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TEXAS APPLICATION FOR MANUFACTURED HOUSING
                                                SALES TAX PERMIT




                                 SUSAN COMBS • TEXAS COMPTROLLER OF PUBLIC ACCOUNTS


                                                             GENERAL INFORMATION

    WHO MUST SUBMIT THIS APPLICATION - This application must be submitted by every manufacturer of manufactured homes or
          industrialized housing who intends to do business in Texas and who will be responsible for collecting and reporting Texas
          Manufactured Housing Sales Tax. (Legal citation: TEX. TAX. CODE ANN. ch. 158).

                 Registration and bonding under the Texas Manufactured Housing Standards Act is required prior to obtaining a
                 Manufactured Housing Sales Tax Permit. For more information on registration and bonding contact the Texas
                 Department of Licensing and Regulation, Manufactured Housing Division, P.O. Box 12157, Austin, TX 78711.

    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 1-800-252-1382 toll free nationwide, or call 512/463-4600.

    Complete this application and mail to:        TEXAS COMPTROLLER OF PUBLIC ACCOUNTS
                                                  111 E. 17th Street
                                                  Austin, Texas 78774-0100

    GENERAL INSTRUCTIONS -
          • Please do not separate pages
          • Type or print
          • Write only in white areas
          • Do not use dashes when entering Social Security, Federal Employer's Identification, Texas Taxpayer or Texas Vendor
            Identification Numbers.

    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 Chapters 552 and 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.

                                                             SPECIFIC INSTRUCTIONS

    Item 1 -       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 2 -       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 5 -       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 8 -       If you check quot;OTHER,quot; identify the type of organization. Examples: Social Club, Independent School District, Family Trust.

    Item 12 - 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).

    Item 16 - DATE - Enter the month, day and year of the first sales date of a manufactured home.


AP-118-1 (Rev.1-07/12)
AP-118-2
                  (Rev.1-07/12)




              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.
AP-118-3
                           (Rev.1-07/12)


TEXAS APPLICATION FOR
                                                                                                                              • TYPE OR PRINT
MANUFACTURED HOUSING SALES TAX PERMIT                                                                                         • Do NOT write in shaded areas.                                                          Page 1

                         1. Legal name of owner (Sole owner, partnership, corporation or other name)


                         2. Mailing address (Street and number, P.O. Box, or rural route and number)
TAXPAYER INFORMATION




                             City                                                                                   State         ZIP code                                County



                         3. Enter a daytime phone number (Area code and number) .........................................................


                         4. Enter your social security number if you are a sole owner ..............................................................
                         5. Taxpayer number for reporting any Texas tax OR Texas identification
                            number if you now have or have ever had one ...............................................................................


                         6. Federal employer’s identification number (FEIN) assigned by the Internal Revenue Service ...............

                                                                                                                                                                   3

                         7. Are you a subsidiary or division of another company? ..........................................................................................................         YES                NO
                             If “YES,” enter number.

                         8. Indicate how your business is owned.                         1 - Sole owner               2 - Partnership                 3 - Texas corporation                   6 - Foreign corporation
                                    7 - Limited partnership                  4 - Other (Explain)
OWNERSHIP




                         9. If the business is a Texas profit corporation, nonprofit
                                                                                                                    Charter number                                              Month     Day        Year
                            corporation, professional corporation, or limited liability
                            company, enter the charter number and date. .............................
                       10. 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 formation                   Charter number                        Month     Day          Year         Texas Certificate of Authority number    Month    Day         Year



                                                                                                                                                                       State      Number
                        11. If the business is a limited partnership or registered limited liability
                            partnership, enter the home state and registered identification number. .................................................

                       12. General partners, principal members/officers, managing directors or managers
                           (ALL GENERAL PARTNERS MUST BE LISTED - Attach additional sheets, if necessary.)
                           Name                                                                             Title                                                         Phone (Area code and number)



                           Home address                                                             City                                                   State                                   ZIP code


                                                                    Date of Birth
                           SSN or FEIN                                                                                                      Driver’s license number            State       County (or country, if outside U.S.)
                                                                     Month     Day        Year
                                                                                                     Percent of
                                                                                                     ownership ______ %
                           Position held             General partner                 Limited partner         Officer    Director                              Corporate stockholder                   Record keeper
                           Name                                                                             Title                                                         Phone (Area code and number)
PROPRIETORS




