Homepage Fill in a Valid Massachusetts Certificate Tax Form
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The Massachusetts Certificate Tax form serves as a crucial document for individuals and businesses seeking to confirm their tax compliance and good standing with the state. This form, issued by the Massachusetts Department of Revenue, allows applicants to request a Certificate of Good Standing or a Waiver of Corporate Tax Lien. It requires detailed applicant information, including the entity's classification, federal tax identification numbers, and legal form of organization. Additionally, the purpose of the application must be clearly specified, whether it is for a nonprofit organization, a corporate reinstatement, or other specific reasons such as liquor licenses or gaming. The form also includes sections for listing tax identification numbers, assets involved in any sale or transfer, and a declaration of tax responsibilities under penalties of perjury. Timely and accurate completion of this form is essential, as any missing information can delay processing. For those seeking efficiency, the Massachusetts Department of Revenue offers an online application option, streamlining the process for businesses and individuals alike.

Massachusetts Certificate Tax Example

Massachusetts Department of Revenue

Request for a Certificate of Good Standing and/or

Tax Compliance or Waiver of Corporate Tax Lien

PO Box 7073, Boston, MA 02204; phone: 617-887-6400; fax: 617-660-3611

1. Applicant information

Name of applicant

Daytime phone number (with area code)

 

 

 

Street address.

Fill in if new address

 

 

 

 

City/Town

State

Zip

2. Taxpayer classification

Federal Employer or Taxpayer Identification number (required)

Entity filing a combined report. If filing a combined report, enter name and FEIN as shown on return:

Name of principal reporting corporationFEIN of entity (required)

Entity taxed as C corporation

Entity taxed as S corporation

Entity is Disregarded (other than a sole-proprietorship). If Disregarded entity, enter FEIN of filing entity as shown on return:

Name of filing entityFEIN of entity (required)

Nonprofit (tax exempt) organization (see instructions)

Entity taxed as a partnership

Entity taxed as an estate

Entity taxed as a trust

Entity taxed as a individual

Entity taxed as a sole-proprietorship (including LLCs tax as sole proprietorship). If entity is taxed as sole-proprietorship, enter name, SSN and FEIN:

Name of sole proprietorshipSSN of sole proprietorship (required) FEIN (required)

3. Legal form of organization

Corporation

Limited Liability Company (LLC)

Partnership (including Limited Liability Partnership, Limited Partnership, or other unincorporated association)

Trust or estate

4. Purpose of application. Fill in one only.

Certificate of Good Standing or Letter of Compliance

Certificate of Good Standing for a Nonprofit Organization (enclose required copy of IRS exemption certificate) Certificate of Good Standing Relating to an ABCC Liquor License Tranfer or Operational/Administrative Changes

5. Reason for application

Cannabis

Corporate reinstatement after administrative dissolution from Secretary of State (domestic/foreign corporation doing business in Massachusetts)

Corporate reinstatement after administrative dissolution from Secretary of State (foreign corporation not doing business in Massachusetts)

Gaming

Liquor licenses

Lottery machines

Professional license renewal

Sale of business Other (specify)

General information on page 2.

Rev. 04/18

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REQUEST FOR CERTIFICATE, PAGE 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of applicant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trade name or DBA

Federal ID or Social Security number (REQUIRED)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. Sale/transfer of license

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fill in if transferring liquor license

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of buyer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of DBA location

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/Town

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

 

 

 

 

 

Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List all tax identification numbers filed for this entity (e.g., meals, sales, withholding, room occupancy or income)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fill in if Waiver of Corporate Tax Lien has been acquired (does not apply to entities not taxed as corporation)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If requesting Waiver of Corporate Tax Lien, attach price and legal description of assets to be sold and complete the following(REQUIRED).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of transferee

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of transfer or sale (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/Town

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

 

 

 

 

 

Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List assets

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. Person to receive response. Fill in applicable ovals.

Send results to taxpayer

Send results to person named below only if taxpayer is in compliance and Power of Attorney is attached

Send results to person named below, even if taxpayer is not in compliance and Power of Attorney is attached

If information is to be mailed to someone other than taxpayer, provide party’s name and mailing address.

Name

Phone number

Fax number

 

 

 

 

Address

 

 

 

 

 

 

 

City/Town

State

Zip

 

Affidavit

Under the penalties of perjury, I declare that my company is responsible for the following taxes (REQUIRED; fill in all that apply).

Withholding Sales/Use Meals Room occupancy Corporate Other (specify)

Signature of taxpayer or corporate officer (REQUIRED)

Date

General information

The fastest and easiest way to obtain a Certificate is via our online application:

Businesses: https://mtc.dor.state.ma.us/mtc/_/?Link=COGS

Individuals: https://mtc.dor.state.ma.us/mtc/_/?Link=COGSIND

If the applicant is a partnership and has not filed a Form 3, Partnership Return of Income, for the last two years, submit complete copies of Form 3 with this application.

Any missing “required” information will delay the processing of your claim.

If a professional license renewal application, all returns must be filed and paid. If in a valid payment agreement, all required payments must be made.

Form Specs

Fact Name Description
Purpose of Form This form is used to request a Certificate of Good Standing or Tax Compliance in Massachusetts.
Governing Law The form is governed by Massachusetts General Laws, Chapter 62C, Section 47.
Applicant Information Applicants must provide their name, phone number, and address on the form.
Taxpayer Classification Entities must indicate their federal tax classification, such as C corporation or partnership.
Legal Forms Various legal forms of organization are recognized, including corporations and LLCs.
Application Purposes Applicants can request a Certificate of Good Standing for various reasons, including liquor licenses.
Waiver of Corporate Tax Lien Entities may request a waiver of corporate tax lien, but this only applies to corporations.
Response Recipient Applicants can specify who should receive the response, including a Power of Attorney option.
Affidavit Requirement Applicants must declare their responsibility for various taxes under penalty of perjury.
Online Application The fastest way to obtain a certificate is through the Massachusetts Department of Revenue's online application.
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