Form Tr-193.1 - Affidavit For Surrender Of Authority For Foreign Corporations

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TR-193.1
(8/15)
Office of Processing and Taxpayer Services
W A Harriman Campus, Albany NY 12227-0852
Affidavit for Surrender of Authority for Foreign Corporations
Corporation name:
Corporation EIN:
, being duly sworn, hereby deposes and says:
1. I am the
(Title)
of
(Corporation name)
2. The corporation requests to surrender its authority to do business in New York State as of
(mm-dd-yy)
3. If the corporation is subject to tax, the corporation’s estimated tax and MTA surcharge for the period
beginning
and ending
is computed as follows:
(mm-dd-yy)
(mm-dd-yy)
Tax before credits by tax base – you must attach a schedule showing the computation of each tax base
Estimated business income base liability:
Estimated capital base liability:
Estimated fixed dollar minimum tax:
Estimated tax credits to be used – you must attach a schedule showing a breakdown of credits by name and
dollar amount
(if applicable)
Total amount of credits to be used:
Estimated tax after credits:
MTA surcharge – you must attach a schedule showing the computation of the MTA surcharge
(if applicable)
Are you subject to the MTA surcharge?
Yes
No
If Yes, estimated MTA surcharge:
Total estimated tax and MTA surcharge:
If you were not subject to tax and want to surrender your authority, mark an X in this box
...........................................
Also indicate the period for which you were authorized in New York State: beginning
(mm-dd-yy)
and ending
(mm-dd-yy)
4. I acknowledge that if this corporation is subject to tax for the period covered by this affidavit, it is required to file a final
New York State tax return and MTA surcharge return (if applicable), and pay any additional tax and surcharge due, no
later than 30 days after the appropriate tax forms are made available on the Tax Department’s Web site.
5. I acknowledge that surrendering this corporation’s authority does not end its obligation to pay taxes if it is subject to tax
or becomes subject to tax in New York State.
6. I acknowledge that this affidavit does not start the period of limitation within which franchise tax may be assessed.

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