Free Application for Reinstatement/Request for Audit - New Mexico

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PUBLIC REGULATION COMMISSION TAX COMPLIANCE DIVISION PO BOX 1269 SANTA FE, NM 87504-1269

APPLICATION FOR REINSTATEMENT
(TYPE OR PRINT LEGIBLY) Pursuant to New Mexico State Statutes the undersigned applies to the commission for Reinstatement:

1. The name of the corporation is____________________________ NMPRC# _____________and the effective date the Certificate of Revocation was filed: Month ______Day ______Year ______ 2. (Mark ("X") on the appropriate item): ____ Grounds for revocation did not exist;
(If applicable, please explain)

___________________________________________________ ___________________________________________________ _____ Grounds have been eliminated upon the filing of delinquent reports and/or fees due. 3. The name satisfies state law regarding availability of corporate name. _________________________ AUTHORIZED OFFICER
(SIGNATURE)

NAME: _______________________________ ADDRESS: ____________________________ CITY: __________________ST: _____ ZIP CODE: ____________

NMPRC-RI 07/03

INTERNAL AUDIT/REINSTATEMENT Date:__________________________
PUBLIC REGULATION COMMISSION TAX COMPLIANCE DIVISION P.O. BOX 1269 SANTA FE, NEW MEXICO 87504-1269 (505) 827-4510 FAX (505) 476-0324

RE: REQUEST FOR AUDIT/REINSTATEMENT
EXACT CORPORATE NAME:_________________________________________________________________ ________________________________________________________________________ NMPRC #__________________________

REQUESTING PARTY NAME:_________________________________________________________________ ADDRESS:______________________________________________________________ CITY:__________________________________________________________________ STATE:___________________________________ZIP CODE:____________________ TELEPHONE # (_________) ____________________ SIGNATURE____________________________________

NOTE: THE PUBLIC REGULATION COMMISSION, TAX COMPLIANCE DIVISION WILL RESEARCH THE FILE AND ADVISE THE CORPORATION, IN WRITING, OF ANY DELINQUENCIES. CORPORATE REPORTS WILL BE INCLUDED, IF REQUIRED, AS WELL AS A SUMMARY OF FEES DUE. ****INFORMATION MUST BE LEGIBLE****