Section 1. Request for Relief and Required Information of the Corporation

The Corporation ( insert the Corporation’s name ), referred to as “the Corporation,” whose employment identification number (EIN) is ( insert the Corporation’s EIN ), located at ( insert the Corporation’s address ), and formed or incorporated on ( insert date ) in ( insert State ), requests relief for an invalid election under § 1362(a)(1) of the Code (S election) or termination of an S election pursuant to § 1362(f), and Rev. Proc. 2022-19, section 3.06, for one or more non-identical governing provisions (as defined in § 1.1361-1(l)).