these forms shall be forwarded to the common parent corporation
to be filed with the consolidated income tax return; and the other filed, at or before the time the consolidated
income tax return is filed, in the office of the collector for the district prescribed for the filing of a separate
return by the subsidiary.

(File this form with the collector for the district in which the subsidiary has its principal office or place of business)
16—50856-1 _U. 8. GOVERNMENT PRINTING OFFICE