Form 69-205, Seller Training Report - Texas Comptroller
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169-205
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0W08150
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(Rev.8-15/3)
PRINT FORM
CLEAR FIELDS
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Seller Training Report
Vendor name and mailing address
Report period
Instructions for Completing Seller Training Report
Who must file —
Required documentation —
Each vendor certified by the Comptroller of Public
Attach the Seller Training Roster (Form 69-204)
Accounts to conduct cigarette, e-cigarette and/or
for each class completed during the period of this
tobacco-related seller training must report
report.
statistical data for classes presented during the
preceding month.
Mail this report with class rosters to —
When to file —
ComPTRolleR oF PublIC ACCounTS
This report must be filed on or before the 15th day of
P.o. box 12010
the month following the month in which the training
Austin, Texas 78711-2010
was completed.
For assistance —
If you have a question concerning this report or seller training reporting requirements, contact the Comptroller of
Public Accounts toll free, nationwide, at 1-800-531-5441, ext. 6-5946, or in Austin, call 512-936-5946.
Enter training session data for the report period
1. Total number of classes scheduled _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
1. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2. Total number of classes conducted _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_
3. Total number of participants who attended training _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_
4. Total number of participants who completed training _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
4.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_
I declare that the information in this document and any attachments is true and correct to the best of my knowledge.
Vendor or authorized agent
business phone
Date
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