COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA PUBLIC REGULATION COMMISSION -against: : APPLICATION FOR TAX CLEARANCE FOR DISSOLUTION/WITHDRAWAL : Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . ***INFORMATION .MUST BE. LEGIBLE*** ................ ....... ... DATE: __________________ THE PEOPLE OF THE STATE OF NEW YORK RE: __________________________________________________________________________________ (PRINT EXACT CORPORATE NAME AS REGISTERED WITH OUR OFFICE) TO NMPRC # ____________________ TAXATION & REVENUE ID # _____________________________ SUBJECT: TAX CLEARANCE REQUEST FOR DISSOLUTION/WITHDRAWAL GREETINGS: THIS CORPORATION IS IN THE PROCESS OF DISSOLVING/WITHDRAWING FROM THE STATE OF NEWWE COMMAND REQUESTING business and excuses being laid aside, you and each of you attend before MEXICO AND IS YOU, that all TAX CLEARANCE. , the Honorable at the Court located at County of in room , on CANNOTday ISSUED A TAX 20 , CLEARANCE FOR A FUTURE DATE noon, and at any recessed , at o'clock in the NOTE: THE CORPORATION the BE of OR IF IT IS or adjourned date, REPORTS AND/OR PAYING FEES DUE. ALSO, A FINAL REPORT the DELINQUENT IN FILINGto testify and give evidence as a witness in this action on the part ofMAY BE REQUIRED FINAL DAY OF BUSINESS: Month __________ Day __________ Year __________. THROUGH THE FINAL DAY OF BUSINESS. YOU WILL BE ADVISED ACCORDINGLY. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to _______________________________________________issued for a maximum penalty of $50 and all damages sustained as a the party on whose behalf this subpoena was SIGNATUREof your failureOR comply. result OF OFFICER to AUTHORIZED AGENT Witness, Honorable NAME: ___________________________________________________ Court in County, day of , 20 , one of the Justices of the ADDRESS: ________________________________________________ CITY: ________________STATE: _______ZIP CODE: ____________ (Attorney must sign above and type name below) TELEPHONE: (_____)_______________________________________ MAIL TO: Attorney(s) for PUBLIC REGULATION COMMISSION TAX COMPLIANCE DIVISION PO BOX 1269 Office and P.O. Address SANTA FE, NM 87504-1269 PHONE: (505) 827-4510 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com