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             66-103
                                                          b.
             (Rev.4-08/7)


TEXAS AUTOMOTIVE OIL FEE REPORT
      69100
   a.                                                                                          DO NOT WRITE IN SHADED AREAS

                                                                                                                       e.
 c. Fee payer number                                          d. Filing period                                                                       f. Due date


                                                                                                                            h. IMPORTANT
                      g. Name and mailing address (Make any necessary name or address changes below.)                         Black out this box if your mailing
                                                                                                                              address has changed. Show changes                1.
                                                                                                                              by the preprinted information.
                                                                                                                              Black out this box if you are no
                                                                                                                              longer in business and write in the              2.
                                                                                                                              date you went out of business.
                                                                                                                                                         Month      Day         Year



                                                                                                                                 i.                                       j.
 INSTRUCTIONS FOR COMPLETING TEXAS AUTOMOTIVE OIL FEE REPORT
 WHO MUST FILE -                                                                          GENERAL INSTRUCTIONS -
  Every person (sole owner, partnership, corporation or other                              - If any preprinted information is not correct, mark out the item and write
  organization) who is responsible for collection and payment of the                         in the correct information.
  Texas Automotive Oil Fee must file this report. Complete and detailed                    - TYPE OR PRINT.
  records must be kept of all automotive oil sold or imported to be sold.                  - Do not write in shaded areas.
  Failure to file this return and pay applicable tax may result in collection
  action as prescribed by Title 2 of the Tax Code.                                        SPECIFIC INFORMATION -
                                                                                            Item 5 - PENALTY: If you file the report or pay the fee after the due date,
 WHEN TO FILE -                                                                             enter penalty. If 1-30 days late, enter 5% of Item 4. If more than 30 days
  Returns must be filed on or before the 25th day of the month following                    late, enter 10% of Item 4.
  each calendar quarter. If the due date falls on a Saturday, Sunday or
                                                                                            Item 6 - INTEREST: If any fee due is unpaid 61 days after the due date,
  legal holiday, the next business day will be the due date. A report
                                                                                            enter interest on the amount in Item 4 at the rate published on Pub.
  must be filed for every quarter even if no fee amount is due.
                                                                                            98-304, online at www.window.state.tx.us or toll free at (877) 447-2834.
 WHO TO CONTACT FOR ASSISTANCE -
  For Automotive Oil Fee assistance contact the Texas State
  Comptroller's Office at (800) 252-5555 toll free nationwide. The Austin
  number is (512) 463-4600.

 Calculate the amount of fee due. Report dollars and cents.
   1. Total quarts of automotive oil sold during this reporting period (ENTER WHOLE QUARTS ONLY)                                         1.

                                                                                                                                                                      .
   2. Oil fee at 1 cent per quart (Multiply Item 1 by .01)                                                                               2.

                                                                                                                                                                      .
   3. Fee payer's discount (Multiply Item 2 by .01)                                                                                      3.

                                                                                                                                                                      .
   4. Net fee due (Item 2 minus Item 3)                                                                                                  4.



                                                                                                                                                                      .
   5. Penalty due (See instructions)                                                                                                     5.
                                                                                                                                                                      .
   6. Interest due (See instructions)                                                                                                    6.

                                                                                                                                                                      .
   7. TOTAL AMOUNT DUE AND PAYABLE (Item 4 plus Item 5 and Item 6)                                                                       7.
                                                                                                                                                l.
                                                                                                        k.

 Taxpayer name


                              Taxpayer number
        T Code                                             Period

                                                                                       I declare that the information in this document and any attachments is true and correct to
                                                                                       the best of my knowledge and belief.
                                                                                                    Fee payer or duly authorized agent

  Make the amount in Item 7 payable to STATE COMPTROLLER
                                                                                        Business phone                                               Date
  Mail to: Comptroller of Public Accounts
            P.O. Box 149360
            Austin, Texas 78714-9360                                                         111 A
66-103 (Rev.4-08/7)

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Miscellaneous Texas Tax Forms-66-103 Texas Automotive Oil Fee Report=

  • 1. Remember to print and sign your report. 66-103 b. (Rev.4-08/7) TEXAS AUTOMOTIVE OIL FEE REPORT 69100 a. DO NOT WRITE IN SHADED AREAS e. c. Fee payer number d. Filing period f. Due date h. IMPORTANT g. Name and mailing address (Make any necessary name or address changes below.) Black out this box if your mailing address has changed. Show changes 1. by the preprinted information. Black out this box if you are no longer in business and write in the 2. date you went out of business. Month Day Year i. j. INSTRUCTIONS FOR COMPLETING TEXAS AUTOMOTIVE OIL FEE REPORT WHO MUST FILE - GENERAL INSTRUCTIONS - Every person (sole owner, partnership, corporation or other - If any preprinted information is not correct, mark out the item and write organization) who is responsible for collection and payment of the in the correct information. Texas Automotive Oil Fee must file this report. Complete and detailed - TYPE OR PRINT. records must be kept of all automotive oil sold or imported to be sold. - Do not write in shaded areas. Failure to file this return and pay applicable tax may result in collection action as prescribed by Title 2 of the Tax Code. SPECIFIC INFORMATION - Item 5 - PENALTY: If you file the report or pay the fee after the due date, WHEN TO FILE - enter penalty. If 1-30 days late, enter 5% of Item 4. If more than 30 days Returns must be filed on or before the 25th day of the month following late, enter 10% of Item 4. each calendar quarter. If the due date falls on a Saturday, Sunday or Item 6 - INTEREST: If any fee due is unpaid 61 days after the due date, legal holiday, the next business day will be the due date. A report enter interest on the amount in Item 4 at the rate published on Pub. must be filed for every quarter even if no fee amount is due. 98-304, online at www.window.state.tx.us or toll free at (877) 447-2834. WHO TO CONTACT FOR ASSISTANCE - For Automotive Oil Fee assistance contact the Texas State Comptroller's Office at (800) 252-5555 toll free nationwide. The Austin number is (512) 463-4600. Calculate the amount of fee due. Report dollars and cents. 1. Total quarts of automotive oil sold during this reporting period (ENTER WHOLE QUARTS ONLY) 1. . 2. Oil fee at 1 cent per quart (Multiply Item 1 by .01) 2. . 3. Fee payer's discount (Multiply Item 2 by .01) 3. . 4. Net fee due (Item 2 minus Item 3) 4. . 5. Penalty due (See instructions) 5. . 6. Interest due (See instructions) 6. . 7. TOTAL AMOUNT DUE AND PAYABLE (Item 4 plus Item 5 and Item 6) 7. l. k. Taxpayer name Taxpayer number T Code Period I declare that the information in this document and any attachments is true and correct to the best of my knowledge and belief. Fee payer or duly authorized agent Make the amount in Item 7 payable to STATE COMPTROLLER Business phone Date Mail to: Comptroller of Public Accounts P.O. Box 149360 Austin, Texas 78714-9360 111 A 66-103 (Rev.4-08/7)