Form Rpd-41359 - Annual Statement Of Pass-Through Entity Withholding

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New Mexico Taxation and Revenue Department
RPD-41359
Rev. 2/3/2012
Annual Statement of Pass-Through Entity Withholding
Pass-through entity’s federal identification number (FEIN)
Tax Year
Pass-through entity’s CRS identification number
Pass-through entity’s name, street address, city,
state, ZIP code and telephone number
Owner’s federal identification number
Check one:
FEIN
Check if address is
outside the U.S.
SSN
New Mexico Net Income of the owner from the pass-through
Owner’s name, street address, city, state, ZIP code
entity
New Mexico state tax withheld
Check if address is
outside the U.S.
Owners must attach this form to the New Mexico state income tax return to claim
the amount of tax withheld against personal income or corporate income tax due.
RPD-41359
New Mexico Taxation and Revenue Department
Rev. 2/3/2012
Annual Statement of Pass-Through Entity Withholding
Pass-through entity’s federal identification number (FEIN)
Tax Year
Pass-through entity’s name, street address, city,
Pass-through entity’s CRS identification number
state, ZIP code and telephone number
Owner’s federal identification number
Check one:
FEIN
Check if address is
outside the U.S.
SSN
New Mexico Net Income of the owner from the pass-through
Owner’s name, street address, city, state, ZIP code
entity
New Mexico state tax withheld
Check if address is
outside the U.S.
Owners must attach this form to the New Mexico state income tax return to claim
the amount of tax withheld against personal income or corporate income tax due.
RPD-41359
New Mexico Taxation and Revenue Department
Rev. 2/3/2012
Annual Statement of Pass-Through Entity Withholding
Pass-through entity’s federal identification number (FEIN)
Tax Year
Pass-through entity’s CRS identification number
Pass-through entity’s name, street address, city,
state, ZIP code and telephone number
Owner’s federal identification number
Check one:
FEIN
Check if address is
outside the U.S.
SSN
New Mexico Net Income of the owner from the pass-through
Owner’s name, street address, city, state, ZIP code
entity
New Mexico state tax withheld
Check if address is
outside the U.S.
Owners must attach this form to the New Mexico state income tax return to claim
the amount of tax withheld against personal income or corporate income tax due.

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