Form Ap-133-2 - Texas Application For Fuels Tax Permit (Page 3 of 3) in pdf

AP-133-4

TEXAS APPLICATION FOR

(Rev. 12-98/13)

FUELS TAX PERMIT

Page 3.

Taxpayer number (Same as Item 8)

28. Legal name of owner (Same as Item 2)

29. • Applicant as PRINCIPAL and surety company as SURETY, their heirs, executors and assigns, are liable to the State of Texas

for $ ______________________________________ .

• Bond is security for Fuels Tax Permit issued to principal under Fuels Tax Law. (Check the type of permit.)

GASOLINE: TEX.TAX CODE ANN. sec. 153.116

DIESEL FUEL: TEX.TAX CODE ANN. sec. 153.218

• The bond will be extended from year to year as a new and separate obligation for each year or portion of a year, and it will remain in full force

until the principal pays to the Comptroller of Public Accounts at Austin, Texas, all taxes, penalties, interest and costs due under the permit

applied for.

• Bond will not be invalidated if the Comptroller recovers on the bond, a new bond is issued or if the permit is revoked, renewed or a new permit

issued.

• The Comptroller may demand a new bond if a new permit is issued or an old one renewed.

• The Comptroller may enforce the obligations of this bond, including filing suit, without exhausting remedies against the principal's assets.

Principal does not need to be made a party to any lawsuit.

Surety authorized representative

sign

here

30. Signed this ___________ day of ________________________ , 19 _______

31. The sole owner, all general partners, corporation president, vice-president, secretary or treasurer or an authorized

representative must sign this application. Representative must submit a written power of attorney with application.

(Attach additional sheets, if necessary.)

I (We) declare that the information in this document and any attachments is true and correct to the best of my (our) knowledge and belief.

Type or print name and title of sole owner, partner or officer

Sole owner, partner or officer

sign

here

Type or print name and title of partner or officer

Partner or officer

sign

here

Type or print name and title of partner or officer

Partner or officer

sign

here

SPECIFIC INSTRUCTIONS - continued

INTERSTATE TRUCKER-DIESEL FUEL - Any person who operates a

BONDING REQUIREMENTS

motor vehicle in this state and other states or countries for commercial

DISTRIBUTOR-GASOLINE - Two times the highest tax that could

purposes if the motor vehicle (1) has two axles with a registered gross

accrue on tax-free gasoline purchased or acquired during a reporting

weight in excess of 26,000 pounds; (2) has three axles; or (3) is used

period. Minimum bond is $30,000 and the maximum bond is $600,000.

in combination and the registered gross weight of the combination

JOBBER-GASOLINE - A bond may be required and shall be deter-

exceeds 26,000 pounds. If base plated in Texas or another IFTA state

mined by the Comptroller based on past tax payment history of the

or Canadian province, do not use this application. If base plated in

applicant. The minimum bond is $30,000. The maximum bond is

Texas, use the Texas Application for International Fuel Tax Agreement

$600,000.

License (Form AP-178). If base plated in another IFTA state or

SUPPLIER-DIESEL FUEL - Two times the highest tax that could

Canadian province, check with that state's officials.

accrue on tax-free diesel fuel purchased or acquired during a reporting

period. The minimum bond is $30,000 and the maximum bond is

AVIATION FUEL DEALER - Any person who is the operator of an

$600,000.

aircraft servicing facility delivering diesel fuel exclusively into the fuel

JOBBER-DIESEL FUEL - A bond may be required and shall be

supply tanks of aircrafts or into equipment used solely for servicing

determined by the Comptroller based on past tax payment history of

aircraft and used exclusively off-highway and does not use, sell or

the applicant. The minimum bond is $30,000. The maximum bond is

distribute any diesel fuel on which a fuels tax is required to be collected

$600,000.

or paid to this state.

BONDED USER-DIESEL FUEL - Two times the highest tax that could

accrue on tax-free diesel fuel purchased or acquired during a reporting

LIQUEFIED GAS

period. The minimum bond is $10,000 and the maximum bond is

DEALER-LIQUEFIED GAS - A dealer authorized to collect and pay

$600,000.

taxes on liquefied gas delivered into the fuel supply tanks of motor

vehicles displaying an out-of-state license plate or a current year IFTA

Item 26 - If the surety company has both a Texas Taxpayer Number

decal and/or vehicles displaying motor vehicle dealers liquefied gas tax

and a Vendor Identification Number, enter only the first eleven digits

decal.

of the Vendor Identification Number.

INTERSTATE TRUCKER LIQUEFIED GAS - Any person that imports

liquefied gas into this state in the fuel supply tanks of motor vehicles

Item 29 - Bonds must be written in accordance with the applicable

owned or operated by that person for commercial purposes. A person

provisions of law depending upon the fuel type which this bond will

operating in this manner must report and pay the tax due on fuel used

cover. The correct fuel type must be checked for this bond to be

in Texas and may make sales or distributions in Texas from that

effective.

person's cargo tanks, but no delivery may be made in Texas into the

fuel supply tanks of motor vehicles not bearing a current liquefied gas

Item 30 - Bond must be dated and signed by the surety company. A

tax decal or a current year IFTA decal without first obtaining the

written power of attorney must be attached to the bond.

required dealer's permit to make taxable sales.

Item 22 - Explanation of bonding requirements:

Form Ap-133-2 - Texas Application For Fuels Tax Permit Page 3

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