Form 00-105 - Qualified Business Claim For Refund Of State Tax
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100-105
TEXAS ENTERPRISE ZONE
(Rev.5-02/3)
b.
QUALIFIED BUSINESS CLAIM FOR
c. Type of refund (Check appropriate type or types)
REFUND OF STATE TAX
Franchise Tax
Sales Tax
Franchise and Sales Tax
Do not write in shaded areas
d. Claimant ID number
e. Zone number
f. Qualified Business number
EZ
QB
Claimant name and mailing address
g.
Black out this box
FM
if your address has
changed.
1
For Comptroller's use only
INV
SD
2
3
You have certain rights under Ch. 559, Government Code, to review, request, and correct information
we have on file about you. Contact us at the address or toll-free number listed on this form.
58500
58400
a. T Code
a. T Code
Franchise Tax
Sales Tax
year
month
day
year
Begin
1.
Period of Claim
Date
1.
month
day
year
End
Date
2.
2.
Jobs certified by TDOC
(Minimum 10 jobs)
3.
3.
Amount of Tax Paid
(See instructions)
FRANCHISE TAX
.25 (25%)
4.
Percentage of tax allowed for refund
FRANCHISE TAX
5.
Total tax eligible for refund
(Multiply Item 3 by Item 4)
6.
4.
Amount of Refund
(Item 5 or $5,000 whichever is
(Item 3 or $5,000
smaller)
whichever is smaller)
h. PM date
h. PM date
I declare that the information in this document and any attachments is true and correct to
Complete this claim and mail to:
the best of my knowledge and belief.
Claimant or Duly Authorized Agent
COMPTROLLER OF PUBLIC ACCOUNTS
111 E. 17th Street
Austin, Texas 78774-0100
(Area code and number)
Phone
Date
For assistance call 1-800-252-5555, Extension 3-4545, toll free nationwide. The Austin number is 512-463-4545.
(From a Telecommunication Device for the Deaf (TDD) ONLY call 1-800-248-4099 toll free. The Austin number is 512-463-4621.)
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