RPD-41071                    STATE OF NEW MEXICO - TAXATION AND REVENUE DEPARTMENT
Rev. 06/28/2017
                                           APPLICATION FOR REFUND
Who Must File This Form. Use this form to apply for a refund of most tax, fees, or surcharges paid to the New Mexico Taxation and 
Revenue Department. Unless your claim is an exception (described next), you are required to complete this form or submit a letter 
with substantially the same information to apply for a tax refund. 
Exceptions for Filing This Form. If your refund claim is the result of overstating the tax due on a previously filed income tax or an oil 
and gas tax return and you are filing an amended return, you do not need to complete and attach this application for a tax refund. A 
complete amended return is sufficient to support a valid claim for tax refund. Other exceptions to filing this application are the tax, fee, 
and surcharge programs listed in the instructions. 
How to File This Form. See the requirements list in Information Required to Claim a Refund on the first page of the instructions. 
The taxpayer or the authorized agent must sign this Application for Refund.
Attach to this application all documentation that supports your refund claim. A claim for refund is not valid unless it is complete and 
verifiable. See the instructions for more information. 
To apply all or any part of your refund to another report period, liability, or another tax, fee, or surcharge program, please state in detail 
the report period, liability, or other tax, fee, or surcharge program to which you want to apply the refund.

 Name of business or taxpayer                                                        Taxpayer identification no. (CRS ID or SSN)

 Mailing address on file

 City, state, ZIP code

 Contact name, if applicable                                                          Phone number

I hereby certify that the State of New Mexico was overpaid the sum of _________________________________________

dollars ($ ___________) in ____________ taxes, fees, or surcharges for the period(s)  ____________ to _____________
                              (type of program) 
                             see top back of this page for list 
                             of tax, fee, surcharge programs
Basis for refund. Briefly state the facts. 

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

Is an amended return submitted with this request? (for previously filed returns, one amended return required for each affected period)

 Yes                              No                     Previously Mailed                        Not Required

 I declare that the information reported on this form and any attached supplements are true and correct.
 ________________________________________   ________________________________   ___________________
 Signature of taxpayer or agent                                       Title                       Date 

 ________________________________________   ________________________________   ___________________
 Type or print name                                                   Email address               Phone

                        Return this form and attachments to the Taxation and Revenue Department,
                                        P.O. Box 630, Santa Fe, New Mexico 87504-0630.

RPD-41071
Rev. 06/28/2017                     Request For Direct Deposit
If you are requesting a refund of tax, fees, or surcharges paid to the New Mexico Taxation and Revenue Department for any of the 
programs listed below and would like your refund deposited directly into your bank account located at a financial institution inside 
the territorial jurisdiction of the United States (U.S.), complete the information. If the information below is incomplete or incorrect, the 
Department mails the refund to the address on file. 
Programs: Combined Report System (CRS) Tax, Personal Income Tax (PIT), Corporate Income and Franchise Tax (CIT), Oil and Gas Proceeds 
Withholding (OGP) Tax, Enhanced 911 Surcharge (E911), Telecommunication Relay Service Surcharge (TRS), Water Conservation Fee (WCF), 
Weight Distance Tax (WDT), and Workers' Compensation Fee (WKC).
                                                                                   Required: Will this refund go to or 
1.  Routing number:                                                                through an account located outside 
                                                                                   the territorial jurisdiction of the U.S.?  
2.  Account number:                                                                If yes, you may not use this refund 
                                                                                   delivery option. 
3.  Type:       Checking           Savings                           4.     Required:                   Yes           No

                                           FOR DEPARTMENT USE ONLY

I analyzed the records of the Taxation and Revenue Department on ____________________________________ , 20 _______
and verified the amount of tax overpayment. I hereby certify that a tax refund is due as claimed according to Section 7-1-26 NMSA 
1978. The amount of overpayment is for the following taxes:

    TAX, FEE, or SURCHARGE PROGRAM                             AMOUNT

 1.                                                 $
                                                                                   Claim number
 2.
                                                                                   Serial number
 3.
                                                                                   Warrant number
                         Total interest to refund

                         Total amount to refund     $

Analysis of reason for overpayment:

Valid overpayment:       o  YES    o  NO            o  Need additional information Credit amount $_______________

Amended returns on file: o  YES    o  NO            o   N / A                      Credit key____________________

                         Date requested ______________________________________

 Documents supporting this refund are on file:
                                                                                   GENERAL APPROVAL
 I recommend refund:

