05-158-A, 2015, Texas Franchise Tax Report
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05-158-A
05-158-A
(Rev.9-13/7)
(Rev.9-13/7)
Texas Franchise Tax Report - Page 1
FILING REQUIREMENTS
Tcode
13250
Annual
13250 Annual
Taxpayer number
Report year
Due date
Privilege period covered by this report
2 0 1 5
05/15/2015
01/01/2015
12/31/2015
Taxpayer name
Secretary of State le number
or Comptroller le number
Mailing address
City
State
Country
ZIP Code
Plus 4
Blacken circle if the
address has changed
Blacken circle if Total Revenue is adjusted for
Blacken circle if this is a combined report
Tiered Partnership Election, see instructions
Blacken circle if this is a Corporation or Limited Liability Company
Blacken circle if this is an Entity other than a Corporation or Limited Liability Company
** If not twelve months, see instructions for annualized revenue
SIC code
NAICS code
m
m
d
d
y
y
m
m
d
d
y
y
Accounting year
Accounting year
begin date**
end date
REVENUE
(Whole dollars only)
0 0
1. Gross receipts or sales
1.
0 0
2. Dividends
2.
0 0
3. Interest
3.
0 0
4. Rents
4.
( can be negative amount )
0 0
5. Royalties
5.
0 0
6. Gains/losses
6.
(can be negative amount)
0 0
7. Other income
7.
(can be negative amount)
0 0
8. Total gross revenue
8.
(Add items 1 thru 7)
0 0
9. Exclusions from gross revenue
9.
(see instructions)
(item 8 minus item 9 if
0 0
10. TOTAL REVENUE
10.
less than zero, enter 0)
COST OF GOODS SOLD
(Whole dollars only)
0 0
11. Cost of goods sold
11.
0 0
12. Indirect or administrative overhead costs
12.
(Limited to 4%)
0 0
13. Other
13.
(see instructions)
0 0
14. TOTAL COST OF GOODS SOLD
14.
(Add items 11 thru 13)
COMPENSATION
(Whole dollars only)
0 0
15. Wages and cash compensation
15.
0 0
16. Employee bene ts
16.
0 0
17. Other
17.
(see instructions)
0 0
18. TOTAL COMPENSATION
18.
(Add items 15 thru 17)
Texas Comptroller O cial Use Only
PROCEED TO NEXT PAGE
VE/DE
PM Date
Page 1 of 2
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