Miscellaneous Texas Tax Forms-AP-110 Texas Application for Gross Receipts Tax Permit--Oil and Gas Well Servicing or Gas, Electric Light, Electric Power or Water Works Plants

1. TEXAS APPLICATION FOR GROSS RECEIPTS TAX PERMIT
Oil and Gas Well Servicing or Gas, Electric Light, Electric Power or Water Works Plants
SUSAN COMBS • COMPTROLLER OF PUBLIC ACCOUNTS
GENERAL INFORMATION
WHO MUST SUBMIT THIS APPLICATION -
You must submit this application if:
• you are a sole owner, partnership, corporation or other organization which intends to do business in Texas AND/OR
• you will be responsible for collecting and/or paying a Gross Receipts Tax.
DEFINITIONS - Oil and Gas Well Servicing: An occupation tax is levied on persons who perform certain services associated with oil and gas
wells. The tax is 2.42 percent of the gross amount of the charge for service, less the reasonable wellhead value of any material used
or consumed in the well. If the tax is collected from a customer it must be included in the service company's gross receipts reported
for tax purposes.
Gas, Electric Light, Electric Power or Water Works Plants: A tax is imposed on each utility company located in an incorporated city
or town having a population of more than 1,000 according to the most recent federal census preceding the filing of the report.
FOR ASSISTANCE - If you have any questions about this application, filing reports or any other tax-related matter, contact the Texas State
Comptroller's Office at 1-800-531-5441, extension 3-4276 toll free nationwide, or call 512/463-4276.
Complete this application and mail to:
COMPTROLLER OF PUBLIC ACCOUNTS
111 E. 17th Street
Austin, Texas 78774-0100
GENERAL INSTRUCTIONS -
• Type or print only in white areas
• Do not use dashes when entering Social Security, Federal Employer's Identification, Texas Taxpayer or Texas Vendor Identification
Numbers.
• Disclosure of your Social Security number is required and authorized under law. It will be used for tax administration and certification
of any individual affected by the law.
Legal cite: 42 U.S.C.A. sec. 405(c)(2)(C)(i)
Under Ch. 559, Government Code, you are entitled to review, request, and correct information we have on file about you,
with limited exceptions in accordance with Ch. 552, Government Code. To request information for review or to request error correction,
contact us at the address or toll-free number listed on this form.
SPECIFIC INSTRUCTIONS
Item 2 - SOLE OWNER - Enter first name, middle initial and last name.
PARTNERSHIP - Enter the legal name of the partnership.
CORPORATION - Enter the legal name exactly as it is registered with the Secretary of State.
OTHER ORGANIZATION - Enter the title of the organization.
Item 3 - Enter the complete mailing address where you want to receive mail from the Comptroller of Public Accounts.
(NOTE: If you want to receive mail for other taxes at a different address, attach a letter with the other addresses.)
Item 8 - If you have both a Texas Taxpayer Number and a Texas Vendor Identification Number, enter only the first eleven digits of the
Vendor Identification Number.
Item 9 - DATE - Enter the month, day and year of the first sales date of oil and gas well servicing or utilities.
Item 10 - If you check quot;OTHER,quot; identify the type of organization. Examples: Social Club, Independent School District, Family Trust.
Item 14 - PARTNERSHIP - Enter the information for ALL partners. If a partner is a corporation, enter the Federal Employer's Identification
(FEI) Number instead of the Social Security Number.
CORPORATION OR OTHER ORGANIZATION - Enter the information for the principal officers (president, vice-president,
secretary, treasurer).
AP-110-1 (Rev.1-07/15)

2. AP-110-2
(Rev.1-07/15)
PLEASE ATTACH A LETTER OF BUSINESS OPERATION FOR ALL PERMIT TYPES. THIS LETTER SHOULD INCLUDE:
• A BRIEF BUSINESS DESCRIPTION; and
• THE NAME AND ADDRESS OF YOUR MAJOR CUSTOMERS.
Below is a listing of taxes and fees collected by the Comptroller of Public Accounts. If you are responsible for reporting or paying one of the listed taxes
or fees, and you DO NOT HAVE A PERMIT OR AN ACCOUNT WITH US FOR THIS PURPOSE, please obtain the proper application by calling toll-free
1-800-252-5555, or by visiting your local Enforcement field office.
