Form Ap-169 - Texas Application For Motor Vehicle Seller-Financed Sales Tax Permit Page 2

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CLEAR FORM
AP-169-2
Texas Application for Motor Vehicle
(Rev.8-11/10)
Seller-Financed Sales Tax Permit
• Please read instructions.
• Type or print.
• Do NOT write in shaded areas.
Page 1
SOLE OWNER IDENTIFICATION
1. Name of sole owner (first name, middle initial and last name)
3. Taxpayer number for reporting any Texas tax OR Texas Identification
2. Social Security number (SSN)
Check here if you DO NOT
Number if you now have or
have a SSN.
have ever had one.
NON-SOLE OWNER IDENTIFICATION
--- All sole owners skip to Item 9. ---
4. Business organization type
Profit Corporation (CT, CF)
General Partnership (PB, PI)
Business Trust (TF)
Please submit a copy of the trust
Nonprofit Corporation (CN, CM)
Professional Corporation (AP, AF)
Trust (TR)
agreement with this application.
Limited Liability Company (CL, CI)
Business Association (AB, AC)
Real Estate Investment Trust (TH, TI)
Limited Partnership (PL, PF)
Joint Venture (PV, PW)
Joint Stock Company (ST, SF)
Professional Corporation (CP, CU)
Holding Company (HF)
Estate (ES)
Other (explain)
5. Legal name of partnership, company, corporation, association, trust or other
6. Taxpayer number for reporting any Texas tax OR Texas Identification Number if you now have or have ever had one.
1
7. Federal Employer Identification Number (FEIN) assigned by the Internal Revenue Service ................................
3
8.
Check here if you do not have an FEIN. ...............................................................................................................
9. Mailing address
Street number, P.O. Box or rural route and box number
City
State/province
ZIP code
County (or country, if outside the U.S.)
10. Name of person to contact regarding day to day business operations
Daytime phone
(
)
If you are a SOLE OWNER, skip to Item 16.
11. If the business is a Texas profit corporation, nonprofit corporation, professional corporation
File number
month
day
year
or limited liability company, enter the file number issued by the Texas Secretary of State
and date. ....................................................................................................................................
12. If the business is a non-Texas profit corporation, nonprofit corporation, professional corporation or limited liability company, enter the state or
country of incorporation, charter number and date, Texas Certificate of Authority number and date.
State/country of inc.
Charter number
month
day
year
Texas Certificate of Authority number
month
day
year
If "YES," attach a
13. If the business is a corporate entity, have you been involved in a merger within the last seven years?
YES
NO
detailed explanation.
State
Number
14. If the business is a limited partnership or registered limited liability
partnership, enter the home state and registered identification number. ......................................................
15. Enter information for all partners - Attach additional sheets, if necessary.
*If a general partner is an individual, enter the SSN of the individual.
Name
Title
Phone (area code and number)
(
)
Home address
City
State
ZIP code
Date of birth
*
SSN or FEIN
Driver license number
State
County (or country, if outside the U.S.)
month
day
year
Percent of
ownership ______ %
Position held:
Partner
Officer
Director
Corporate stockholder
Record keeper
Name
Title
Phone (area code and number)
(
)
Home address
City
State
ZIP code
Date of birth
*
SSN or FEIN
Driver license number
State
County (or country, if outside the U.S.)
month
day
year
Percent of
ownership ______ %
Position held:
Partner
Officer
Director
Corporate stockholder
Record keeper

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