                           Home address                                                             City                                                   State                                   ZIP code


                                                                    Date of Birth
                           SSN or FEIN                                                                                                      Driver’s license number            State       County (or country, if outside U.S.)
                                                                     Month     Day        Year
                                                                                                     Percent of
                                                                                                     ownership ______ %
                           Position held             General partner                 Limited 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’s license number            State       County (or country, if outside U.S.)
                                                                     Month     Day        Year
                                                                                                     Percent of
                                                                                                     ownership ______ %
                           Position held             General partner                 Limited partner         Officer    Director                              Corporate stockholder                   Record keeper
AP-118-4
                                   (Rev.1-07/12)


TEXAS APPLICATION FOR                                                                                                               • TYPE OR PRINT
MANUFACTURED HOUSING SALES TAX PERMIT                                                                                               • Do NOT write in shaded areas.                                                  Page 2
13. Legal name of owner (Same as Item 1)



                             14. Enter the business trade name and location where your records are maintained.
                                   Trade name
WORKING ADDRESS




                                   Street address of location where records are maintained                                                                       Business phone (Area code & number)



                                   City                                                                                 State           ZIP code                               County




                             15. Texas Department of Labor and Standards Registration Number(s)



                                                                                                                                                                                        Month       Day       Year


                             16. Enter the date of first business operation in Texas. .............................................................................................


                             If you purchased an existing business or business assets, complete Items 17-20. If you did not, skip to Item 21.
                             17. Enter the former owner’s trade name. If known, enter the former owner’s Texas taxpayer number.
                                   Trade name                                                                                                                        Taxpayer number of former owner
PREVIOUS OWNER INFORMATION




                             18. Enter the former owner’s legal name. If known, enter the former owner’s address and telephone number.
                                   Legal name former owner                                                                                                       Phone (Area code & number)



                                   Street address of former owner



                                   City                                                                                 State           ZIP code                               County




                             19. Check each of the following items you purchased.
                                          Inventory                               Corporate stock                               Equipment                           Real estate                           Other assets

                             20. Purchase price of this business or assets and the date of purchase.                                                    Month        Day              Year


                                   Purchase price                                                                           Date of purchase


                             21. The sole owner, all general partners, corporation president, vice-president, secretary or treasurer,                                                 Date of application
                                                                                                                                                                                        Month       Day       Year
                                 managing director, or an authorized representative must sign this application. Representative
                                 must submit a written power of attorney with application.
                                 (Attach additional sheets, if necessary.)

                                   I (We) declare that the information in this document and any attachments is true and correct to the best of my (our) knowledge and belief.
SIGNATURES




                                   Type or print name and title of sole owner, partner or officer                                           Sole owner, partner or officer




                                   Type or print name and title of partner or officer                                                       Partner or officer




                                   Type or print name and title of partner or officer                                                       Partner or officer




Field office number                                        E.O. name                                                                                     User ID                             Date

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Miscellaneous Texas Tax Forms-AP-118 Texas Application for Manufactured Housing Sales Tax Permit

