Form Rpd-41071 - Application For Tax Refund - 2000 printable pdf download

Form Rpd-41071 - Application For Tax Refund - 2000

RPD-41071

REV. 08/2000

STATE OF NEW MEXICO - TAXATION AND REVENUE DEPARTMENT

APPLICATION FOR TAX REFUND

any

Do not take an overpayment as a credit on a subsequent report.

Firm Name

New Mexico CRS Identification Number

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 _______________ to __________________

(type of tax)

Basis for refund: _______________________________________________________________________________________

____________________________________________________________________________________________________________

_________________________________________________________________________________________________________

If you would like your check directly deposited complete the following information.

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.

Form Rpd-41071 - Application For Tax Refund - 2000