CALIFORNIA FORM
Request for Tax Clearance
3555
Certificate — Corporations
California corporation number
Corporation name
Current address
Phone number
(
)
Date business
Date business
Latest income period
commenced
ceased or will
for which a California
in California:
cease in California:
return has been filed:
The Franchise Tax Board will issue a tax clearance certificate when all taxes have been paid or secured. If a final
return has not been filed, one should be filed within 2 months and 15 days after the close of the month in which the
dissolution or withdrawal takes place. All returns remain subject to audit until expiration of the normal statutes of
limitation.
Please indicate the status of ANY IRS activity:
Is the IRS currently examining the corporation or has the
Has the IRS redetermined the corporation’s income tax
liability for any prior year(s) that you have not previously
corporation been notified of a pending examination?
No If yes, indicate the years involved:
reported to us?
Yes
No
Yes
If yes, send us a copy of the Revenue Agent’s Report.
Current examination:
__________________________
Pending examination:
__________________________
COMPLETE PAGES 2 AND 3 OF THIS FORM FOR AN INDIVIDUAL OR OTHER ENTITY ASSUMPTION OF
TAX LIABILITY. COMPLETE PAGE 4 FOR A CORPORATION, LIMITED LIABILITY COMPANY, OR LIMITED
LIABILITY PARTNERSHIP ASSUMPTION OF TAX LIABILITY.
If the tax clearance certificate is to be issued on a taxes paid basis, check this box and provide a copy of your
final tax return.
Supplemental Information. Please furnish the following information if the business conducted in California will be
continued by another corporation after the merger of the original corporation.
Name of transferee
California corporation number of transferee
Date assets transferred to transferee
Section of the Internal Revenue Code applicable to the transfer of
Taxpayer’s Business or assets: ______________
If the tax clearance certificate is to be mailed to someone other than the corporation listed above, complete the following:
(A copy of the tax clearance certificate will be sent to the Secretary of State.)
Name
Address
Phone number (
)
Mail completed form to:
DOCUMENT FILING SUPPORT UNIT
SECRETARY OF STATE – BUSINESS FILINGS
1500 ELEVENTH ST
SACRAMENTO CA 95814
For more information concerning this form, telephone the Franchise Tax Board at (916) 845-4124.
Assistance for persons with disabilities: We comply with provisions of the Americans with Disabilities Act. Persons
with hearing or speech impairments, call: from voice phone (800) 735-2922, or from TTY/TDD (800) 822-6268.
FTB 3555 C1 (REV 11-1999) PAGE 1