Form 69-118 - Texas Outdoor Advertising Of Cigarettes Or Tobacco Products Fee Report
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1PRINT FORM
CLEAR FIELDS
69-118
(Rev.12-02/3)
b.
A report must be filed even if no fee is due.
TEXAS OUTDOOR ADVERTISING OF CIGARETTES
You have certain rights
under Ch. 559, Government Code, to review,
OR TOBACCO PRODUCTS FEE REPORT
request, and correct information we have on file about you. Contact us at
the address or toll-free number listed on this form.
c. Taxpayer number assigned by Comptroller
d. Filing period
e.
a.
f. Due date
90100
T Code
281
Deposit code
g. Taxpayer name and mailing address(Make any necessary name or address changes below.)
IMPORTANT
h.
Blacken this box if your mailing address has changed.
Show changes by the preprinted information.
Blacken this box if you are no longer in business
and write in the date you
went out of business.
INSTRUCTIONS FOR COMPLETING TEXAS OUTDOOR ADVERTISING OF
CIGARETTES OR TOBACCO PRODUCTS FEE REPORT
(Refer to Cigarette & Tobacco Products Regulations, Rule 3.1201)
WHO MUST FILE -
GENERAL INSTRUCTIONS -
Every person (sole owner, partnership, corporation, or other organiza-
- If any preprinted information is not correct, mark out the item and write
tion) that purchases outdoor advertising of cigarettes or tobacco
in the correct information.
products in Texas must file this report and pay the fee due.
- TYPE OR PRINT.
- Do not write in shaded areas.
Outdoor advertising is defined as a medium, including a structure,
display, light device, figure, painting, drawing, message, plaque, poster,
SPECIFIC INFORMATION -
Item 1 - TAXABLE GROSS SALES PRICE: Enter the sum of
sign, or billboard, that is used to advertise or to inform; and is visible
from the main-traveled way of a street or highway. Outdoor advertising
production costs, including the cost of layout, paper, materials,
printing, distribution, and sign installation; media costs,
does not include a medium displayed inside a building, even if the
medium is visible from outside the building; or a medium that displays
including the cost for leasing billboards, or any other outdoor
space where a message or sign is displayed; and the cost of
the name of the business, unless that medium also contains a cigarette
sales or commissions paid to an agency or broker. Do not
or tobacco product trade mark, brand or trade name, or logo type.
include the cost of design and artwork.
WHEN TO FILE -
Item 4 - CREDIT ADJUSTMENTS: Use this line to make adjustments
Reports must be filed on or before the 20th day of the month following
when contract amounts have to be changed. Examples
each reporting period. If the due date falls on a Saturday, Sunday, or
include: fee paid on contracts previously reported which have
legal holiday, the next business day will be the due date. A report must
been cancelled, nullified, voided, or amended.
be filed for every quarter, even if no fee amount is due.
Item 6 - PENALTY: If you file the report or pay the fee due after the
FOR ASSISTANCE -
due date, enter penalty. If 1-30 days late, enter 5% of Item 5. If
For assistance, contact the Texas State Comptroller's office at
more than 30 days late, enter 10% of Item 5.
1-800-531-5441, extension 3-4276, toll free nationwide. The Austin
Item 7 - INTEREST: If any fee due is unpaid 61 days after the due
number is 512/463-4276. If you're calling from a Telecommunications
date, enter interest on the amount in Item 5 at the rate
Device for the deaf (TDD), call 1-800-248-4099 toll free. The Austin
published in Pub. 98-304, toll free at 1-877-44RATE4, or
TDD number is 512/463-4621.
online at <
Calculate the amount of fee due. Report in dollars and cents.
1. Total taxable gross sales price
1.
2. Fee rate (10%)
2.
3. Fee due this period
(Multiply Item 1 by Item 2)
3.
4. Credit adjustments
(See instructions)
4.
5. Net fee due
5.
(Item 3 minus Item 4)
6. Penalty due
6.
(See instructions)
7. Interest due
7.
(See instructions)
8. TOTAL AMOUNT DUE AND PAYABLE
8.
(Item 5 plus Item 6 and Item 7)
Make the amount in Item 8 payable to
I declare that the information in this document and all attachments is true and correct
to the best of my knowledge and belief.
STATE COMPTROLLER
Authorized agent
Our mailing address is
COMPTROLLER OF PUBLIC ACCOUNTS
Daytime phone
Date
111 E. 17th Street
(Area code & number)
Austin, TX 78774-0100
69-118 (Rev.12-02/3)
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