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      Check one             Sales Tax           Diesel Fuel                           Gasoline          International Fuel Tax Agreement                        Pari-Mutuel Wagering
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      IRREVOCABLE LETTER OF CREDIT NUMBER ____________________________________________________ Date _____________________

      Comptroller of Public Accounts
      111 E. 17th Street
      Austin, Texas 78774-0100

      Dear Comptroller:

      We hereby issue our irrevocable letter of credit in your favor for the account of ______________________________________________________
       ____________________________________________________________________________________________________________________
      up to an aggregate amount of $ ___________________________________ . This amount is available by your drafts at sight drawn on
       ____________________________________________________________________________________________________________________
      bearing the clause: “Drawn under letter of credit number ________________________________________ of ____________________________
       ________________________________________________________________________________________ .” The draft must be accompanied
      by:


                 1. A “Payment Demand Notice” issued by the Comptroller on the account identified above, and


                 2. A microfilm copy of the original of this letter of credit.


                This letter of credit expires on _____________________________________ .


                We hereby engage with you that drafts drawn under and in compliance with the terms of this letter of credit will be duly honored upon
                presentation at our office.


                This letter of credit is subject to the Uniform Customs and Practice for Documentary Credits (2007 revision), International Chamber of
                Commerce Publication No. 600.




                                                        Name of financial institution officer (Type or print)



                                                        Title of officer



                                                                      Officer




                                                        Name of financial institution (Type or print)                                              FEI number



                                                        Address




                                                                                                         Complete the taxpayer information below
                                                        Taxpayer name (Legal entity name only)



                                                        Taxpayer number, Social Security number or FEI number



                                                        Taxpayer mailing address




                00-812
                (Rev.7-07/13)


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 listed on this form.
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.

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  • 1. CLEAR FORM Check one Sales Tax Diesel Fuel Gasoline International Fuel Tax Agreement Pari-Mutuel Wagering Texas Petroleum Products Delivery Fee Mixed Beverage Gross Receipts Fireworks Sales Tax Cigarette Tax Tobacco Tax Customs Broker IRREVOCABLE LETTER OF CREDIT NUMBER ____________________________________________________ Date _____________________ Comptroller of Public Accounts 111 E. 17th Street Austin, Texas 78774-0100 Dear Comptroller: We hereby issue our irrevocable letter of credit in your favor for the account of ______________________________________________________ ____________________________________________________________________________________________________________________ up to an aggregate amount of $ ___________________________________ . This amount is available by your drafts at sight drawn on ____________________________________________________________________________________________________________________ bearing the clause: “Drawn under letter of credit number ________________________________________ of ____________________________ ________________________________________________________________________________________ .” The draft must be accompanied by: 1. A “Payment Demand Notice” issued by the Comptroller on the account identified above, and 2. A microfilm copy of the original of this letter of credit. This letter of credit expires on _____________________________________ . We hereby engage with you that drafts drawn under and in compliance with the terms of this letter of credit will be duly honored upon presentation at our office. This letter of credit is subject to the Uniform Customs and Practice for Documentary Credits (2007 revision), International Chamber of Commerce Publication No. 600. Name of financial institution officer (Type or print) Title of officer Officer Name of financial institution (Type or print) FEI number Address Complete the taxpayer information below Taxpayer name (Legal entity name only) Taxpayer number, Social Security number or FEI number Taxpayer mailing address 00-812 (Rev.7-07/13) 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 listed on this form. 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.