Form Ftb 3557-Application For Certificate Of Revivor printable pdf download

Form Ftb 3557-Application For Certificate Of Revivor

STATE OF CALIFORNIA

FRANCHISE TAX BOARD

PO BOX 942857

SACRAMENTO CA 94257-2021

Application for Certificate of Revivor

Before the Franchise Tax Board of the Sate of California

In the Matter of the Application for Certificate of Revivor of:

Corporation Number

Corporation Name

Address

I request that this corporation be relieved from suspension or forfeiture. All required payments, returns or

documents have been previously submitted or are enclosed.

Print Name ______________________________________

Title __________________________________

Signature ________________________________________

Date __________________________________

Daytime Phone Number ____________________________

Any stockholder or creditor or a majority of the surviving trustees or directors, officers or any other person

having an interest in the relief from suspension may sign on behalf of a bank or corporation.

Any officer, stockholder, creditor or any other person having an interest in the relief from forfeiture may sign on

behalf of a foreign bank or corporation.

ASSISTANCE

Telephone assistance is available from 7 a.m. until 8 p.m. Monday through Friday and from 7 a.m. until 4 p.m. on Saturdays. From the first

working day in January through the due date for filing a tax return (generally April 15), service is available from 6 a.m. until midnight, Monday

through Friday and from 7 a.m. until 4 p.m. on Saturdays and holidays. We may modify these hours without notice to meet operational needs.

From within the United States, call . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (800) 852-5711

From outside the United States, call (not toll-free) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (916) 845-6500

Website at:

Assistance for persons with disabilities: We comply with the Americans with Disabilities Act. Persons with hearing or speech impair-

ments, call: from voice phone (800) 735-2922, or from TTY/TDD (800) 822-6268.

FTB 3557 (REV 12-2000)

Form Ftb 3557-Application For Certificate Of Revivor