Form 00-224 - Detailed Report Of Dishonored Checks
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200-224
STATE OF TEXAS
PRINT FORM
CLEAR FIELDS
(Rev.2-02/3)
COMPTROLLER OF PUBLIC ACCOUNTS
DETAILED REPORT OF DISHONORED CHECKS
Under Ch. 559, Government Code, you are entitled to review, request, and correct information we have on file about you, with limited exceptions in accordance
with Ch. 552, Government Code. To request information for review or to request error correction, contact us at the address or toll-free number listed on this form.
Motor Vehicle Sales and Use Tax Supplement for Dishonored Checks
Page ____ of ____
Boat and Boat Motor Sales and Use Tax Supplement for Dishonored Checks
a. County name
b. Filing period
d. Date
c.
RTS
DATE OF
AMOUNT OF
AMOUNT OF
PERSONAL DATA OF ISSUER OF DISHONORED CHECK
(Name, home address, telephone number, Social Security number, FEI
TRANSACTION
DISHONORED
MOTOR VEHICLE
BOAT
number, driver's license number, employer name and address)
NUMBER
CHECK
TAX & PENALTY
TAX & PENALTY
TOTAL CREDIT THIS PAGE
X
MINUS BOAT COMMISSION
TOTAL AMOUNT
(Make copies of this form if additional sheets are necessary.)
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Parent category: Financial