Form Rpd-41367 12 - Annual Withholding Of Net Income From A Pass-Through Entity Detail Report - New Mexico Taxation And Revenue Department

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RPD-41367 12
New Mexico Taxation and Revenue Department
*129080200*
Rev. 12/04/2012
2012 Annual Withholding of Net Income
From a Pass-Through Entity Detail Report
Page ______ of _______
Check if amended
Pass-through entity’s name
PTE’s FEIN
Line 1. Total New Mexico net income
Check the type of New Mexico income tax return that the pass-through entity files for the current tax year.
PTE
S-Corp
FID-1
CIT-1
Other - _________________________
PTE’s tax year if other than the full 2012 calendar year.
Due date of the PTE’s federal return.
Beginning of tax year
Last day of tax year
Original Due Date
Extended Due Date
MM
DD
CCYY
MM
DD
CCYY
Col. 5
Owner’s name,
Column 2
Column 3
Column 4
RPD-41353
Owner’s SSN/FEIN
Owner’s share of
Owner’s share of
street address,
on file
allocable net income
withholding tax
city, state, ZIP code
YES
Check one:
FEIN
SSN
Check if outside the U.S.
YES
Check one:
FEIN
SSN
Check if outside the U.S.
YES
Check one:
FEIN
SSN
Check if outside the U.S.
2.
Line 2. Total withholding this page
File this report on-line using the Department’s
3.
Line 3. Total withholding from all pages
web site at https://efile.state.nm.us. If you
cannot electronically file, see the instructions.
4.
Line 4. Withholding tax passed to owners
5.
Line 5. Tax paid on Form RPD-41355
For assistance completing this return
Line 6. Subtotal Subtract the sum of lines 4
6.
call (505) 827-0825.
and 5, from line 3. (May not be less than zero)
7.
Line 7. Penalty
8.
Line 8. Interest
9.
Line 9. Total due Add lines 6, 7 and 8.
I declare I have examined this form and to the best of my knowledge and belief it is true, correct and complete.
Authorized signature ___________________________________________________ Date ____________________________________________
Phone number ___________________________________ E-mail address _________________________________________________________
PTW-D

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