Form Cat Es - Request To Change Election Status
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1
2CAT ES
Rev. 3/13
Reset Form
Request to Change
Please do not
Election Status
use staples.
CAT account number
FEIN/SSN
Date of original consolidation
Eff. date of change request
M
M
D D
Y Y
M
M
D D
Y Y
Use only UPPERCASE letters.
Reporting member's name
Section 1 – Change in Status
You must attach a complete organizational chart (including percentages of ownership between all entities) showing the
business structure that refl ects its common owner for purposes of the CAT. The chart must comply with R.C. 5751.011, R.C.
5751.012 and O.A.C. 5703-29-02.
1. New taxpayer type: (Check only one)
Consolidated elected at 80%
Consolidated elected at 50%
Combined
Single
By checking either consolidated box above, the group hereby elects to fi le a consolidated return. Any consolidated election will
remain in effect for eight calendar quarters and is automatically renewed unless cancelled by the registrant prior to the expiration
of the eight calendar quarters.
Existing consolidated elected taxpayer groups wishing to cancel a previous election to consolidate should complete section 2 of
this form.
Please reference R.C. 5751.011 and 5751.012, as well as information releases CAT 2005-05 and CAT 2005-16 for a detailed
explanation of each fi ling status.
If changing to a consolidated elected or combined taxpayer group and adding members, attach CAT AR.
2. If the group is a consolidated elected taxpayer group, does the group elect to include its non-U.S. entities?
Number of members
Yes
No
N/A (currently do not have any non-U.S. entities)
3. Please enter the total number of members, including the primary/reporting member.
Primary/reporting member's fi rst name
M.I.
Last name
Section 2 – Cancellation of Consolidated Election
By checking this box, the above-referenced taxpayer group hereby notifi es the tax commissioner that the group cancels its election
to consolidate. Such cancellation is not effective until the expiration of eight calendar quarters from the time of election or renewal
to consolidate. The group will become a combined taxpayer group, providing common ownership exists, pursuant to rule 5703-
29-19. Please attach documentation indicating how each entity should now be registered.
Note: This section should only be answered if an existing consolidated elected taxpayer group wishes to notify the tax commissioner
of the cancellation of their previous consolidated election. I hereby declare the above to be true and correct to the best of my
knowledge and belief.
SIGN HERE (required)
I declare under penalty of perjury that I am the taxpayer or the taxpayer’s authorized agent having knowledge of the relevant facts in
this matter to fi le this request to change election status.
Signature
Date (MM/DD/YY)
Name
Title
Any member acquired or formed after the fi ling of the initial registration shall be included in the group. The group must notify the tax
commissioner of any additions with either the next tax return fi led or form CAT AR. You must attach a complete organizational chart
(including percentages of ownership between all entities) showing the business structure that refl ects its common owner for
purposes of the CAT. The chart must comply with R.C. 5751.011, R.C. 5751.012 and O.A.C. 5703-29-02.
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