Free Biennial Profit Corporate Report - New Mexico

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RETURN TO: NM PUBLIC REGULATION COMMISSION CORPORATIONS BUREAU P.O. BOX 1269 SANTA FE NM 87504-1269

FOREIGN PROFIT CORPORATION
BIENNIAL REPORT______ For taxable year ending_____/____/_______

OR
SUPPLEMENTAL REPORT___________( if any information changes)

Please see instructions on back of page. 1 Name EXACT CORPORATE NAME Address AND U.S. MAILING City, State, Zip ADDRESS 2 NMPRC Certificate of Authority Number 3 State or country of incorporation 4 Principal Office Outside New Mexico Street City, State, Zip

5 REGISTERED AGENT AND OFFICE LOCATIION WITHIN NEW MEXICO FOR SERVICE OF PROCESS
(Filing corporation cannot be its own agent) Name Street Address City, Zip 6 REGISTERED OFFICE LOCATION IN STATE OR COUNTRY OF INCORPORATION Street Address City, State, Zip TAX ID NUMBER 8 NEXT ANNUAL MEETING 9 Principal Place of Business In New Mexico Street City, State, Zip

7

10

DIRECTORS AND OFFICERS List names and addresses of ALL the directors and officers and identify every title each director holds. Name and Address Office/Title Director Director Director President Vice President Secretary Treasurer Attach schedule of additional directors and officers if needed (optional) Additional Titles

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SIGNATURE Under penalties of perjury, I declare and affirm that I have examined this report, including the accompanying schedules and statements, and that all statements contained therein are true and correct.

Date

Printed Name

Signature

Title

12

PAYMENT OF FILING FEE AND LATE FILING PENALTY a Report filing fee b Late filing penalty ($200.00) except supplemental PRC extension, if any, must be submitted with this report

NMPRC USE ONLY
$ 25.00

Amount Remitted

Postmark Date

c TOTAL AMOUNT DUE with corporate report (lines a + b)
PLEASE DO NOT SUBMIT CASH FOR PAYMENT

$

INSTRUCTIONS This report is required by, and must comply with the requirements of, NMSA 1978 Sections 53-5-2 through 535-9 and 12.3.2.13 NMAC. A corporation must file a supplemental report if the corporation makes any changes listed in NMSA 1978 Section 53-5-2. Please type or print legibly. At the top right of the form, indicate whether the report is a biennial or supplemental report, and the closing date of the taxable year of the report (if a biennial report). 1. Provide the exact name of the corporation and U.S. postal mailing address. If available, attach a mailing label from the Public Regulation Commission. 2. 3. Insert the Certificate of Authority Number issued by the New Mexico Public Regulation Commission. Indicate the state or country under whose laws the corporation is incorporated.

4. Provide the address of your principal place of business outside New Mexico if different from the address of the registered office, or "NONE" if applicable. 5. Indicate the address of the registered office of the corporation in New Mexico, and the name of its registered agent at that address. For additional information on the requirements for registered office and agent, see NMSA 1978 Sections 53-11-11, 53-11-12, and 53-11-13 and 12.3.2.11 NMAC. If within a municipality, the address must be a street address; if outside a municipality, you must include geographic location, including well-known landmarks. 6. Insert the address of the registered office of the corporation in the state or country of incorporation.

Provide the corporation's taxpayer identification number issued by the revenue processing division of 7. the New Mexico taxation and revenue department. 8. 9. Provide the date for the next annual meeting of shareholders for election of directors. Provide the address of your principal place of business within New Mexico.

10. Indicate the names and respective addresses of the directors and officers of the corporation. You must list any officers and titles required by the state or country under whose laws the corporation is incorporated. If the corporation's articles of incorporation or by-laws confer additional titles on the officers, you may provide these in the right column, but this is not required. 11. The chairman of the board, president, vice president, secretary, principal accounting officer or authorized agent of the corporation must sign and swear to the statements in the report. 12. A biennial report is due on or before the fifteenth day of the third month following the end of the corporation's taxable year (see Subsection C of 12.3.2.11 NMAC for information on determining your filing year). A supplemental report is due within thirty (30) days of the change necessitating the report. If not filed by these dates, you owe a late penalty of two hundred dollars ($200.00), unless the Commission granted an extension pursuant to NMSA Section 53-5-6. If the report is late and the Commission did not grant an extension, insert two hundred dollars ($200.00) in box 12b and total the fees owed. Payment of fees must accompany this report or the Commission will not accept it for filing. You may pay by check or money order made out to the New Mexico Public Regulation Commission. If the Commission granted an extension, you must attach a copy of the extension to this report. [12.3.2.13 NMAC - N, 7-15-05]