Form Bt-144-C - Application To Purchase Coin-Operated Device Decal(S) Page 3
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3Instructions – Application To Purchase Coin-Operated Device Decals
Section 1:
• Enter the Owner’s Name, mailing address and phone number.
• Enter the Owner’s FEI or SSN number
• Enter the Owner’s Coin Device Account number. (If you do not have an account number you must complete Oklahoma
Business Registration Packet A.)
Section 2:
Provide the number of decals you are ordering for each decal type.
Section 3:
Provide the number of special decals you are ordering for each decal type. Special decals are for limited use. OTC Rule
710:25-1-7 states ……” In those instances where a coin-operated device will be available for use by the public for a limited
period of time less than one (1) year, such as in connection with fairs, carnivals and places of amusements that operate only
during certain seasons of the year, the Commission will issue a special decal for one or more calendar months. The fee for
each calendar month will be computed on the basis of one-tenth (1/10th) of the annual rate for the type of device operated.
Each special decal must be firmly affixed, as defined by 710:25-1-1(b), to the device for which it is purchased, in the same
manner as other decals, and may not be transferred to any other machine.”
Section 4:
• Check the box for the reason for purchasing Special Decals.
• Provide the Location of the devices.
• Provide the months for the special decals.
Section 5:
Enter the amount of penalty due if any of your machines have been sealed.
Section 6:
Enter the total amount due.
Section 7:
Sign and date the application.
When you are finished, mail completed form to:
Oklahoma Tax Commission
Taxpayer Assistance Division
Post Office Box 26920
Oklahoma City, OK 73126-0920
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