RPD-41096                    STATE OF NEW MEXICO - TAXATION AND REVENUE DEPARTMENT
Rev. 11/29/2011

               APPLICATION FOR EXTENSION OF TIME TO FILE

               PLEASE TYPE OR PRINT                            INSTRUCTIONS ON REVERSE SIDE
Name of individual, firm or organization

Mailing address

City                                                                                     State            ZIP code

New Mexico ID number                    Social security number                           Federal ID number

               NOTE: If a federal automatic extension has been obtained for the period of this extension, 
                     you do not need to submit Form RPD-41096, Application for Extension of Time to File. 
To qualify for an extension, this form must be submitted on or before the due date of the return or the extended due date of the return.
An extension of time to file a return and pay the New Mexico tax liability is hereby requested, until _______________________.
NOTE: By obtaining an extension of time to file your return, penalty for failure to file and pay is waived through the extension period, pro-
vided you file the return and pay the tax shown on the return by the extended due date. Interest accrues even if the taxpayer obtains an 
extension of time to file and pay the return. Interest is assessed daily at the quarterly rate established for individuals by the U.S. Internal 
Revenue Code on the amount of tax due. Annual and daily interest rates for each quarter are posted on the Department web site.
Complete all three statements about the tax return that you wish to request an extension of time to file. 
(Submit a separate extension request for each return. Do not combine multiple returns or multiple report periods on one application.)
1.  The extension refers to the following New Mexico tax return (check one):
       Personal Income Tax Return                Pass-Through Entity Return
     Fiduciary Income Tax Return                 CRS-1, Combined Report of Gross Receipts, Compensating and Withholding Tax
     Corporate Income and Franchise Tax Return   Other
     S Corporate Income and Franchise Tax Return
2.  For _______________________(year), or other taxable period beginning ___________________ and ending _________________.

3.  State in detail the reason the extension is needed.

I declare that the information stated above is true and correct in every material matter.

                                        Printed Name                                                      Date

                                   Authorized Signature                                                   Title
                                                 DEPARTMENT USE ONLY
Under the Provisions of Section 7-1-13 NMSA 1978, your application for extension of time to file your tax return and pay the tax shown to be due 
thereon has been reviewed. NOTE: Interest accrues even if an extension is granted.
  Your application has been:                                   Authorized by:
   Approved
   Disapproved
   Approved with correction                                                             Revenue Processing Division Bureau Chief
      Extended for _________________days
  Explanation of correction:                                   Date of determination: ____________________________  

  _________________________________________________            Initials of first reviewer ______  
  _________________________________________________
                                                               Extension number: _______________________________  
  _________________________________________________

                     Taxation and Revenue Department, P.O. Box 630, Santa Fe, New Mexico  87504-0630

RPD-41096                  STATE OF NEW MEXICO - TAXATION AND REVENUE DEPARTMENT
Rev. 11/29/2011

                           EXTENSION OF TIME TO FILE

                                           INSTRUCTIONS FOR 
                Form RPD-41096, Application for Extension of Time to File

By obtaining an extension of time to file your return, penalty for failure to file and pay is waived through the extension period, 
provided you file the return and pay the tax shown on the return by the extended due date. However, interest accrues even if 
the taxpayer obtains an extension of time to file and pay the return. To avoid interest, make a payment of the tax to be due 
by the original return due date. Interest is assessed daily at the quarterly rate established for individuals by the U.S. Internal 
Revenue Code on the amount of tax due. Annual and daily interest rates for each quarter are posted on the Department 
web site.
WHEN TO FILE: An application for extension of time to file must be postmarked on or before the due date for filing the return 
or the extended due date of the return if a federal automatic extension or a New Mexico extension has been obtained. If a 
federal automatic extension is obtained, and you file and pay the return by the extended due date allowed by the IRS, Form 
RPD-41096, does not need to be submitted. New Mexico recognizes and accepts an Internal Revenue Service automatic 
extension of time to file. 
HOW AND WHERE TO FILE: Complete this form and send it to the Taxation and Revenue Department, P.O. Box 630, 
Santa Fe, NM 87504-0630. If you are including an extension payment for a personal income tax return, corporate income 
and franchise tax return, S corporate income and franchise tax return or fiduciary income tax return with the extension, also 
attach the applicable extension payment voucher (Forms PIT-EXT, CIT-EXT, S-Corp-EXT or FID-EXT) and submit the forms 
to the address on the payment voucher. The address varies depending upon the tax program.  
REASONS FOR EXTENSIONS: The Taxation and Revenue Department will grant a reasonable extension of time for filing a 
return if the taxpayer files a timely application which establishes that he is unable to file the return by the due date because 
of circumstances beyond his control. Inability to pay the tax due is not sufficient reason for issuance of an extension. Also, 
extensions will not be granted to tax practitioners because of excessive work load.
PERIOD FOR EXTENSIONS: Generally, a timely initial application for extension of time to file will be automatically granted 
for a period not to exceed 60 days. Longer periods of time will not be granted unless sufficient need for the extended period 
is clearly shown. Form RPD-41096 may also be used to request an additional extension. When used for that purpose, a 
copy of the previous state or federal automatic extension should be attached to the application.
The secretary or delegate may, for good cause, extend in favor of an individual taxpayer or a class of taxpayers, for no more 
than a total of twelve (12) months, the date on which payment of any tax is required or on which any return required by 
provision of the Tax Administration Act, Sections 7-1-1 to 7-1-82 NMSA 1978, must be filed, but no extension shall prevent 
the accrual of interest as otherwise provided by law. If the secretary believes it necessary to assure the collection of the tax, 
the secretary may require, as a condition of granting any extension, that the taxpayer furnish security in accordance with 
the provisions of Section 7-1-54 NMSA 1978.
SIGNATURE: The application must be signed by the taxpayer or a duly authorized agent. If the taxpayer is unable to sign 
the application because of illness, absence, or other good cause, any person standing in close personal or business rela-
tionship to him may sign the application. However, the signer must state the reasons for his signature and his relationship 
to the taxpayer.