This appears to be all that is needed – you have indicated the correct form. Bob's question is related to whether there is some other reorganization that is a part of the plan. Otherwise why implement a split? I have seen changes such as creating voting and nonvoting shares and issuing more nonvoting to affect valuation.
¶S-3784. Statements furnished to certificate holders or nominees for organizational changes affecting basis.
According to forms or regs IRS prescribes, every person required to make an information return reporting organizational changes affecting basis (described at ¶ S-3821 et seq.) with respect to a specified security (defined at ¶ S-3782 ) must furnish to the nominee with respect to the specified security (or certificate holder if there is no nominee) a written statement showing:11
· (1) the name, address, and phone number of the information contact of the person required to make the return,12
· (2) the information required to be shown on the return with respect to the security,13 and
· (3) any other information IRS prescribes.14
RIA observation: A nominee is a person who holds property for someone else's account in the nominee's name. A brokerage account in which the brokerage holds securities in the brokerage's name ("street name"), instead of the account holder's name, is a common type of nominee arrangement.
An issuer may satisfy the statement requirement by furnishing a copy of the information return.14.1
A separate statement must be furnished to each holder of record of the security as of the date of the organizational action and all subsequent holders of record up to the date the issuer furnishes the statement. If the issuer records the security on its books in the name of a nominee, the issuer must furnish the statement to the nominee in lieu of the holder. However, if the nominee is the issuer, an agent of the issuer, or a plan operated by the issuer, the issuer must furnish the statement to the holder.14.2
An issuer is not required to furnish an issuer statement to a holder or its nominee if the holder is an exempt recipient.14.3
An S corporation is deemed to meet the statement requirement for any organizational actions affecting the basis of its stock if the corporation reports the effect of the organizational action on a timely filed Schedule K-1 (Form 1120S) for each shareholder and timely furnishes copies of these schedules to all proper parties.14.4
A regulated investment company (RIC) or real estate investment trust (REIT) that reports undistributed capital gains to shareholders is deemed to have satisfied the statement requirement for undistributed capital gains affecting the basis of its stock if the RIC or REIT timely files and furnishes the information return required under the RIC and REIT rules to all proper parties for the organizational action.14.5
An acquiring or successor entity of an issuer that fails to satisfy the statement obligation is required to satisfy the obligation. If neither the issuer nor the acquiring or successor entity satisfies this obligation, both are jointly and severally liable for any applicable penalties.14.6
An issuer may use an agent to satisfy the statement requirement for the issuer. However, the issuer remains liable for penalties for any failure to comply unless it is shown that the failure is due to reasonable cause and not willful neglect.14.7
For when IRS can waive the filing of the statement if the information is made publicly available, see ¶ S-3786 .
For organizational actions to which the Reg § 1.6045B-1 rules apply, see ¶ S-3781 .
11 Code Sec. 6045B(c) .
12 Code Sec. 6045B(c)(1) .
13 Code Sec. 6045B(c)(2) .
14 Code Sec. 6045B(c)(3) .
14.1 Reg § 1.6045B-1(b)(1) .
14.2 Reg § 1.6045B-1(b)(3) .
14.3 Reg § 1.6045B-1(b)(5)(i) .
14.4 Reg § 1.6045B-1(c) .
14.5 Reg § 1.6045B-1(d) .
14.6 Reg § 1.6045B-1(e) .
14.7 Reg § 1.6045B-1(f) .