The Indiana AD-19 (2) Form (State Form 49707) is the specific legal document required for foreign corporations—meaning those incorporated in a state other than Indiana but authorized to do business within Indiana—to regain their active status after administrative dissolution or revocation. When a foreign corporation’s certificate of authority is revoked by the Indiana Secretary of State (often for missing annual reports or tax filings), the company cannot simply resume operations. It must first prove to the Indiana Department of Revenue (DOR) that it has caught up on all tax obligations. This affidavit serves as a sworn statement by a corporate officer verifying that all necessary tax returns (income, sales, and withholding) have been filed and paid. Once the DOR approves this affidavit, they issue the tax clearance needed to officially apply for reinstatement with the Secretary of State.
How To File The AD-19 (2) Form
Like its domestic counterpart, the AD-19 (2) is a sworn affidavit that must be physically signed and mailed; it cannot be filed electronically. You must complete every applicable line accurately to avoid rejection. Once completed and signed by an authorized officer, mail the original form to the specific division handling clearances.
Mailing Address:
Indiana Department of Revenue
Titles & Clearances Division
P.O. Box 6072
Indianapolis, IN 46206-6072
How to Complete Form AD-19 (2)
The form is structured as a continuous paragraph. Below is the step-by-step guide to filling in each blank space in the order it appears on the document.
1. Affiant Name
Line 1: Print the full name of the individual completing this form. This person must be a responsible officer or authorized representative of the corporation.
2. Official Capacity And Corporation Name
Line 2 (First Blank): Enter the official title of the person named in Line 1 (e.g., President, Chief Financial Officer).
Line 2 (Second Blank): Write the full legal name of the foreign corporation exactly as it is registered.
3. State Of Incorporation And Date
Line 3 (State): Enter the name of the state (or country) where the corporation was originally legally formed.
Line 3 (Date): Enter the date (Month/Day/Year) of original incorporation in that home state.
4. Indiana Authorization Date
Line 4: Enter the date (Month/Day/Year) the corporation was originally authorized to transact business in the State of Indiana.
5. Principal Office Address
Line 5 (Address): Write the street address of the corporation’s main office.
Line 5 (County, City, State, ZIP): Fill in the county, city, state, and ZIP code for that principal office.
6. Identification Numbers
Line 6: Enter the corporation’s Federal Employer Identification Number (FEIN).
Line 7: Enter the corporation’s 10-digit Indiana Taxpayer Identification Number (TID) used for sales and/or withholding taxes.
7. Location Of Books And Records
Line 8: Provide the full physical address where the corporation’s financial records and ledgers are currently stored.
Line 9: Write the name of the person responsible for maintaining these records (e.g., “In care of [Name]”).
8. Nature Of Business
Line 10: Describe the primary type of business activity the corporation conducts (e.g., “Software Consulting,” “Manufacturing Auto Parts”).
9. Tax Filing Affirmation
By signing this form, you are swearing under penalty of perjury that all Indiana taxable income received on and after May 1, 1933, has been properly reported on returns filed with the Indiana Department of Revenue and that all taxes have been paid.
10. Filing History Details
Line 12 (Income Tax Year Ending): Enter the month and year of the last Indiana income tax return filed (e.g., 12/2023).
Line 13 (Sales/Withholding Period Ending): Enter the month and year of the last sales and/or withholding tax return filed.
Line 13 (Filed Under Name): Write the business name used on those specific tax returns (usually the corporation name).
11. Signature And Verification
Signature Line: The officer named in Line 1 must sign the document here.
Title Line: Re-enter the officer’s title (must match the capacity stated in Line 2).
Date Line: Enter the date the form is signed.
Important Note: This document is legally binding. Ensure all tax returns mentioned (income, sales, withholding) are actually filed and paid before submitting this affidavit, as false statements can lead to perjury charges and denial of reinstatement.