NEW MEXICO MORTGAGE FINANCE AUTHORITY
MFA USE ONLY
State of New Mexico
_________________
Project No.
Affordable Housing Tax Credit
Qualifying Contribution:_____________________________
Approved Tax Credit Amount:______________________
INVESTMENT VOUCHER
Reviewed By:__________________ Date:_____________
CERTIFICATION
Voucher Number:________________________________
Approved by:__________________________________
Part I: Donor Identification
Business or Individual's name:______________________________________________________________________________
Mailing address:_________________________________________________________________________________________
__________________________________________________________________________________
Contact person:___________________________________________email:__________________________________________
Daytime phone No.________________________________Fax__________________________________________________
Part II: Entity Eligibility
Please complete the section below that describes your filing status at the time the contribution was made
A Corporation filing New Mexico Corporate Income and Franchise tax return (Form CIT)
1.)
Corporation name:__________________________________CRS ID No.:_________________FEIN:_____________
An entity filing New Mexico Income and Information Return for Pass-through Entities (Form PTE)
2.)
(Complete part III and attach an additional sheet if necessary to include all members, partners, or shareholders)
Business name and owner:__________________________CRS ID No.:__________________FEIN:_____________
An individual or entity filing a New Mexico Fiduciary Return (Form FID)
3.)
Individual name:_______________________________________FEIN:____________________________________
4.)
A business or corporation filing New Mexico Combined Report System Return (Form CRS-1)
Business name and owner:___________________________CRS ID No.:__________________________________
5.)
An individual filing New Mexico Personal Income Tax Return (Form PIT-1)
Individual name:______________________________________SSN:_____________________________________
6.)
An eligible company filing NM Enhanced 911 Services Surcharge Return (Form RPD-41114)
Company name:______________________________________CRS ID No.:_______________________________
7.)
A telecommunications company filing NM Telecommunication Relay Service Surcharge Return (Form RPD-41116)
Company name:______________________________________CRS ID No.:_______________________________
Part III: Pass-through Entity Information
Please provide information on all members, partners, or shareholders. If an entity listed is also a pass-through entity
provide the information on all members, partners, or shareholders of that entity by attaching an additional schedule.
Name(s)
Social Security Numbers
% Ownership
%
%
%
%
%
%