  • 1. TEXAS APPLICATION FOR MANUFACTURED HOUSING SALES TAX PERMIT SUSAN COMBS • TEXAS COMPTROLLER OF PUBLIC ACCOUNTS GENERAL INFORMATION WHO MUST SUBMIT THIS APPLICATION - This application must be submitted by every manufacturer of manufactured homes or industrialized housing who intends to do business in Texas and who will be responsible for collecting and reporting Texas Manufactured Housing Sales Tax. (Legal citation: TEX. TAX. CODE ANN. ch. 158). Registration and bonding under the Texas Manufactured Housing Standards Act is required prior to obtaining a Manufactured Housing Sales Tax Permit. For more information on registration and bonding contact the Texas Department of Licensing and Regulation, Manufactured Housing Division, P.O. Box 12157, Austin, TX 78711. 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 1-800-252-1382 toll free nationwide, or call 512/463-4600. Complete this application and mail to: TEXAS COMPTROLLER OF PUBLIC ACCOUNTS 111 E. 17th Street Austin, Texas 78774-0100 GENERAL INSTRUCTIONS - • Please do not separate pages • Type or print • Write only in white areas • Do not use dashes when entering Social Security, Federal Employer's Identification, Texas Taxpayer or Texas Vendor Identification Numbers. 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 Chapters 552 and 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. SPECIFIC INSTRUCTIONS Item 1 - 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 2 - 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 5 - 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 8 - If you check quot;OTHER,quot; identify the type of organization. Examples: Social Club, Independent School District, Family Trust. Item 12 - 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). Item 16 - DATE - Enter the month, day and year of the first sales date of a manufactured home. AP-118-1 (Rev.1-07/12)
  • 2. AP-118-2 (Rev.1-07/12) 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-118-3 (Rev.1-07/12) TEXAS APPLICATION FOR • TYPE OR PRINT MANUFACTURED HOUSING SALES TAX PERMIT • Do NOT write in shaded areas. Page 1 1. Legal name of owner (Sole owner, partnership, corporation or other name) 2. Mailing address (Street and number, P.O. Box, or rural route and number) TAXPAYER INFORMATION City State ZIP code County 3. Enter a daytime phone number (Area code and number) ......................................................... 4. Enter your social security number if you are a sole owner .............................................................. 5. Taxpayer number for reporting any Texas tax OR Texas identification number if you now have or have ever had one ............................................................................... 6. Federal employer’s identification number (FEIN) assigned by the Internal Revenue Service ............... 3 7. Are you a subsidiary or division of another company? .......................................................................................................... YES NO If “YES,” enter number. 8. Indicate how your business is owned. 1 - Sole owner 2 - Partnership 3 - Texas corporation 6 - Foreign corporation 7 - Limited partnership 4 - Other (Explain) OWNERSHIP 9. If the business is a Texas profit corporation, nonprofit Charter number Month Day Year corporation, professional corporation, or limited liability company, enter the charter number and date. ............................. 10. 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 formation Charter number Month Day Year Texas Certificate of Authority number Month Day Year State Number 11. If the business is a limited partnership or registered limited liability partnership, enter the home state and registered identification number. ................................................. 12. General partners, principal members/officers, managing directors or managers (ALL GENERAL PARTNERS MUST BE LISTED - Attach additional sheets, if necessary.) Name Title Phone (Area code and number) Home address City State ZIP code Date of Birth SSN or FEIN Driver’s license number State County (or country, if outside U.S.) Month Day Year Percent of ownership ______ % Position held General partner Limited partner Officer Director Corporate stockholder Record keeper Name Title Phone (Area code and number) PROPRIETORS Home address City State ZIP code Date of Birth SSN or FEIN Driver’s license number State County (or country, if outside U.S.) Month Day Year Percent of ownership ______ % Position held General partner Limited 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’s license number State County (or country, if outside U.S.) Month Day Year Percent of ownership ______ % Position held General partner Limited partner Officer Director Corporate stockholder Record keeper
  • 4. AP-118-4 (Rev.1-07/12) TEXAS APPLICATION FOR • TYPE OR PRINT MANUFACTURED HOUSING SALES TAX PERMIT • Do NOT write in shaded areas. Page 2 13. Legal name of owner (Same as Item 1) 14. Enter the business trade name and location where your records are maintained. Trade name WORKING ADDRESS Street address of location where records are maintained Business phone (Area code & number) City State ZIP code County 15. Texas Department of Labor and Standards Registration Number(s) Month Day Year 16. Enter the date of first business operation in Texas. ............................................................................................. If you purchased an existing business or business assets, complete Items 17-20. If you did not, skip to Item 21. 17. Enter the former owner’s trade name. If known, enter the former owner’s Texas taxpayer number. Trade name Taxpayer number of former owner PREVIOUS OWNER INFORMATION 18. Enter the former owner’s legal name. If known, enter the former owner’s address and telephone number. Legal name former owner Phone (Area code & number) Street address of former owner City State ZIP code County 19. Check each of the following items you purchased. Inventory Corporate stock Equipment Real estate Other assets 20. Purchase price of this business or assets and the date of purchase. Month Day Year Purchase price Date of purchase 21. The sole owner, all general partners, corporation president, vice-president, secretary or treasurer, Date of application Month Day Year managing director, or an authorized representative must sign this application. Representative must submit a written power of attorney with application. (Attach additional sheets, if necessary.) I (We) declare that the information in this document and any attachments is true and correct to the best of my (our) knowledge and belief. SIGNATURES Type or print name and title of sole owner, partner or officer Sole owner, partner or officer Type or print name and title of partner or officer Partner or officer Type or print name and title of partner or officer Partner or officer Field office number E.O. name User ID Date