RPD-41353
State of New Mexico - Taxation and Revenue Department
Rev. 9/9/2013
OWNER’S OR REMITTEE’S AGREEMENT TO PAY WITHHOLDING
ON BEHALF OF A PASS-THROUGH ENTITY OR REMITTER
PASS-THROUGH ENTITY’S OR REMITTER’S (Payor)
OWNER’S OR REMITTEE’S
NAME AND MAILING ADDRESS
NAME AND MAILING ADDRESS
Name
Name
Street or other mailing address
Street or other mailing address
City, state and ZIP code
City, state and ZIP code
Federal employer identification number
Federal employer identification number
Check one:
FEIN
Check one:
FEIN
SSN
SSN
Effective period of agreement (you must check one):
Current Year
Indefinite Term
Through _____________
A remitter may enter into an agreement with certain remittees that the remittee will remit to the New Mexico
Taxation and Revenue Department at the time and in the manner required by the Department the amounts that
the remitter is required to withhold and remit with respect to payments to the remittee. Similarly, a pass-through
entity may enter into an agreement with a certain owner that the owner will remit to the Department the amounts
that the pass-through entity is required to withhold and remit with respect to payments to the owner. Qualifying
remittees or owners are those that are individuals who are not residents of New Mexico or businesses that are
not principally located in New Mexico. IMPORTANT: A PTE that is a personal service business cannot enter into
an agreement with its owners. See page 2 for the definition of a personal service business.
The agreement must be in the remitter’s or pass-through entity’s possession at the time it files its return for the tax
year to which the agreement pertains. The agreement may remain in effect for a single tax year, multiple tax years,
or an indefinite term, and may be revoked or amended on mutual agreement of the parties. When a non-resident
owner becomes a resident of New Mexico, the agreement submitted by that owner is revoked automatically.
Remittances to the Department pursuant to this agreement may be counted towards the corporate income tax
or personal income tax liability of remittee’s or owner’s estimated tax liability, and may not be credited to the
estimated tax due by the remitter or the pass-through entity.
The signature of both parties is required:
I agree to make timely payment of all taxes imposed by the State of New Mexico with respect to my share of the income re-
ported by the pass-through entity or remitter named above, to whom I have made this agreement.
Owner’s or remittee’s signature _____________________________________________________
Date _______________
Title _____________________________________________________
Pass-through entity’s or remitter’s signature ___________________________________________
Date _______________
Title _____________________________________________________