Tax Clearance Request (DOL) Form. This is a New Mexico form and can be use in Department Of Labor Statewide.
Tags: Tax Clearance Request (DOL), New Mexico Statewide, Department Of Labor
State of New Mexico Department of Labor EMPLOYMENT SECURITY DIVISION UNEMPLOYMENT INSURANCE BUREAU TAX SECTION TAX CLEARANCE REQUEST for purposes of corporate Dissolution or Withdrawal Send to: New Mexico Department of Labor ES Section Supervisor, Office sub-section(Clearance) PO Box 2281 Albuquerque, New Mexico 87103 1. Corporation dissolving or withdrawing from New Mexico Name: _________________________________________________________ Federal Employer Identification number :_______________________________ Public Regulation Number: _________________________________________ Address:_________________________________________________________ City, State, Zip :____________________________________________________ 2. Has the above corporation ever paid wages in New Mexico? No Yes If No, proceed to item #5 If Yes, continue to item #3 3. Has this corporation ever been registered with the New Mexico Department of Labor to pay unemployment Yes insurance taxes? No If Yes, Please provide the Employer Account Number:_________________________ Last date wages were paid in New Mexico: __________________________________ If No, please complete form ES-802, Status Report in its entirety and return with this request. Yes 4. Has final wage report and monies been submitted: No If no please submit final report and monies due with this request 5. Mailing address for Clearance Certificate if different from above address: Address:______________________________________________________________ City, State, Zip _________________________________________________________ 6. Requested by: Name and title(Print):___________________________________________________ Phone number ______________ Fax number______________ Email_______________________ 7. Signature: __________________________________________________________ OFFICE USE ONLY No Wages Paid in New Mexico, OK for Clearance Wages Paid in New Mexico, OK for Clearance because: Account Number Inactive No Delinquency File by employer number File by Alpha American LegalNet, Inc. www.FormsWorkflow.com