Form 05-359 - Request For Certificate Of Account Status To Terminate A Taxable Entity'S Existence In Texas Or Registration - Tx Comptroller Of Public Accounts

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05-359

(Rev.4-12/12)

PRINT FORM

CLEAR FIELDS

Request for Certificate of Account Status to

Terminate a Taxable Entity’s Existence in Texas or Registration

An entity that intends to terminate its legal existence or registration must satisfy filing requirements for all taxes administered by the Comptroller under Title 2

of the Texas Tax Code. In addition, all accounts for those taxes must be closed. To determine if the entity is current in tax requirements, or to close any open

tax accounts, call us at 1-800-252-1381 or 512-463-4600. More information about this process is available online at

Section A - Entity Information

Entity’s legal name

Taxpayer number

File number (from the Texas Secretary of State)

1. Is the entity a member of an affiliated group that will be required to file a combined report? ......................................................

YES

If “YES,” enter the following information for the entity that will report on your behalf. If “NO,” skip to Section B.

Legal name of reporting entity

Texas taxpayer number / FEI number

2. Is the entity’s accounting year begin date on or after the combined group’s accounting year

begin date on its franchise tax report? .........................................................................................................................................

YES

If “YES,” this entity’s information must be included in the combined group report. If “NO,” enter the following information:

This entity’s

The day before the combined

month

day

year

month

day

year

accounting year

group’s accounting year

begin date ............................................

Section B - Texas Entity -

If the entity was formed in Texas, indicate the filing for which the certificate is required.

Termination

Merger

Entity conversion

Section C - Non-Texas Entity -

If the entity was formed outside of Texas, please complete the following information.

1. Is the entity still conducting business in Texas? ..........................................................................................................................

YES

month

day

year

2. If “NO,” enter the entity’s last day of business in Texas ...........................................

3. Does the entity currently have an active charter in its home state? ............................................................................................

YES

4. If “NO,” indicate the type and date of termination:

month

day

year

Termination effective date .........................

Merger effective date .................................

Name of survivor _______________________________________

Entity conversion effective date .................

Note: If the home state charter has been terminated, home state documentation must be included. The home state documentation must bear the seal of

the appropriate filing agency and the effective date of the filing.

Section D - Receiving Your Certificate

Does this entity have a forfeited certificate or registration that needs to be reinstated before ending its existence

or registration in Texas? ..................................................................................................................................................................

YES

Please indicate how you would like to receive your certificate:

FAX number

Telephone number

FAX

(area code and number) ________________________________ (area code and number) ___________________________________

.PDF

Email address ______________________________________________________________________________________________

Mail

Mailing address ______________________________________ City _____________________ State _______ ZIP code __________

You can file documents online with the Secretary of State using SOSDirect at

Your account will be reviewed to determine eligibility. If eligible, a certificate will be sent using the format selected. If not eligible, we will notify you in

writing what is required to be eligible. All requests are processed in the order they are received regardless of the format you select. Assistance is

also available at your local field office. Field office locations are available online at

Your name (Please type or print)

Phone number and extension

Authorized agent

Mail to: Comptroller of Public Accounts

Visit us online at or call 1-800-252-1381 or 512-463-4600.

P.O. Box 149348

Austin, TX 78714-9348

Under Ch. 559, Government Code, you are entitled to review, request and correct information we have on file about you, with limited exceptions in accordance with Ch. 552,

Government Code. To request information for review or to request error correction, contact us at the address or phone number listed on this form.