Form Pit-5 - New Mexico Qualified Business Facility Rehabilitation Credit - 2002
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1PIT-5
NEW MEXICO QUALIFIED BUSINESS FACILITY REHABILITATION CREDIT
REV. 02/2002
Name
Social Security Number
Address
City / State / Zip code
o
o
NOTE: Failure to attach this form and the approval from the New Mexico Enterprise Zone Pro-
gram Officer to your income tax return will result in denial of the credit claimed.
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