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Delaware Application for Tax Clearance Certificate
Extracted from PDF file 2023-delaware-form-clr-app.pdf, last modified January 2024Application for Tax Clearance Certificate
CLR-APP APPLICATION FOR TAX CLEARANCE CERTIFICATE PRINT RESET Taxpayer ID Number (FEIN or SSN) 1. Name of Business/Taxpayer 2. Address of Business/Taxpayer Phone Number P.O. Box or Street and Number County City or Town Zip Code State 3. Name, Address and Phone No. of Attorney or Rep to whom Clearance Certificate should be sent (if different from #2) Name Phone Number P.O. Box or Street and Number City or Town Zip Code State County 4. Name(s), Home Address(es) and Social Security No.(s) of Sole Proprietor, General Partners, Business Trustee, President and Treasurer of the Corporation or Chief Executive Officer or Majority Owner of Entity. (Attach listing if necessary) Name Social Security Number P.O. Box or Street and Number City Phone Number State Zip Code 5. Type of Business Domestic Corporation (Incorporated in DE) Foreign Corporation (not incorporated in DE) Liquidating Trust Partnership Proprietorship Limited Liability Company Association Business Trust Nonprofit Corporation (Please submit copy of 501(c) exemption letter) Limited Liability Partnership If Domestic Corporation, give incorporation date. Other (Specify) If Foreign Corporation, give state where incorporated and Date of Certificate of Authority in Delaware. Date business started in Delaware Date Terminated Registered Delaware Address, P.O. Box, Street and Number City or Town State County Zip Code 6. Describe the business activity in Delaware, including services performed and rendered, and give principal commodity sold at wholesale or retail. If sales or construction are involved, please explain. If manufacturer’s representatives or independent contractors perform activities, render services or execute sales on behalf of the entity rather than entity’s employees, please specify what activities were performed, what services were rendered and what type of sales were executed. 7. Did the entity have employees for which DELAWARE personal income tax was required to be withheld from wages? If yes, explain. 8. Did taxpayer ever hold any of the following licenses, permits or accounts with the State of Delaware? (a) Corporation Tax Yes No Period to Revenue ID No. (b) Liquor License Yes No Period to License No. (c) Motor Fuels Yes No Period to Permit No. (d) Cigarette and/or Tobacco Tax Yes No Period to License No. (e) Public Accommodations Tax Yes No Period to License No. (f) Motor Carrier Yes No Period to License No. (g) Lottery Yes No Period to Agent No. (h) Public Transportation Assistance Yes No Period to License No. (i) Delaware Unemployment Compensation Yes No Period to Account No. (j) Marijuana Retail Store Yes No Period to OMC License No. (k) Marijuana Testing Facility Yes No Period to OMC License No. (l) Marijuana Cultivation Facility Yes No Period to OMC License No. (m) Marijuana Product Manufacturing Yes No Period to OMC License No. DFCLRAPP2024019999V1 Revised 20240117 Page 1 Yes No CLR-APP APPLICATION FOR TAX CLEARANCE CERTIFICATE Yes 9. Were the assets or activities of the business acquired in whole or in part from a prior business entity? (If “Yes”, give predecessor’s name, address and acquisition date.) Name No Acquisition Date MM DD YYYY P.O. Box or Street and Number Phone Number City or Town County State 10. Has the business held title to any real estate in the last five years from the date of this application? Yes Zip Code No • If “Yes”, complete Schedule A (Page 4). • If you currently hold title to real estate in Delaware, complete Schedule B (Page 5). 11. Will the assets or activities of the business be transferred to another? (a) Corporation Yes No If Other, Explain: (b) Partnership Yes No (c) Proprietorship Yes No (d) Liquidating Trust Yes No (e) Association Yes No (f) Other Yes No Name of New Owner Street Address of New Owner City State Zip Code 12. Purpose of clearance certificate (check appropriate block): Date A. Dissolution of Entity through Department of State. MM DD YYYY B. Dissolution of Entity through Court of Chancery. Date Court was petitioned and county: C. Withdrawal of Foreign Entity through Department of State. D. Merger or consolidation of two or more Entities where surviving Entity is not subject to the jurisdiction of Delaware. E. Liquor License F. Marijuana License G. Other 13. Location of business records, available for audit of Delaware Operations. P.O. Box or Street and Number Phone Number City or Town County State Zip Code 14. List any matters pending with the Delaware Division of Revenue (e.g. petitions, appeals): 15. Did the business ever, within the State of Delaware (a) Engage in the sale or lease of tangible personal property since Sept. 1, 1953? Yes No Period to (b) File Delaware Unemployment Compensation Yes No Period to If “Yes”, give Account No. (See question 8i.) 16. Have you terminated your business activities in Delaware Yes No Yes No If “Yes”, give distribution of assets date: If “No”, explain: If a Foreign Corporation, have you terminated business in the state of your incorporation? 