Fillable Form Ap-159 - Coastal Protection Fee printable pdf download

TEXAS QUESTIONNAIRE - COASTAL PROTECTION FEE

SUSAN COMBS • TEXAS COMPTROLLER OF PUBLIC ACCOUNTS

INSTRUCTIONS FOR COMPLETING TEXAS QUESTIONNAIRE FOR COASTAL PROTECTION FEE

WHO MUST SUBMIT THIS QUESTIONNAIRE -

This questionnaire must be submitted by every person (sole owner, partnership, corporation or other organization) who transfers crude oil and

condensate from or to vessels at a marine terminal located in Texas.

DEFINITIONS -

MARINE TERMINAL - Any terminal facility used for transferring crude oil to or from vessels.

VESSEL - Includes every description of water craft or other contrivance used or capable of being used as a means of transportation on water,

whether self-propelled or otherwise, including barges.

WHO TO CONTACT FOR ASSISTANCE -

If you have any questions concerning this questionnaire, filing tax returns or any other tax-related matter, call 1-800-252-1384 toll free nationwide, or

call 512/463-4600.

GENERAL INSTRUCTIONS -

• Please write only in white areas.

• When entering a Social Security Number, Federal Employer's I dentification (FEI) Number, Texas Taxpayer Number or Vendor Identification Number,

do not enter dashes.

• Disclosure of the Social Security Number is required and authorized under law and will be used for the purpose of tax administration.

SPECIFIC INSTRUCTIONS

Item 1 - SOLE OWNER: Enter first name, middle initial and last name.

Item 9 - OTHER ORGANIZATION: Explain the type of organization.

PARTNERSHIP: Enter the legal name of the partnership.

Examples: Social Club, Independent School District, Family Trust, Joint

CORPORATION: Enter legal name exactly as it is registered with the

Venture. NOTE: For Joint Venture list the managing partner (or the

Secretary of State.

partner acting as the authorized agent for the venture) and the names of

OTHER ORGANIZATION: Enter the title of the organization.

two other principal partners. Principal partners are those having the

largest claim to a share of the venture's profits under the terms of the

Item 2 - Enter complete mailing address where you wish to receive mail

Joint Venture Agreement. A copy of the Joint Venture Agreement must be

from the Comptroller of Public Accounts. If you wish to receive mail at a

filed with this questionnaire if the agreement is available.

different address for other taxes, attach a letter with the other ad-

TEXAS CORPORATION: Enter Charter Number assigned by the

dresses.

Secretary of State and date of the charter.

FOREIGN CORPORATION (Chartered out-of-Texas): Enter the state in

Item 3 - Enter the Federal Employer's Identification (FEI) Number

which business is incorporated and Charter Number AND Texas

assigned to your business by the Internal Revenue Service.

Certificate of Authority Number and date.

Item 4 - Enter Social Security Number only if this is a sole owner.

LIMITED PARTNERSHIP: Enter state in which partnership is registered

and identification number.

Item 5 - Check this block if you have neither a Social Security Number

nor a FEI Number.

Item 10 - PARTNERSHIP: Enter information for all partners. If a partner

is a corporation, enter the Federal Employer's Identification (FEI) Number

Item 7 - If you have both a Texas Taxpayer and Vendor Identification

of the corporation.

Number, enter only the first eleven digits of the Vendor Identification

CORPORATION or OTHER ORGANIZATION: Enter the information for

Number.

the principal officers (president, secretary, vice-president).

FEDERAL PRIVACY ACT - Disclosure of your social security number is required and authorized under law, for the purpose of tax administration and

identification of any individual affected by applicable law. 42 U.S.C. §405(c)(2)(C)(i); Tex. Govt. Code §§403.011 and 403.078. Release of information

on this form in response to a public information request will be governed by the Public Information Act, Chapter 552, Government Code, and

applicable federal law.

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.

Field office

Complete this questionnaire and mail to:

COMPTROLLER OF PUBLIC ACCOUNTS

E.O.

Destin

111 E. 17th Street

Austin, TX 78774-0100

Date