California Form 3555 - Request For Tax Clearance Certificate - Corporations - 2003
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4Request for Tax Clearance
CALIFORNIA FORM
3555
Certificate — Corporations
Corporation Name
California Identification Number
Current Address
Phone Number
Federal Employer Identification Number
(
)
Date operations commenced
Date operations ceased
Latest California tax return
in California:
or will cease in California:
Income period:
Date filed:
Has the IRS changed the
All tax returns must be filed and balances due must be paid or
corporation’s income tax liability for
secured before we will issue a Tax Clearance Certificate. All returns
any years that you have not reported
will remain subject to audit until the expiration of the normal statutes
to us?
of limitations.
Yes
No
If an individual or another business entity will act as the Assumer of any
If yes, send us a copy of the
future tax liability, check the Assumer box below and follow the
Revenue Agent’s Report.
appropriate instructions. Requests taking advantage of the Assumer
method generally receive a Tax Clearance Certificate within 30 days.
If the corporation is currently being
examined or an examination is
Assumer
Individual or Trust complete pages 2 and 3.
pending, identify the agency or
Corporate, LLC, or LLP complete pages 3 and 4.
agencies below:
If you are requesting a tax clearance without an Assumer, check the
IRS
FTB
Both
appropriate box below. Requests other than the Assumer method
generally take 6 to 9 months to receive a Tax Clearance Certificate.
If being examined, indicate which
years:
Surety Bond
Cash Deposit
Current: ______________________
Taxes Paid – A final return must be filed before we will issue a
Pending: _____________________
Tax Clearance Certificate based on Taxes Paid.
Supplemental information. Please furnish the following information ONLY if the corporation is merging into another
business entity and the other business entity will continue to conduct business in California after the merger.
Name of Transferee
California Identification Number of Transferee
Current Address
Phone Number
Federal Employer Identification Number
(
)
Date Assets Transferred to Transferee
Section of the Internal Revenue Code applicable to the transfer of
taxpayer’s business or assets:
We will send a copy of the Tax Clearance Certificate to the California Secretary of State. If we are to mail the
original Tax Clearance Certificate to someone other than the corporation listed above, please complete the following:
Name
Phone Number
(
)
Address
Mail completed form to:
DOCUMENT FILING SUPPORT UNIT
SECRETARY OF STATE – BUSINESS FILINGS
1500 11TH STREET
SACRAMENTO CA 95814-5701
For more information concerning this form, telephone the Franchise Tax Board at (916) 845-4124.
Assistance for persons with disabilities: We comply with the Americans with Disabilities Act. Persons with hearing or
speech impairments please call TTY/TDD (800) 822-6268.
FTB 3555 C1 (REV 11-2003) PAGE 1
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