Form RPD-41362 Agricultural Biomass Tax Credit Approval

(505) 476 3683 AGRICULTURAL BIOMASS TAX CREDIT APPROVAL by the New Mexico Energy Minerals and Natural Resources Department (EMNRD) Mail to New Mexico Taxation and Rev enue Department Edit Error P O Box 5418 Santa Fe New Mexico 87502 5418 For assistance completing this form call Holder if other than eligible facility owner If the qualifying facility is owned by a partnership or other business association the owner may pass the credit to its member(s) manager(s) partners(s) shareholder(s) or beneficiary(ies) by completing Section II and submitting a Form RPD 41362 Agricultural Biomass Tax Credit Approval for each member partner shareholder or ben eficiary Members managers partners and beneficiaries may claim a credit only in proportion to their interest in the partnership or other business association and will be issued an approval for their portion of the credit Mailing address City state and ZIP code Name of contact Phone number E mail address Name of holder if other than facility owner Social security or federal employer identification number Name of owner of the qualifying facility Social security or federal employer identification number obtain approval for the agricultural biomass tax credit Once approved this form will be returned to the owner or the holder Phone numberName of contact Percentage of ownership interest in the partnership or other business association Purpose of this Form This form is required to be completed and submitted to the Taxation and Revenue Department to SECTION III SECTION II SECTION I Signature of facility owner Date Under penalty of perjury I certify that I have examined this form and attachments and to the best of my knowledge and belief it is true correct and complete State of New Mexico Taxation and Revenue Department Statement of the facility owner: (Mark the box to certify the statement below ) I certify that I have not and will not claim the agricultural biomass tax credit pursuant to Section 7 2 18 26 NMSA 1978 and Section 7 2A 26 NMSA 1978 for transportation of the same agricultural biomass on which the claim for that agricultural biomass tax credit is based Statement of the holder if other than facility owner: (Mark the box to certify the statement below ) I certify that I have not and will not claim the agricultural biomass tax credit pursuant to Section 7 2 18 26 NMSA 1978 and Section 7 2A 26 NMSA 1978 for transportation of the same agricultural biomass on which the claim for that agricultural biomass tax credit is based TO BE COMPLETED BY THE TAXATION AND REVENUE DEPARTMENT Credit number: Approved amount of agricultural biomass tax credit:Date of approval of the credit: Agricultural biomass tax credit is approved as submitted Agricultural biomass tax credit is not approved See the attached explanation Agricultural biomass tax credit is approved but the amount of the credit has been adjusted See the attached explanation Signature of Secretary or authorized delegate: Date: Name (please print): Title: Under penalty of perjury I certify that I have examined this form and attachments and to the best of my knowledge and belief it is true correct and complete Signature of holder if other than building owner Date who may begin claiming the credit Attach a copy of the certificate of eligibility for the agricultural biomass tax credit issued