17. Number of employees and total gross payrolls during the last five operating years (as reported to the Social Security Admin.) Year DFCLRAPP2024029999V1 Revised 20240117 Total Employees Delaware Employees Page 2 Total Gross Payroll Delaware Gross Payroll CLR-APP APPLICATION FOR TAX CLEARANCE CERTIFICATE 18. Have the officers received any remuneration, in cash or other form, for services performed in Delaware during the current calendar year or during any of the preceding four calendar years? Yes No 19. Were any remunerated services performed for the business in Delaware, which you believe did not constitute “employment” as defined in the Delaware Unemployment Compensation Law? Yes No If “Yes”, explain: 20. A. Average number of stockholders during the last five years: B. Number of stockholders as of this report: C. List names and home addresses of stock transfer agents who have handled the corporation’s stock: Name Address Yes D. Were all shares presented and property redeemed from any stock called for redemption or retired? No 21. The figures below must agree with the last corporate tax report filed with the Delaware Division of Revenue. Date of Report: Total Liabilities: MM DD YYYY Total Assets: Total Equity (net worth): 22. A. List the amount of corporate bonds issued and still outstanding as of this report. Show each issue separately and include name and address of any transfer or paying agents. Issue Agent Number of Outstanding Bonds Amount B. List names and addresses of transfer or paying agents not listed above who have handled corporate bond issues. Name Address 23. Do you have within your custody, possession or control any abandoned and unclaimed (escheatable) funds or assets such as dividends, payroll, deposits, outstanding checks, stock certificates, unidentified deposits, accounts payable debit balances, gift certificates, outstanding debentures or interest, royalties, mineral rights or funds due missing shareholders or other unclaimed amounts payable? Yes No 24. Has the business filed a Delaware Abandoned and Unclaimed Property Report for the preceding year? Yes No CERTIFICATION: I certify that the information provided (including Schedules, if applicable) on this application has been examined by me and is, to the best of my knowledge, true and correct. (Certification must agree with individuals listed in Question 4) AUTHORIZED SIGNATURE DATE Direct telephone inquiries to the Delaware Division of Revenue at: Mail a copy of this form with Form 8821 DE (Authorization to Release Tax Information) along with a check in the amount of $40 (Business)/$20 (Individual) made payable to Delaware Division of Revenue. Office of Tax Enforcement Delaware Division of Revenue 820 North French Street Wilmington, DE 19801 (302) 577-8445 DFCLRAPP2024039999V1 Revised 20240117 PHONE NUMBER Page 3 CLR-APP APPLICATION FOR TAX CLEARANCE CERTIFICATE SCHEDULE A - STATEMENT OF ACQUISITION AND/OR DISPOSITION OF DELAWARE REAL ESTATE WITHIN FIVE YEARS FROM THE DATE OF THIS APPLICATION Name of Transferee (EE) or Transferor (OR). Indicate each by symbol EE or OR. Date of Transfer Property Location by Local Political Subdivision & County (MM/DD/YYYY) Original Cost Acquisition Date (MM/DD/YYYY) Land 1 2 3 4 County Assessed Value Actual Consideration including Encumbrance Assumed* Actual Monetary Worth (Market Value) at Time of Transfer* Amount of Delaware Realty Transfer Tax PAID 1 2 3 4 L ist all real estate now owned in Delaware that the business will dispose of prior to or at the time of the action for which a clearance is required. If under agreement of disposition, attach copy of executed agreement for each property so affected. * Complete if applicable. If transfer represents less than a full fee-simple interest in the property, explain on a separate sheet of paper. DFCLRAPP2024049999V1 Revised 20240117 Page 4 Explanation Building CLR-APP APPLICATION FOR TAX CLEARANCE CERTIFICATE SCHEDULE B - STATEMENT OF ALL DELAWARE REAL ESTATE NOW OWNED Property Location by Local Political Subdivision & County Acquisition Date (MM/DD/YYYY) Original Cost Land County Assessed Value Building 1 2 3 4 Actual Monetary Worth (Market Value) at Time of Transfer* Amount of Delaware Realty Transfer Tax PAID at Acquisition** Explanation 1 2 3 4 L ist all real estate now owned in Delaware that the business will dispose of prior to or at the time of the action for which a clearance is required. If under agreement of disposition, attach copy of executed agreement for each property so affected. * Complete if applicable. If transfer represents less than a full fee-simple interest in the property, explain on a separate sheet of paper. ** If no realty transfer tax was paid, explain on attached sheet or in “Explanation” column above. DFCLRAPP2024059999V1 Revised 20240117 Page 5 Actual Consideration including Encumbrance Assumed*
Form CLR-APP
More about the Delaware Form CLR-APP Other TY 2023
We last updated the Application for Tax Clearance Certificate in February 2024, so this is the latest version of Form CLR-APP, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form CLR-APP directly from TaxFormFinder. You can print other Delaware tax forms here.
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| Form Code | Form Name |
|---|---|
| Form CLR-APP | Application for Tax Clearance Certificate |
View all 65 Delaware Income Tax Forms
Form Sources:
Delaware usually releases forms for the current tax year between January and April. We last updated Delaware Form CLR-APP from the Division of Revenue in February 2024.
Historical Past-Year Versions of Delaware Form CLR-APP
We have a total of three past-year versions of Form CLR-APP in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
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