Application For Tax Clearance For Dissolution/withdrawal - New Mexico Public Regulation Commission

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PUBLIC REGULATION COMMISSION
APPLICATION FOR TAX CLEARANCE FOR DISSOLUTION/WITHDRAWAL
** INFORMATION MUST BE LEGIBLE **
DATE: _______________
RE: __________________________________________________________________________________
(PRINT EXACT CORPORATE NAME AS REGISTERED WITH OUR OFFICE)
NMPRC #: ___________________
TAXATION AND REVENUE ID #: ___________________________
SUBJECT: TAX CLEARANCE REQUEST FOR DISSOLUTION/WITHDRAWAL
THIS CORPORATION IS IN THE PROCESS OF DISSOLVING/WITHDRAWING FROM THE STATE OF NEW
MEXICO AND IS REQUESTING TAX CLEARANCE.
FINAL DAY OF BUSINESS:
Month _____________ Day _________ Year __________
NOTE: THE CORPORATION CANNOT BE ISSUED A TAX CLEARANCE FOR A FUTURE DATE OR IF IT IS
DELINQUENT IN FILING REPORTS AND/OR PAYING FEES DUE. ALSO, A FINAL REPORT MAY BE REQUIRED
THROUGHT THE FINAL DAY OF BUSINESS. YOU WILL BE ADVISED ACCORDINGLY.
_______________________________________
SIGNATURE OF OFFICER OR AUTHORIZED AGENT
NAME: ____________________________________________
ADDRESS: _________________________________________
CITY: __________________ STATE: ______ ZIP: ___________
TELEPHONE: ________________________________________
MAIL TO:
PUBLIC REGULATION COMMISSION
TAX COMPLIANCE DIVISION
PO BOX 1269
SANTA FE, NM 87504-1269
PHONE (505) 827-4510

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