 Initiated by                                                                      Secretary or Delegate

 Section supervisor                                  Date                          IF REQUIRED

 Bureau Chief                                        Date                          Attorney General's Office

RPD-41071                STATE OF NEW MEXICO - TAXATION AND REVENUE DEPARTMENT
Rev. 06/28/2017
                                  APPLICATION FOR REFUND Instructions

Exceptions to Filing RPD-41071                                      Interest on Overpayment 
The following tax, fee, or surcharge programs require you to file a The Department requires a complete and approved refund claim 
special form instead of this RPD-41071, Application for Refund, to  before calculating interest on an overpayment. The Department 
claim a refund for their program:                                   does not pay interest on refunds for the following tax credits:
● For a refund of oil and gas taxes other than the oil and gas      ● Investment
  proceeds withholding tax, use RPD-41136, Application for          ● Laboratory partnership with small business 
  Tax Refund - Oil and Gas.                                         ● Technology jobs and research and development
● For a refund of withholding tax on the net income of a            ● Film production
  pass-through entity (PTE) reported on    PTE New Mexico           ● Affordable housing
  Information Return for Pass-Through Entities, use                 ● Rural job
  RPD-41373, Application for Refund of Tax Withheld From            ● High-wage jobs
  Pass-Through Entities. 
● For an overpayment of tax withheld on RPD-41367,                  Requirements for Requesting CRS-1 Tax Refunds
                                                                    The documents to attach when you request a CRS-1 tax refund 
  Pass-Through Entity Withholding Detail (PTW-D) Report,            depend on the reason for your refund claim. To claim a refund of 
  use RPD-41373, Application for Refund of Tax Withheld             gross receipts tax paid because you did not claim: 
  From Pass-Through Entities. 
                                                                    ● An allowable deduction, attach a copy of either of the 
● For a refund of vehicle-related or driver-related taxes or fees,    following, if applicable: 
  use MVD-10208, Request for Refund. 
                                                                      ♦     The nontaxable transaction certificate (NTTC) the 
● For a refund of Tobacco Products Tax, use RPD-41318,                      buyer executed so the Department can verify the buyer 
  Application for Tobacco Products Tax Refund.                              executed it properly and timely 
● For a refund of a spoiled or damaged cigarette stamp, use           ♦     Any other documentation necessary to support the 
  RPD-41211, Application for Refund of Cigarette Tax.                       deduction (for example, a farmer or rancher statement)
Follow the instructions for the applicable refund form to apply for ● An exemption, attach documentation necessary to support 
your refund and find out about required attachments.                  the exemption (for example, invoices or contracts) 

Information Required to Claim a Refund                              E-filing CRS Returns
According to Section 7-1-26 NMSA 1978, the following                If the Department requires you to e-file a CRS-1 return, this 
information is required to claim a refund:                          requirement extends to e-filing all CRS-1 amended returns.
● Taxpayer's name, address, and identification number               NOTE: You can only mail RPD-41071, Application for Refund, 
                                                                    with its required attachments to the Department.
● Type of tax for which the refund is claimed, the credit or 
  rebate denied, or the property levied upon                        CRS Resources
● Sum of money or other property claimed                            To find out if you are required to e-file CRS-1 returns, see  
                                                                    FYI-108, Electronic Filing Mandate. You can find FYI-108 at 
● Period(s) for which the overpayment was made                      www.tax.newmexico.gov/forms-publications.aspx. On that page, 
● Brief statement of the facts and law on which the                 click Publications,FYIs, and 100 Series-General Information      . 
  claim is based, referred to as the basis for refund, and 
  documentation to support and substantiate the taxpayer's          The following publications describe allowable deductions, 
  basis for the refund                                              exemptions, and credits against these taxes and the required 
● If applicable, a copy of an amended return for each tax           documentation to support a refund claim:
  period for which the refund is claimed.                           ● Overview of Gross Receipts & Compensating Taxes 
                                                                      published in the CRS Filers Kit
When to Attach an Amended Return                                    ● FYI-105, Gross Reciepts & Compensating Taxes - An 
If your refund is the result of overstating the tax, fees, or         Overview
surcharges due on a previously filed return, you are required         
to attach a fully completed amended return for each affected        Request for Direct Deposit
period. Regardless of the number of amended periods, only one       If you want your refund directly deposited into your checking or 
Application for Refund is required per refund claim.                savings account, complete the Request For Direct Deposit 
IMPORTANT: When filing an amended return, submit all                section. Failure to complete all lines and boxes in this section 
supporting forms, schedules, and backup as requested by the         results in the Department mailing a paper check to the address 
instructions.                                                       on file.

