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Get NM DFA FCD 2021-2024

, CERTIFICATION FCD 04/2021 TYPE OR PRINT NEATLY, PLEASE REFER TO INSTRUCTIONS FOR MORE INFORMATION PART I: SUPPLIER INFORMATION 1. Name: (as shown on your income tax return).Name is required; do not leave blank. 2 . Business name/disregarded entity name, if different from #1: 3. Entity Type (Check only one, unless you are or have been a State of New Mexico Employee, then also check State of New Mexico Employee box): Government (Local, State, Federal, Tribe) Individual / Sole Proprietorshi.

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