Form Rpd-41071 - Application For Tax Refund - 2003
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2RPD-41071
STATE OF NEW MEXICO - TAXATION AND REVENUE DEPARTMENT
REV. 04/2003
APPLICATION FOR TAX REFUND
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This form is to be used to apply for a tax refund from the Taxation and Revenue Department. Do not use this form if you have overpaid income tax,
estate tax or any oil and gas taxes. See the appropriate forms for instructions on filing an amended return.
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If you are changing any information for prior reporting periods, you should submit an amended report for each period affected. Regardless of the number
of periods amended, on Application for Tax Refund will suffice.
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The basis for refund must relate why the overpayment was made, i.e., what caused it. Do not merely enter the word "overpayment". Attach a letter of
explanation if the space provided for basis for refund is insufficient.
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The Taxation and Revenue Department has the right to offset all or part of an allowed tax refund against any tax liabilities you may owe.
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This form must be signed by the taxpayer or the taxpayer's authorized agent.
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If you are claiming a refund of gross receipts tax because you did not claim an allowable deduction, you must attach the following, if applicable:
1)
a copy of the nontaxable transaction certificate executed by the buyer so we can verify the NTTC was executed timely; or
2)
a copy of other substantiation or documentation necessary to support the deduction (e.g. farmer or rancher statement).
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If you are claiming a refund of gross receipts because of an exemption that you did not claim, you must attach documentation necessary to support
the exemption (i.e., invoices, contracts, etc.).
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Do not take an overpayment as a credit on a subsequent report.
New Mexico CRS Identification No.
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Firm Name
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Mailing Address
City, State, Zip Code
I hereby certify that the State of New Mexico was overpaid the sum of ________________________________________________
dollars ($ __________________) in _____________________ taxes, for the period(s) ______________ to _________________
(type of tax)
Basis for refund: _______________________________________________________________________________________
____________________________________________________________________________________________________________
_________________________________________________________________________________________________________
If you would like your check directly deposited complete the following information.
1.
Routing Number:
3.
Type:
Checking
Savings
2.
Account Number:
I declare that the information reported on this form and any attached supplements is true and correct as to every material matter.
Signature of taxpayer or agent __________________________________ Title _____________________ Date ______________
Type or print name _____________________________________________________________________________________
Return this form to the Taxation and Revenue Department, P.O. Box 630, Santa Fe, New Mexico 87504-0630.
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