Reg. § 1.9000-4 Form and content of statement.
(a) Information to be shown The statement shall be filed on Form 2175 which may be obtained from district directors. It shall be filed with the district director for the internal revenue district in which the return was filed. The statement shall be prepared in accordance with the instructions contained thereon and shall show the following information:
(1) The name and address of the taxpayer,
(2) The amounts of each type of income deferred under section ,
(3) The amount of the addition to each reserve deducted under section ,
(4) The taxable income and the tax liability of the taxpayer computed with the application of sections and ,
(5) The taxable income and the tax liability of the taxpayer computed without the application of sections and ,
(6) The details of the recomputation of taxable income and tax liability, including any changes in other items of income, deductions, and credits resulting from the repeal of sections and , and
(7) If self-employment tax is increased, the computations and information required on page 3 of Schedule C, Form 1040.
(b) Procedure for recomputing tax liability In determining the taxable income and the tax liability computed without the application of sections and , such items as vacation pay and prepaid subscription income shall be reported under the law and regulations applicable to the taxable year as if such sections had not been enacted. The tax liability for the year shall be recomputed by restoring to taxable income the amount of income deferred under section and the amount of the deduction taken under section . Other deductions or credits affected by such changes in taxable income shall be adjusted. For example, if the deduction for contributions allowed for the taxable year was limited under section , the amount of such deduction shall be recomputed, giving effect to the increase in adjusted gross income or taxable income, as the case may be, by reason of the adjustments required by the repeal of sections and .