1121 Form 8594 (PDF)

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f8594.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).

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Form

(Rev. November 2021) Department of the Treasury Internal Revenue Service

Under Section 1060

• Attach to your income tax return.

• Go to www.irs.gov/Form8594 for instructions and the latest information.

OMB No. 1545-0074

Attachment

Sequence No. 169

Name as shown on return Identifying number as shown on return

Check the box that identifies you:

Address (number, street, and room or suite no.)

City or town, state, and ZIP code

5 Did the purchaser and seller provide for an allocation of the sales price in the sales contract or in another

written document signed by both parties? . . . . . . . . . . . . . . . . . . . . . Yes No

If “Yes,” are the aggregate fair market values (FMV) listed for each of asset Classes I, II, III, IV, V, VI, and VII the amounts agreed upon in your sales contract or in a separate written document? . . . . . . . . Yes No

6

In the purchase of the group of assets (or stock), did the purchaser also purchase a license or a covenant not to compete, or enter into a lease agreement, employment contract, management contract, or similar arrangement with the seller (or managers, directors, owners, or employees of the seller)? . . . . . . Yes No

If “Yes,” attach a statement that specifies (a) the type of agreement and (b) the maximum amount of consideration (not including interest) paid or to be paid under the agreement. See instructions.

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 63768Z Form 8594 (Rev. 11-2021)

Form 8594 (Rev. 11-2021) Page 2 Part III Supplemental Statement— Complete only if amending an original statement or previously filed supplemental

statement because of an increase or decrease in consideration. See instructions. 7 Tax year and tax return form number with which the original Form 8594 and any supplemental statements were filed.

9 Reason(s) for increase or decrease. Attach additional sheets if more space is needed.

Form 8594 (Rev. 11-2021)