Texas Franchise Tax Report Ownership Information Report Draft

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TEXAS FRANCHISE TAX REPORT

(1-08)

OWNERSHIP INFORMATION REPORT

Tcode

13197

(To be filed by Entities other than Corporations or Limited Liability Companies)

Taxpayer number

Report year

2 0 0 8

Taxpayer name

Secretary of State file number or

Comptroller file number

Mailing address

City

State

Country

ZIP Code

Plus 4

SECTION A

Enter the information required for each general partnership, each person or entity that owns an interest of ten percent (10%) or more in this entity.

Name

MEMBER

LIMITED PARTNER

GENERAL PARTNER

What type of owner?

(Blacken only one)

Mailing address

FEIN

Percentage of ownership

%

City

State

ZIP Code

Plus 4

Name

MEMBER

LIMITED PARTNER

GENERAL PARTNER

What type of owner?

(Blacken only one)

Mailing address

FEIN

Percentage of ownership

%

City

State

ZIP Code

Plus 4

Name

MEMBER

LIMITED PARTNER

GENERAL PARTNER

What type of owner?

(Blacken only one)

Mailing address

FEIN

Percentage of ownership

%

City

State

ZIP Code

Plus 4

Name

MEMBER

LIMITED PARTNER

GENERAL PARTNER

What type of owner?

(Blacken only one)

Mailing address

FEIN

Percentage of ownership

%

City

State

ZIP Code

Plus 4

SECTION B

Enter the information required for each entity, if any, in which this partnership, association, trust or other entity owns an interest

of ten percent (10%) or more.

Name of owned (subsidiary) corporation or entity

State of formation

FEIN

Percentage of Ownership

Name of owned (subsidiary) corporation or entity

State of formation

FEIN

Percentage of Ownership

Registered agent and registered office currently on file. (See instructions if you need to make changes)

Agent:

City

State

ZIP Code

Plus 4

Office:

The above information is authorized by Section 171.201(a)(2), Section 171.201(a)(3) and 171.202(a)(4) for each entity.

Use additional sheets for Sections A and B as necessary.

I declare that the information in this document and any attachments is true and correct to the best of my knowledge and belief, as of the date below, and that a copy of this report has been

mailed to each person named in this report who is an officer, director or member and who is not currently employed by this, or a related, corporation or limited liability company.

Title

Date

Area code and phone number

(

)

-

Texas Comptroller Official Use Only

VE/DE

PIR IND

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