CRS-1-Short Form CRS-1 Combined Report-Short Form For 3 or Fewer Business Locations, Codes or Lines of Detail

If you will need more forms please download additional forms from our website at www tax newmexico gov Please file your CRS 1 Forms in accordance with your filing status: i e monthly quarterly semi annually If you do not know your filing status please contact your local district office To e file visit the TRD web page at www tax newmexico gov Under "Online Services" click on "Gross Receipts/Compensating/Withholding Tax E filing" then click on the "efile" button " Follow the instructions to e file your return First time filers must register for online filing Upon completion of this form sign date and enter your E mail address on the form Make check payable to You will receive more CRS 1 Forms in the CRS 1 Filer's Kit mailed every June and December COMBINED REPORT FORM CRS 1 NAME STREET / BOX CITY STATE ZIP DEPARTMENT USE ONLY Do not write in this area Due date: 25th of month following end of report period File the CRS 1 Form online through the Department's web site: Go Paperless! INTEREST 6 Keep this copy as part of your records Mail to: NM Taxation and Revenue Department P O Box 25128 Santa Fe NM 87504 5128 Municipality / CountyNameA SpecialB Code* C Location Code D Gross Receipts(Excluding Tax) E Total Deductions F Taxable Gross Receipts G Tax Rate H Gross ReceiptsTax Name ID No No New Mexico Taxation and Revenue Department Mail to: NM Taxation and Revenue Department P O Box 25128 Santa Fe New Mexico 87504 5128 P O Box 25128 Santa Fe NM 87504 5128 PENALTY 5 Penalty will be assessed for nonpayment of timely reports Please indicate your CRS ID number on your check Please complete if not preprinted Rev 09/2010 I declare that I have examined this return including any accompanying schedules and statements and to the best of my knowledge and belief it is true correct and complete Signature of taxpayer or agent Title Date E mail address Tax E filing" then click on the "efile" button " TAXPAYER'S COPY Tear at perforation and return bottom portion only to: through Month Day Year Month Day Year Payment made by: Automated Clearinghouse Deposit Date Federal Wire Transfer Date Check if applicable: Amended Report TAX PERIOD Print NM CRS Phone COMPENSATING TAX 2 through Month Day Year Month Day Year Payment made by: Automated Clearinghouse Deposit Date Federal Wire Transfer Date Check if applicable: Amended Report TAX PERIOD Print NM CRS Phone PENALTY TOTAL TAX DUE TOTAL GROSS RECEIPTS TAX WITHHOLDING TAX INTEREST TOTAL AMOUNT DUE COMPENSATING TAX 1 2 3 5 6 7 4 HFD $ C GE Total Deductions Taxable Gross Receipts Tax RateGross Receipts(Excluding Tax) Location Code $ Municipality / CountyNameA SpecialB Code* TOTAL COLUMNS D E and H *See instructions for column B Gross ReceiptsTax TOTAL AMOUNT DUE 7 TOTAL COLUMNS D E and H *See instructions for column B $ $ TOTAL GROSS RECEIPTS TAX 1 TOTAL TAX DUE 4 Under "Online Services" click on "Gross Receipts/Compensating/Withholding WITHHOLDING TAX 3 www tax newmexico gov