Form 69-205 - Seller Training Report printable pdf download

Form 69-205 - Seller Training Report

69-205

(Rev.3-99/2)

SELLER TRAINING REPORT

Vendor name and mailing address

Report period

INSTRUCTIONS FOR COMPLETING SELLER TRAINING REPORT

WHO MUST FILE —

REQUIRED DOCUMENTATION —

Each vendor certified by the Comptroller of Public

Attach the Seller Training Roster (Form 69-204) for

Accounts to conduct tobacco-related seller training

each class completed during the period of this

must report statistical data for classes presented

report.

during the preceding month.

MAIL THIS REPORT WITH CLASS ROSTERS TO —

WHEN TO FILE —

COMPTROLLER OF PUBLIC ACCOUNTS

This report must be filed on or before the 15th day of

P.O. Box 12010

the month following the month in which the training

Austin, Texas 78711-2010

was completed.

FOR ASSISTANCE —

If you have a question concerning this report or seller training reporting requirements, contact the Comptroller of

Public Accounts toll free, nationwide, at 1-800-531-5441, ext. 6-5946, or in Austin, call (512) 936-5946. If you’re

calling from a Telecommunications Device for the Deaf (TDD), the toll-free number is 1-800-248-4099, or in Austin,

(512) 463-4621.

ENTER TRAINING SESSION DATA FOR THE REPORT PERIOD

1. Total number of classes scheduled _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1. _______________

2. Total number of classes conducted _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2. _______________

3. Total number of participants who attended training _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3. _______________

4. Total number of participants who completed training _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4. _______________

I declare that the information in this document and any attachments is true and correct to the best of my knowledge.

Vendor or authorized agent

Business phone

Date

Form 69-205 - Seller Training Report