The California 3555 form is a Request for Tax Clearance that corporations must complete to obtain a tax clearance certificate from the Franchise Tax Board. This certificate confirms that all taxes have been paid or secured, allowing for the proper dissolution of a corporation. For assistance in completing this form, please click the button below.
The California 3555 form, also known as the Request for Tax Clearance, plays a crucial role for corporations and other entities seeking to ensure compliance with state tax obligations. This form is primarily used to obtain a tax clearance certificate, which signifies that all taxes owed to the state have been paid or secured. It requires essential information such as the corporation's name, California corporation number, current address, and federal employer identification number. Additionally, the form prompts the applicant to disclose significant dates, including when the business commenced and when it ceased operations or plans to cease. It also addresses any IRS activity that may affect the corporation's tax liabilities, ensuring transparency in the tax clearance process. If the business is undergoing a merger or transfer of assets, the form includes sections for supplemental information regarding the transferee corporation. Completing this form accurately is vital, as it not only facilitates the issuance of the tax clearance certificate but also helps avoid potential audits or penalties. As you navigate this process, be mindful of the detailed requirements and the importance of timely submission to the Franchise Tax Board.
Request for Tax Clearance
CALIFORNIA FORM
3 5 5 5
Certificate — Corporations
Corporation name
California corporation number
Current address
Phone number
Federal employer identification number
(
)
Date business commenced
Date business ceased or will
Latest income period for which a
Date filed:
in California:
cease in California:
California tax return has been filed:
We will issue a tax clearance certificate when all taxes have been paid or secured. All returns remain subject to audit until expiration of the normal statutes of limitation.
Please indicate the status of ANY IRS activity:
Has the IRS redetermined the corporation’s income tax
Is the IRS or the FTB currently examining the corporation
liability for any prior years that you have not previously
or has it notified the corporation of a pending examination?
reported to us? ❏ Yes ❏ No
❏ Yes ❏ No If yes, indicate the years involved:
If yes, send us a copy of the Revenue Agent’s Report.
Current examination:
__________________________
Pending examination:
Complete pages 2 and 3 of this form for an individual or other entity assumption of tax liability. Complete page 4 for a corporation, limited liability company, or limited liability partnership assumption of tax liability.
If we are to issue the tax clearance certificate on a taxes paid basis, please check this box and provide a copy of your final tax return. ❏
Supplemental Information. Please furnish the following information if another corporation will continue to conduct the business in California after the merger of the original corporation.
Name of transferee
California corporation number of transferee
Date assets transferred to transferee
Section of the Internal Revenue Code applicable to the transfer of
taxpayer’s business or assets: ______________
If we are to mail the tax clearance certificate to somewhere other than the corporation listed above, please complete the following: (We will send a copy of the tax clearance certificate to the Secretary of State.)
Name
Address
Phone number (
Mail completed form to: DOCUMENT FILING SUPPORT UNIT
SECRETARY OF STATE – BUSINESS FILINGS 1500 11TH STREET
SACRAMENTO CA 95814
For more information concerning this form, telephone the Franchise Tax Board at (916) 845-4124.
Assistance for persons with disabilities: We comply with the Americans with Disabilities Act. Persons with hearing or
speech impairments, call: from voice phone (800) 735-2922, or from TTY/TDD (800) 822-6268.
FTB 3555 C1 (REV 09-2001) PAGE 1
Please complete Section A or B below.
A. INDIVIDUAL ASSUMPTION OF TAX LIABILITY
( )
I unconditionally agree to file or cause to be filed with the Franchise Tax Board, under the provisions of the Bank and Corporation Tax Law, all tax returns and data required and to pay in full all accrued or accruing tax liabilities, penalties, interest, and fees due from the above named corporation at the effective date of dissolution or surrender.
My net worth (assets minus liabilities) is not less than: $ _____________________ .
(We require a detailed financial statement [PAGE 3].)
Name of individual assumer (print)
Social security number
Date
Signature
B. TRUST ASSUMPTION OF TAX LIABILITY
This trust unconditionally agrees to file or cause to be filed with the Franchise Tax Board, under the provisions of the Bank and Corporation Tax Law, all tax returns and data required and to pay in full all accrued or accruing tax liabilities, penalties, interest, and fees due from the above named corporation at the effective date of dissolution or surrender:
Name of trust
Trust federal identification number
Trustee’s name (print)
Trustee’s signature
FOR PRIVACY ACT NOTICE, SEE FORM FTB 1131.
FTB 3555 C1 (REV 09-2001) PAGE 2
FINANCIAL STATEMENT FOR INDIVIDUAL OR OTHER ENTITY
Corporation number
Statement of Assets and Liabilities
Item
Present
Liabilities
Equity in
value (A)
balance due (B)
asset
Cash
Bank accounts
Stocks and bonds
Cash or loan value of insurance
Household furniture
Real property
Vehicles
Other assets (describe)
Federal taxes outstanding
Loans
Other (include judgements)
Net assets
(Total column A less total column B)
$
General Information (Please attach additional schedules if necessary.)
Net annual income
Source (name of business or employer)
Banks and savings and loan accounts (names and addresses)
Description and license number of each vehicle
Stocks and bonds (name of company, number of shares, etc.)
Real property (brief descriptions and locations)
I certify that the information above is correct to the best of my knowledge.
Assumer’s name (print) _____________________________________________________________________________________________________
Assumer’s address
____________________________________________________________ Phone number (
_______________________
Assumer’s signature
__________________________________________________________________________
FTB 3555 C1 (REV 09-2001) PAGE 3
CORPORATION, LIMITED LIABILITY COMPANY, OR LIMITED LIABILITY PARTNERSHIP ASSUMPTION OF TAX LIABILITY
The Assumption of Tax Liability
of (1) __________________________________________________________ )
A corporation
) ________________________
California Corporation number, Secretary of
State file number, or federal employer
by (2) _________________________________________________________ )
identification number
A corporation, limited liability company, or limited liability partnership
(Name of assumer) __________________________________________________ unconditionally
agrees to file with the Franchise Tax Board all tax returns and data required and pay in full all tax liabilities, penalties, interest and fees of (1) _________________________________________
_________________________________________________________________________________; at the
effective date of dissolution or surrender of the corporation.
(2) _________________________________________
Exact corporation, limited liability company, or limited liability partnership name
_______________________________________
_________________________________________
Printed name and title of officer/manager/partner/member
Signature and title of officer/manager/partner/member
State of _______________________________
County of _____________________________
On ________________________________________ before me, the undersigned, a notary public in and for
said state, personally appeared _______________________________________________________________
_______________________________________________________________________________________
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature ________________________________________________________
Name __________________________________________________________
(typed or printed)
Note: LLC, LLP, and corporation assumers must provide a financial statement.
FTB 3555 C1 (REV 09-2001) PAGE 4
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