Amusement Tax - If you engage in any business dealing with coin-oper- Hotel Occupancy Tax - If you provide sleeping accommodations to
ated machines OR engage in business to own or operate coin-operated the public for a cost of $2 or more per day, you must complete Form
machines exclusively on premises occupied by and in connection with AP-102.
the business, you must complete Form AP-146 or Form AP-147.
International Fuel Tax Agreement (IFTA) - If you operate qualified
Automotive Oil Sales Fee - If you manufacture and sell automotive oil in motor vehicles which require you to be licensed under the Interna-
Texas; or you import or cause automotive oil to be imported into Texas for tional Fuel Tax Agreement, you must complete Form AP-178.
sale, use, or consumption; or you sell more than 25,000 gallons of auto-
motive oil annually and you own a warehouse or distribution center lo- Manufactured Housing Sales Tax - If you are a manufacturer of
cated in Texas, you must complete Form AP-161. manufactured homes or industrialized housing engaged in business
in Texas, you must complete Form AP-118.
Battery Sales Fee - If you sell or offer to sell new or used lead acid
batteries, you must complete Form AP-160. Maquiladora Export Permit - If you are a maquiladora enterprise and
wish to make tax-free purchases in Texas for export to Mexico, you
Cement Production Tax - If you manufacture or produce cement in must complete Form AP-153, to receive the permit.
Texas, or you import cement into Texas and you distribute or sell cement
in intrastate commerce or use the cement in Texas, you must complete Motor Vehicle Seller-Financed Sales Tax - If you finance sales of
Form AP-171. motor vehicles and collect Motor Vehicle Sales Tax in periodic
payments, you must complete Form AP-169.
Cigarette, Cigar and/or Tobacco Products Tax - If you wholesale,
distribute, store, or make retail sales of cigarettes, cigars, and/or tobacco Motor Vehicle Gross Rental Tax - If you rent motor vehicles in Texas,
TAX TYPE(S)
products, you must complete Form AP-175 or Form AP-193. you must complete Form AP-143.
Coastal Protection Fee - If you transfer crude oil and condensate to or Petroleum Products Delivery Fee - If you are required to be licensed
from vessels at a marine terminal located in Texas, you must complete under Texas Water Code, sec. 26.3574, you must complete Form
Form AP-159. AP-154.
Crude Oil and Natural Gas Production Taxes - If you produce and/or Sales and Use Tax - If you engage in business in Texas; AND you sell
purchase crude oil and/or natural gas, you must complete Form AP-134. or lease tangible personal property or provide taxable services in
Texas to customers in Texas; and/or you acquire tangible personal
Direct Payment Permit - If you annually purchase at least $800,000 worth property or taxable services from out-of-state suppliers that do not
of taxable items for your own use and not for resale, you must complete hold a Texas Sales or Use Tax permit, you must complete Form
Form AP-101 to qualify for the permit. AP-201.
Franchise Tax - If you are a non-Texas corporation or a non-Texas limited Sulphur Production Tax - If you own, control, manage, lease, or
liability company without a certificate of authority, you must complete operate a sulphur mine, well, or shaft, or produce sulphur by any
Form AP-114. method, system, or manner, you must complete Form AP-171.
Fuels Tax - If you are required to be licensed under Texas Fuels Tax Law, Texas Customs Broker License - If you have been licensed by the
you must complete Form AP-133. If you transport motor fuel for others in United States Customs Service AND want to issue export certifica-
this state as a Common or Contract Carrier, you must complete Form tions, you must complete Form AP-168.
AP-198.
Telecommunications Infrastructure Fund - If you are a telecommu-
Gross Receipts Tax - If you provide certain services on oil and gas wells nication utility company or a mobile service provider who collects and
OR are a utility company located in an incorporated city or town having a pays taxes on telecommunications receipts under Texas Tax Code,
population of more than 1,000 according to the most recent federal census Chapter 151, you must complete Form AP-201.
and intend to do business in Texas, you must complete Form
AP-110.

