Form Ap-157 - Texas Sole Owner Application - 2005 Page 2
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2AP-157 (Back)
TEXAS SOLE OWNER APPLICATION
(Rev.7-05/12)
FOR SALES TAX PERMIT; USE TAX PERMIT; OFF-ROAD, HEAVY DUTY DIESEL POWERED
• TYPE OR PRINT
EQUIPMENT SURCHARGE; FIREWORKS TAX; 9-1-1 EMERGENCY
Page 2
• Do NOT write in shaded areas.
COMMUNICATIONS; AND/OR TELECOMMUNICATIONS INFRASTRUCTURE FUND ASSESSMENT
12. Legal name of sole owner (Same as Item 4)
SSN
Answer the questions below about the location in Item 11 by checking "YES" or "NO."
O/L
TRANSIT LISTINGS
13. Is your business located inside a transit authority .......................................................................................................................
YES
NO
SPD LISTINGS
14. Is your business located inside a special purpose district (SPD)? ................................................................................................
YES
NO
15. Will you deliver in your own vehicles, provide taxable services, or have sales/service representatives going from this location to customers located in:
another city?
YES
NO ...... another county?
YES
NO .... another transit?
YES
NO ..... another SPD?
YES
NO
16. Will you ship from this location to other customers via common carrier? ......................................................................................
YES
NO
17. Are you a seller with no established place of business selling at a temporary location (trade show, event, or door to door)? .....
YES
NO
18. Will you have out-of-state suppliers shipping taxable items directly to customers' locations in Texas? ........................................
YES
NO
19. Check the box that best represents your anticipated quarterly state sales tax collections:
less than $250
$250-$1,500
greater than $1,500
month
day
year
20. Enter the date of the first business operation that is subject to sales or use tax, or the date
you plan to start such business operation. (Date cannot be more than 90 days in the future.) .............................................
21. Is your business operated all year? .....
YES
NO If "NO," list the months you will operate.
22. Will you sell any type of alcoholic beverages? ....
YES
NO
If "YES," type of permit you will hold:
mixed beverage
beer and wine
23. If you sell fireworks, are you a ..........................................................
distributor
jobber
manufacturer
retailer
24. Do you sell, lease, or rent off-road, heavy duty diesel powered equipment? ............................................................................
YES
NO
25. Do you sell health spa memberships?
YES
NO
If “YES,” a copy of your SOS certificate of registration must accompany this application.
26. Brief description of your business activities for this location, and the primary products or services to be sold.
NAICS
27. Will you be required to report interest earned on sales tax? (See "Specific Instructions") .......................................................
YES
NO
28. Are you engaged in business in Texas as defined below? .........................................................................................................
YES
NO
• ENGAGED IN BUSINESS: You are engaged in business in Texas if you or your independent salespersons make sales, leases or rentals, or take orders for tangible
personal property, or deliver tangible personal property or perform taxable services; or have lease (personal) property, a warehouse or other location in Texas; or benefit
from a location in Texas of authorized installations, servicing or repair facilities; or allow a franchisee or licensee to operate under your trade name if they are required
to collect Texas tax.
29. Location of all distribution points, warehouses, or offices in Texas (Attach additional sheets, if necessary.)
30. Do you receive compensation for providing telecommunications services? ............................................
YES
NO
If “YES,” you are responsible for the Telecommunications Infrastructure Fund (TIF) assessment and should complete Items 31-32.
If “NO,” skip to Item 34.
month
day
year
31. Date of the first business operation that is subject to the Telecommunications Infrastructure Fund
assessment in Texas or the date you plan to start such business operation. ..............................................................................
32. Telecommunications provider type ............................
Telecommunications Utility (24)
Commercial Mobile Service Provider (25)
33. 9-1-1 Emergency communications fees you collect under Health and Safety Code, Chapter 771. (Check all that apply.)
9-1-1 (Wireless) Emergency Service Fee (91) ............
9-1-1 Emergency Service Fee (92) ......
9-1-1 Equalization Surcharge (93)
If you purchased an existing business or business assets, complete Items 34-37.
34. Previous owner’s trade name.
Previous owner’s taxpayer no.
number
35. Previous owner’s legal name, address and phone number, if available.
Name
Phone (Area code and number)
Address
36. Check each of the following items you purchased.
Inventory
Corporate stock
Equipment
Real estate
Other assets
37. Purchase price of this business or assets and the date of purchase.
month
day
year
$
Purchase price
Date of purchase
38. The sole owner or an authorized representative must sign. A representative must submit a written power of attorney.
Date of signature
I declare that the information in this document and any attachments is true and correct to the best of my knowledge
month
day
year
and belief. Applicants must be 18 or older. Parents/Legal Guardians may apply for a permit on behalf of a minor.
Type or print name of sole owner
Date of Birth
Drivers license number/state
Sole owner
YOUR PERMIT MUST BE PROMINENTLY DISPLAYED IN YOUR PLACE OF BUSINESS.
THE INFORMATION ON YOUR PERMIT IS PUBLIC INFORMATION.
OPEN RECORDS NOTICE - Your name, address, and phone number are public information under the Texas Public Information Act, Chapter 552, Government Code.
Field office or section number
Employee Name
User ID
Date
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