- 1 -
|
TR-193.1(7/20)
Office of Processing and Taxpayer Services
W A Harriman Campus, Albany NY 12227-0852 Send this statement to us by fax to: 518-435-2995
Affidavit for Surrender of Authority for Foreign Corporations
Legal name of corporation:
Employer identification number (EIN):
I, (print name), being duly sworn, hereby depose and say:
1. I am the (title, must be an officer or legal representative)
of (legal name of corporation)
2. The corporation requests to surrender its authority to do business in New York State as of (today’s
date, mm-dd-yy)
3. The corporation was not subject to tax under Article 9 or Article 9-A, and therefore did not file New York State
tax returns or reports for the following periods that began on or after January 1, 2015 (attach additional sheets if
necessary):
Tax period beginning date (mm-dd-yy) Tax period ending date (mm-dd-yy)
4. I acknowledge that surrendering this corporation’s authority does not end its obligation to pay taxes if it is subject to tax
or becomes subject to tax in New York State.
5. I acknowledge that this affidavit does not start the period of limitation within which franchise tax may be assessed.
6. I acknowledge that this corporation must satisfy all open tax periods prior to consent being issued.
(Certification on page 2)
www.tax.ny.gov
|