Ohio Commercial Activity Tax - Request to Change Election Status

Commercial Activity Tax - Request to Change Election Status
Form CAT ES
CAT ES

Request to Change
Election Status

Please do not
use staples.
CAT account number

Rev. 11/23

FEIN/SSN

Date of original consolidation

MM D D Y Y

Eff. date of change request

MM D D Y Y

Use only UPPERCASE letters.
Reporting member's name

Section 1 – Change in Status
Please attach a complete organizational chart (including percentages of ownership between all entities) showing the business
structure that reflects 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%	

	

	

By

	


	 Existing

	


	 Please

	

	

Consolidated elected at 50%	

Combined 	

Single

checking either consolidated box above, the group hereby elects to file 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.
consolidated elected taxpayer groups wishing to cancel a previous election to consolidate should complete section 2 of
this form.
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 filing 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?
	

Yes	

No	

Number of members

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 first name

M.I.

,

Last name

Section 2 – Cancellation of Consolidated Election
By checking this box, the above-referenced taxpayer group hereby notifies 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 570329-19. 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 file this request to change election status.



Signature	

Date (MM/DD/YY)

Name	

Title

Any member acquired or formed after the filing 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 filed or form CAT AR. You must attach a complete organizational chart
(including percentages of ownership between all entities) showing the business structure that reflects 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.

CAT ES

Rev. 11/23

Request to Change
Election Status

Please do not
use staples.

Contact person: The taxpayer will be represented in the matter by the following individual. Please attach a Declaration of Tax
Representative (form TBOR 1), which can be found on the department’s Web site at tax.ohio.gov.
Your first name

M.I. Last name

Home address (number and street)
City
Telephone
Title

State

ZIP code

Fax
E-mail

Options to submit this request: Electronically: tax.ohio.gov – Contact Us - Online Notice Response
Service or gateway.ohio.gov – Online Notice Response Service: eFax – 206-666-4462; Mail: Ohio
Department of Taxation, Business Tax Division - CAT ES, P.O. Box 16158, Columbus OH 43216-6158