Form Acd-31096 - Tax Clearance Request
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3State of New Mexico
ACD - 31096
DEPARTMENT USE ONLY
REV. 03/00
Taxation and Revenue Department
A. Control log number
B. Date Received
TAX CLEARANCE REQUEST
2. NM Taxation & Revenue Dept. Identification
Number
q
q
q
q
q
q
q
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q
Check the Box in Item 15, 17, 18 or 19 to show
q
which license/permit is to be transferred.
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q
q
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IF BUSINESS/LICENSE/PERMIT IS TO BE OPERATED BY ANOTHER TAXPAYER
GIVE NAME AND ADDRESS BELOW
23. NM Taxation & Revenue Dept. Identification
Number
I declare I have examined this request and all attachments and to the best of my knowledge and belief the information is
true, correct and complete.
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