California Form 3555 - Request For Tax Clearance Certificate

California Form 3555 - Request For Tax Clearance Certificate - Corporations Page 2

INDIVIDUAL ASSUMPTION OF TAX LIABILITY

California corporation number

Corporation name

I unconditionally agree to file or cause to be filed with the Franchise Tax Board, under the provisions of the Bank and

Corporation Tax Law, such tax returns and data that may be required and to pay in full all accrued or accruing liabilities for

tax, penalty and/or interest and fees due from the above corporation.

My net worth (assets minus liabilities) is not less than: $ _____________________ .

(A detailed financial statement, PAGE 3, is required.)

Name of individual assumer: (Must be resident of California)

Social security no.

Address

Phone number (

)

Date

Signature

TRUST ASSUMPTION OF TAX LIABILITY

California corporation number

Corporation name

This trust unconditionally agrees to file or cause to be filed with the Franchise Tax Board, under the provisions of the

Bank and Corporation Tax Law, such returns and data that may be required and to pay in full all accrued or accruing

liabilities for tax, penalty and/or interest and fees due from the above corporation.

(A detailed financial statement, PAGE 3, is required.)

Name of California trust

Trust federal identification number

Address

Phone number (

)

Date

Trustee’s signature

FOR PRIVACY ACT NOTICE, SEE FORM FTB 1131.

FTB 3555 C1 (REV 11-1999) PAGE 2

California Form 3555 - Request For Tax Clearance Certificate - Corporations Page 2