3. AP-110-3
(Rev.1-07/15)
TEXAS APPLICATION
FOR
GROSS RECEIPTS TAX PERMIT
• Please read instructions • TYPE or PRINT • Do not write in shaded areas Page 1
For Comptroller 's use only
Oil and Gas Well Servicing Gas
1. Check the type(s) applicable ................................. Electric Light and/or Power Water Works Plants
Job name FEEAPP
2. Legal name of owner (Sole owner, partnership, corporation, or other name) 00991
•
TAXPAYER IDENTIFICATION
Tax type / reason
3. Mailing address (Street & number, P.O. Box or rural route and box number)
2 0
•
City State ZIP code County Reference number
• • •
Master name change
•
4. Enter a daytime phone number (Area code and number) .....................
0 - Send
1 - Do not send
5. Enter your Social Security number if you are a sole owner ...................
6. Enter your Federal Employer's Identification Number (FEIN), if any Master account set-up
assigned by the United States Internal Revenue Service ..................... 1
XAMAST
3 Master mailing
address change
If quot;YES,quot; enter number.
XUMAST
7. Are you a subsidiary or division
of another company? ...................................................... YES NO County code
8. Do you now have a taxpayer number for reporting any If quot;YES,quot; enter number.
Texas tax OR a Texas Vendor Identification Number? .. YES NO
Ownership type
9. The first sales date of well Oil and gas well servicing Utilities
servicing or utilities (month, day, year) .................
OWNERSHIP
10. Indicate how your business is owned. ................... Sole owner Partnership Texas corporation Master phone number
add / change
Foreign corporation Limited partnership Other (Explain) ___________________________________
File number File date
XUMAST
11. If your business is a Texas corporation,
enter the file number and date. ................ Secondary mailing
address set-up
12. If your business is a corporation in another state, enter the file number and date.
XAADDR
Home state Charter number Texas Certificate of Authority number Texas Cert. of Authority date Tax type
13. If your business is a limited partnership, Home state Identification number
County code
enter the home state and identification number .................
14. General partners, principle officers, managing directors, or managers. (Attach additional sheets, if necessary.)
Partnership set-up
Name Social Security or Federal Employer's identification no. Title
XAPRTN
• •
Home address (Street & number, city, state, ZIP code) Phone (Area code & number) GROSS RECEIPTS
TAX SET-UP
Name Social Security or Federal Employer's identification no. Title XASTAT
• • Tax type
PROPRIETORS
Home address (Street & number, city, state, ZIP code) Phone (Area code & number)
Effective date
mm dd yyyy
Name Social Security or Federal Employer's identification no. Title •
• •
Vendor hold
Home address (Street & number, city, state, ZIP code) Phone (Area code & number)
1 = Yes
• 2 = No
Name Social Security or Federal Employer's identification no. Title Included in audit
• • 1 = Yes
•
Home address (Street & number, city, state, ZIP code) Phone (Area code & number) 2 = No

4. AP-110-4
(Rev.1-07/15)
TEXAS APPLICATION
FOR
GROSS RECEIPTS TAX PERMIT
• Please read instructions • TYPE or PRINT • Do not write in shaded areas Page 2
15. Legal name of owner (Same as Item 2)
IF YOU PURCHASED AN EXISTING BUSINESS OR BUSINESS ASSETS, COMPLETE ITEMS 16-19. For Comptroller 's use only
IF YOU DID NOT, SKIP TO ITEM 20.
OF NR
16. Enter the former owner's trade name. If known, enter the former owner's Texas taxpayer number.
Trade name Taxpayer number of former owner
SUCCESSOR INFORMATION
Former owner is
Active
17. Enter the former owner's legal name. If known, enter the former owner's address and telephone number. OOB
Legal name Phone (Area code and number)
Address of former owner (Street & number, city, state, ZIP code)
18. Check each of the following items you purchased. (this includes the value of stock exchanged for assets.)
Inventory Corporate stock Equipment Real estate Other assets
19. Enter the purchase price of the business or assets purchased and the date of purchase.
Purchase price Date of purchase (month, day, year)
$
The sole owner, all general partners, corporation president, vice-president, secretary, treasurer, or an Date of application (month, day, year)
authorized representative must sign this application. Representative must submit a written power of attorney
with application. (Attach additional sheets, if necessary.)
SIGNATURES
20. I (We) declare that the information in this document and any attachments are true and correct to the best of my (our) knowledge and belief.
Type or print name and title of sole owner, partner, or officer Sole owner, partner, or officer
Type or print name and title of sole owner, partner, or officer Sole owner, partner, or officer
Type or print name and title of sole owner, partner, or officer Sole owner, partner, or officer
Field office number E.O. name User ID Date