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Rpd-41350 9/4/12 - E-File Exception Request Form - State Of New Mexico - Taxation And Revenue Department

STATE OF NEW MEXICO - TAXATION AND REVENUE DEPARTMENT

RPD - 41350

Rev. 09/04/2012

E-FILE EXCEPTION REQUEST FORM

Name of individual, firm or organization

Mailing address

City

State

ZIP code

NM CRS ID. No.

FEIN or SSN

NM weight distance tax ID. No.

Check one:

FEIN

SSN

Who May Use This Form: A taxpayer may request an exception from the requirement to e-file Combined Reporting Sys-

tem (CRS), Weight Distance Tax (WDT) returns, Form RPD-41374, Annual Report of Non-Resident Remittees Holding an

Agreement to Pay Tax on Oil and Gas Proceeds (OGP-D) or Form RPD-41367, Annual Withholding of Net Income From

a Pass-Through Entity Detail Report, (PTW-D) by filing Form RPD-41350, E-File Exception Request Form. Exceptions will

be granted if a hardship exists and there is no reasonable access to the Internet in the taxpayer's community. The taxpayer

must also show a good faith effort to comply with the electronic filing requirements before an exception is granted.

NOTE: To qualify for exception, this form must be received by the Department at least 30 days before the taxpayer's

electronic return is originally due.

Complete all three statements about the tax program that you wish to request an exception to file electronically.

You must submit Form RPD-41350 annually for each calendar year for which you wish to request an exception of the e-file

requirement. The Department will notify you of the results of the approval.

1. The exception requested is for the following New Mexico tax return (check one):

CRS-1, Combined Reporting of Gross Receipts, Compensating and Withholding Tax

Weight Distance Tax

Form RPD-41374, Annual Report of Non-Resident Remittees Holding an Agreement to Pay Tax on Oil and Gas Proceeds

Form RPD-41367, Annual Withholding of Net Income From a Pass-Through Entity Detail Report

2. For calendar year _____________. (One calendar year per application.)

3. Provide a clear statement of the hardship that exists, the reason you feel there is no reasonable Internet access in

your community, and the good faith efforts taken to comply. If additional space is needed, attach a separate page.

I declare that the information stated above is true and correct in every material matter.

Printed Name

Date

Authorized Signature

Title

DEPARTMENT USE ONLY

The Department has reviewed this request for exception from the requirement to e-file the above returns.

The request has been:

Authorized by:

Approved

Denied

For the year: _________________________________

Explanation for denial, if applicable:

Signature of Secretary or Delegate

_____________________________________________________

Date of determination: ____________________________

_____________________________________________________

Initials of first reviewer ______

Exception number: ___________

Revenue Processing Division, P.O. Box 5418, Santa Fe, New Mexico 87504-5418

Rpd-41350 9/4/12 - E-File Exception Request Form - State Of New Mexico - Taxation And Revenue Department

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