SOS TC 1/1 APPLICATION FOR TAX CLEARANCE FOR DISSOLUTION/WITHDRAWAL (TYPE OR PRINT LEGIBLY) Date: The exact name of the entity as registered with our office is: Taxation and Revenue ID SUBJECT: Tax Clearance Request for Dissolution/Withdrawal This entity 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 entity cannot be issued a Tax Clearance for a future date or if it is delinquent in filing reports and/or paying fees due. A final report may be required through the final day of business, you will be advised accordingly. Signature of Officer or Authorized Agent NAME: ADDRESS: CITY: ST: ZIP CODE: TELEPHONE: EMAIL ADDRESS: MAIL TO: Secretary of State-Tax Compliance Section 325 Don Gaspar, Suite 300, Santa Fe NM 87501 American LegalNet, Inc. www.FormsWorkFlow.com SUBMIT ORIGINAL AND A COPY TYPE OR PRINT LEGIBLY Profit Corporation ARTICLES OF DISSOLUTION Pursuant to the provisions of Section 53-16-11 of the New Mexico Business Corporation Act, the undersigned corporation adopts the following Articles of Dissolution for the purpose of dissolving the corporation: ARTICLE ONE: The name (include #): ARTICLE TWO: A Statement of Intent to Dissolve the corporation was filed with the Secrery of State on: ARTICLE THREE: All debts, obligations and liabilities of the corporation have been paid and discharged or adequate provision has been made therefore. The remaining property and assets of the corporation have been distributed among its shareholders in accordance with their respective rights and interests. There are no suits pending against the corporation in any court, or adequate provision has been made for the satisfaction of any judgment, order or decree that may be entered against it in any pending suit. Dated: By Signature of Authorized Officer THE CLEARANCES FOR DISSOLUTION ISSUED BY THE FOLLOWING NEW MEXICO STATE AGENCIES MUST BE ATTACHED TO THIS DOCUMENT: Taxation and Revenue Department (223Certificate of No Tax Due224)Department of (223Certificate of Compliance224)Secretary of State (223Letter of Clearance224) Form DPR-DV (revised /1 American LegalNet, Inc. www.FormsWorkFlow.com DOCUMENT DELIVERY INSTRUCTION FORM (You must have one Document Delivery Instruction Form for each filing being submitted) Entity Name: Mailing Address (Include city, state and zip code): Contact Name: Contact Phone Number: Contact Email: IF YOU HAVE SELECTED TO PICK UP YOUR DOCUMENTS, OUR OFFICE WILL CONTACT YOU WHEN YOUR DOCUMENTS ARE COMPLETED AND READY FOR PICK UP. DOCUMENTS WILL NOT BE HELD FOR MORE THAN 5 BUSINESS DAYS. IF YOU HAVE NOT PICKED THEM UP WITHIN THAT TIME FRAME, THEY WILL BE MAILED TO THE ADDRESS LISTED ABOVE. PLEASE CONTACT OUR OFFICE AT 800-477-3632 AND NOTIFY US IF YOU ARE NOT ABLE TO PICK THEM UP WITHIN THAT TIME FRAME. ---THANK YOU New Mexico Secretary of State Business Services Division 325 Don Gaspar, Suite 300 267 Santa Fe, NM 87501 (800)477-3632 267 www.sos.state.nm.us Please check how the documents are to be delivered Will Pick Up Mail to Address Above American LegalNet, Inc. www.FormsWorkFlow.com