File number (from the Texas Secretary of State)
1. Is the entity a member of an affiliated group that will be required to file a combined report? |
YES |
If “YES,” enter the following information for the entity that will report on your behalf. If “NO,” skip to Section B.
Legal name of reporting entityTexas taxpayer number / FEI number
2. Is the entity’s accounting year begin date on or after the combined group’s accounting year |
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begin date on its franchise tax report? |
YES |
If “YES,” this entity’s information must be included in the combined group report. If “NO,” enter the following information:
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This entity’s |
month |
day |
year |
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accounting year |
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|
|
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begin date............................................
The day before the combined |
month |
day |
year |
group’s accounting year |
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begin date............................................
Section B - Texas Entity - If the entity was formed in Texas, indicate the filing for which the certificate is required.
Section C - Non-Texas Entity - If the entity was formed outside of Texas, please complete the following information.
1. Is the entity still conducting business in Texas? ..........................................................................................................................
Merger effective date.................................
Entity conversion effective date.................
Name of survivor_______________________________________
NOTE: If the home state charter has been terminated, home state documentation must be included. The home state documentation must bear the seal of the appropriate filing agency and the effective date of the filing.
Section D - Receiving Your Certificate
Does this entity have a forfeited certificate or registration that needs to be reinstated before ending its existence |
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or registration in Texas? |
YES |
Please indicate how you would like to receive your certificate:
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FAX number |
Telephone number |
FAX |
(area code and number)________________________________ (area code and number) ___________________________________ |
.PDF |
Email address ______________________________________________________________________________________________ |
Mail |
Mailing address ______________________________________ City _____________________ State _______ ZIP code __________ |
You can file documents online with the Secretary of State using SOSDirect at www.sos.state.tx.us/corp/sosda/index.shtml.
Your account will be reviewed to determine eligibility. If eligible, a certificate will be sent using the format selected. If not eligible, we will notify you in writing what is required to be eligible. All requests are processed in the order they are received regardless of the format you select. Assistance is also available at your local field office. Field office locations are available online at www.comptroller.texas.gov/about/contact/locations.php.
Your name (Please type or print)
Phone number and extension
Visit us online at www.comptroller.texas.gov/taxes/franchise/
or call 1-800-252-1381 or 512-463-4600.
Mail to: Comptroller of Public Accounts P.O. Box 149348
Austin, TX 78714-9348
Under Ch. 559, Government Code, you are entitled to review, request and correct information we have on file about you, with limited exceptions in accordance with Ch. 552, Government Code. To request information for review or to request error correction, contact us at the address or phone number listed on this form.