RPD-41071                    STATE OF NEW MEXICO - TAXATION AND REVENUE DEPARTMENT
Rev. 06/28/2017
                                 APPLICATION FOR REFUND Instructions

NOTE: Direct deposits are only allowable to the taxpayer’s             ●   If you answer the question incorrectly, the National 
account. The Department is not responsible if a financial                  Automated Clearing House Association (NACHA) or the 
institution refuses a direct deposit, or if misapplication of a direct     Office of Foreign Assets Control (OFAC) may delay, reject, or 
deposit refund was caused by a taxpayer's error, negligence, or            freeze your refund.
malfeasance.                                                           ●   If your bank does not accept your Request For Direct 
                                                                           Deposit entries, the Department mails a check to you.
Lines 1 and 2 and Boxes 3 and 4
Line 1. The routing number, for bank identification, has nine digits. 
If the first two digits are not 01 through 12 or 21 through 32, the    Your Rights and Refund Claims 
system rejects the direct deposit and you receive a check.             This sections gives you information about your rights regarding 
                                                                       tax liabilities and offsets and about denials of claims.
NOTE: If your check states it is payable through a different bank 
than the financial institution where you have your checking or         Tax Liabilities
savings account, do not use the routing number on that check.          If you have any tax liability, the Taxation and Revenue 
Instead, contact your financial institution for the correct routing    Department may offset all or part of an allowed refund against 
number to enter on this line.                                          such liability. 
                                                                       To claim a refund of an overpayment due to an offset by the 
Line 2. Your account number has up to 17 characters. Include           Department, please attach a copy of the offset notice.
hyphens, but omit spaces and special symbols as you enter the 
number from left to right. Leave unused boxes blank. On the            Refund Claim Denials
sample check, the account number is 2015551517. Do not include         If the Department denies your claim for refund in whole or in 
the check number.                                                      part, you may file a protest with the Department within 90 days of 
                                                                       either mailing or delivery of the denial, or you may file a lawsuit in 
Box 3. Mark an  Xin the  Checking or Savings box to indicate the       Santa Fe District Court.
type of account.
                                                                       If the Department does not take action on your completed claim 
                                                                       within 180 days of receiving your claim, you may elect to treat the 
Box 4. Mark an  Xin the  YES or NO box to answer whether the 
                                                                       refund claim as denied, which allows you to pursue the remedies 
funds for your refund would go to or through an account located 
                                                                       stated in the preceding paragraph.
outside the U.S. Marking NO means the financial institution's 
location is within the territorial jurisdiction of the U.S., which     If the Department requests additional relevant documentation 
includes any of the following:                                         from you, the claim in not complete. If you submit the requested 
                                                                       documentation within the required time period, the Department 
● W  ithin the U.S.
                                                                       uses the date the Department received the complete 
● On a U.S. military base                                              documentation as the start of the 180 days. If you do not provide 
● In Ame   rican Samoa, Guam, the Northern Mariana Islands,            the additional relevant documentation, the claim for refund 
     Puerto Rico, or the U.S. Virgin Islands                           remains incomplete.
                                                                       For more information about your remedies, please see 
What Happens for Different Answers in Box 4                            FYI-402, Taxpayer Remedies. You can find FYI-402 at
                                                                       www.tax.newmexico.gov/forms-publications.aspx. Click 
●    If you mark an  Xin the YES box, you cannot use direct 
                                                                       Publications,FYIs , and then  400 Series-Tax Administration      .
     deposit. Either use a different bank account or to leave the 
     Request For Direct Deposit section blank to receive a 
     paper check at the address on file.                               For More Information, Forms, and Instructions
                                                                       If you have any questions, including which documents to file with 
●    If you do not answer the question, the Department mails           a refund application or an amended return, call the Department 
     your refund to you in a paper check. To comply with federal       toll free at (866) 809-2335 or visit your local district office. 
     banking rules, anyone who wants their refund directly 
     deposited into their account must answer this question.           To find copies of tax forms on the Department website, click  
                                                                       www.tax.newmexico.gov/forms-publications.aspx. Then select the 
                                                                       tax program or click the magnifying glass icon and enter the form 
                                                                       number.