Texas Franchise Tax Report Form - Comptroller Of Public Accounts
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6TEXAS FRANCHISE TAX REPORT - Page 1
RESET FORM
PRINT FORM
05-158-A
(Rev. 4-09/3)
FILING REQUIREMENTS
Tcode
13250 Annual
Taxpayer number
Report year
Due date
Privilege period covered by this report
Taxpayer name
Secretary of State file number
or Comptroller file 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 171.1015.
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
m
m
d
d
y
y
m
m
d
d
y
y
SIC code
NAICS code
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.
0 0
,
,
,
,
.
5. Royalties
5.
0 0
,
,
,
,
.
6. Gains/losses
6.
0 0
,
,
,
,
.
7. Other income
7.
0 0
,
,
,
,
.
8. Total gross revenue
8.
(Add Items 1 thru 7)
0 0
,
,
,
,
.
9. Exclusions from gross revenue
9.
(Item 8 minus Item 9)
0 0
,
,
,
,
.
10. TOTAL REVENUE
10.
(If 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 benefits
16.
0 0
,
,
,
,
.
17. Other
17.
(See instructions)
0 0
,
,
,
,
.
18. TOTAL COMPENSATION
18.
(Add items 15 thru 17)
Texas Comptroller Official Use Only
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PM Date
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