Form 3555l - Request For Tax Clearance Certificate Limited Liability Company Or Limited Liability Partnership - California Secretary Of State
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4Request for Tax Clearance Certificate
CALIFORNIA FORM
Limited Liability Company or Limited Liability Partnership
3555L
Secretary of State file number
Limited Liability Company (LLC) or Limited Liability Partnership (LLP) name
Current address
Phone number
Federal employer identification number
(
)
Date LLC or LLP
Date LLC or LLP ceased
Latest income period for
commenced to do
or will cease to do
which a California tax
business in California:
business in California:
return has been filed:
The Franchise Tax Board will issue a Tax Clearance Certificate when all taxes have been paid or secured.
Check tax return form filed:
Form 100
Form 565
Form 568
Indicate the status of ANY IRS activity:
Has the IRS redetermined the LLC’s or LLP’s income tax
Is the IRS currently examing the LLC or LLP, or has the
LLC or LLP been notified of a pending examination?
liability for any prior year(s) that you have not previously
reported to us?
Yes
No
Yes
No If yes, please indicate the years involved:
If yes, please furnish a copy of the Revenue Agent’s
Current Examination:
__________________
Report.
Pending Examination:
__________________
COMPLETE PAGES 2 AND 3 OF THIS FORM FOR AN INDIVIDUAL OR TRUST ASSUMPTION OF TAX
LIABILITY. COMPLETE PAGE 4 FOR A CORPORATION, LLC or LLP ASSUMPTION OF TAX LIABILITY.
If the Tax Clearance Certificate is to be issued on a taxes paid basis, check this box.
Supplemental Information. Furnish the following information if the business conducted in California will be
continued by another corporation, LLC or LLP after the taxpayer’s dissolution or withdrawal.
Name of transferee
California corporation number or Secretary of State file number
of transferee
Federal employee identification number
Accounting period of 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 LLC or LLP listed above, complete the
following: (A copy of the Tax Clearance Certificate will be sent to the Secretary of State.)
Name
Address
Mail completed form to:
SECRETARY OF STATE
LIMITED LIABILITY COMPANY UNIT
PO BOX 944228
SACRAMENTO CA 94244-2280
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 3555L C1 (REV 11-1999) PAGE 1
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