Form Rpd-41285 - New Mexico Annual Statement Of Withholding Of Oil And Gas Proceeds
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3RPD-41285
New Mexico Taxation and Revenue Department
Rev. 09/02/2014
Annual Statement of Withholding of Oil and Gas Proceeds
Remitter’s federal identification number
Tax Year
Mark one
FEIN
box
SSN
Remitter’s CRS identification number (optional)
Remitter’s (payer’s) name, street address, city,
state, ZIP code, and phone number
Remittee’s federal identification number
Mark one
FEIN
Mark box if address
outside the U.S.
box
SSN
Gross oil and gas proceeds
Remittee’s (recipient’s) name, street address, city,
state, and ZIP code
New Mexico state tax withheld
Mark box if address
outside the U.S.
Remittees (recipients) must attach this form to their New Mexico state income tax return to claim
the amount of tax withheld against personal income or corporate income tax due.
New Mexico Taxation and Revenue Department
RPD-41285
Rev. 09/02/2014
Annual Statement of Withholding of Oil and Gas Proceeds
Remitter’s federal identification number
Tax Year
Mark one
FEIN
box
SSN
Remitter’s CRS identification number (optional)
Remitter’s (payer’s) name, street address, city,
state, ZIP code, and phone number
Remittee’s federal identification number
Mark one
FEIN
Mark box if address
outside the U.S.
box
SSN
Gross oil and gas proceeds
Remittee’s (recipient’s) name, street address, city,
state, and ZIP code
New Mexico state tax withheld
Mark box if address
outside the U.S.
Remittees (recipients) must attach this form to their New Mexico state income tax return to claim
the amount of tax withheld against personal income or corporate income tax due.
New Mexico Taxation and Revenue Department
RPD-41285
Rev. 09/02/2014
Annual Statement of Withholding of Oil and Gas Proceeds
Remitter’s federal identification number
Tax Year
Mark one
FEIN
box
SSN
Remitter’s CRS identification number (optional)
Remitter’s (payer’s) name, street address, city,
state, ZIP code, and phone number
Remittee’s federal identification number
Mark box if address
Mark one
FEIN
outside the U.S.
box
SSN
Gross oil and gas proceeds
Remittee’s (recipient’s) name, street address, city,
state, and ZIP code
New Mexico state tax withheld
Mark box if address
outside the U.S.
Remittees (recipients) must attach this form to their 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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