
Request for Certicate of Account Status to
Terminate a Taxable Entity’s Existence in Texas or Registration
An entity that intends to terminate its legal existence or registration must satisfy ling requirements for all taxes administered by the Comptroller under Title 2 of
the Texas Tax Code. In addition, all accounts for those taxes must be closed. To determine if the entity is current in tax requirements, or to close any open tax
accounts, call us at 1-800-252-1381 or 512-463-4600. More information about this process is available online at www.comptroller.texas.gov/taxes/franchise/.
05-359
(Rev.2-17/13)
Termination Merger Entity conversion
Section B - Texas Entity - If the entity was formed in Texas, indicate the ling for which the certicate is required.
Please indicate how you would like to receive your certicate:
FAX number Telephone number
FAX (area code and number) ________________________________ (area code and number) ___________________________________
.PDF Email address ______________________________________________________________________________________________
Mail Mailing address ______________________________________ City _____________________ State _______ ZIP code __________
Does this entity have a forfeited certicate or registration that needs to be reinstated before ending its existence
or registration in Texas? .................................................................................................................................................................. YES NO
You can le documents online with the Secretary of State using SOSDirect at www.sos.state.tx.us/corp/sosda/index.shtml.
Section D - Receiving Your Certicate
Under Ch. 559, Government Code, you are entitled to review, request and correct information we have on le about you, with limited exceptions in accordance with Ch. 552,
Government Code. To request information for review or to request error correction, contact us at the address or phone number listed on this form.
Entity’s legal name Taxpayer number File number (from the Texas Secretary of State)
The day before the combined
group’s accounting year
begin date ............................................
1. Is the entity a member of an afliated group that will be required to le a combined report? ...................................................... YES NO
If “YES,” enter the following information for the entity that will report on your behalf. If “NO,” skip to Section B.
2. Is the entity’s accounting year begin date on or after the combined group’s accounting year
begin date on its franchise tax report? ......................................................................................................................................... YES NO
If “YES,” this entity’s information must be included in the combined group report. If “NO,” enter the following information:
Legal name of reporting entity Texas taxpayer number / FEI number
This entity’s
month day year month day year
accounting year
begin date ............................................
Section A - Entity Information
Your name (Please type or print) Phone number and extension
Authorized agent
Mail to: Comptroller of Public Accounts
P.O. Box 149348
Austin, TX 78714-9348
Visit us online at www.comptroller.texas.gov/taxes/franchise/
or call 1-800-252-1381 or 512-463-4600.
1. Is the entity still conducting business in Texas? .......................................................................................................................... YES
3. Does the entity currently have an active charter in its home state? ............................................................................................
NO
2. If “NO,” enter the entity’s last day of business in Texas ...........................................
YES NO
4. If “NO,” indicate the type and date of termination:
Termination effective date .........................
Merger effective date ................................. Name of survivor _______________________________________
Entity conversion effective date .................
month day year
month day year
Note: If the home state charter has been terminated, home state documentation must be included. The home state documentation must bear the seal of
the appropriate ling agency and the effective date of the ling.
Section C - Non-Texas Entity - If the entity was formed outside of Texas, please complete the following information.
Your account will be reviewed to determine eligibility. If eligible, a certicate will be sent using the format selected. If not eligible, we will notify you in
writing what is required to be eligible. All requests are processed in the order they are received regardless of the format you select. Assistance is
also available at your local eld ofce. Field ofce locations are available online at www.comptroller.texas.gov/about/contact/locations.php.