Form 50-113 - Application For Exemption Of Goods Exported From Texas - 2015 Page 3

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Form

Texas Comptroller of Public Accounts

50-113

9. What was the market value of your inventory on Jan. 1 of this year, or Sept. 1 of last year if

________________________

qualified for Sept. 1 inventory appraisal? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

________________________

10. What is the value of the inventory you claim will be exempt this year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

SECTION 5: Additional Documents to be Provided

You are required to attach to this application a description of the types of items in the inventory.

SECTION 6: Certification and Signature

NOTICE REGARDING PENALTIES FOR MAKING OR FILING AN APPLICATION CONTAINING A FALSE STATEMENT: If you make a false statement

on this form, you could be found guilty of a Class A misdemeanor or a state jail felony under Penal Code Section 37.10.

__________________________________________________________________________

, swear or affirm the following:

Printed Name of Property Owner or Authorized Representative

1. that each fact contained in this application is true and correct;

2. that the property described in this application meets the qualifications under Texas law for the exemption claimed; and

3. that I have read and understand the Notice Regarding Penalties for Making or Filing an Application Containing a False Statement.

_____________________________________________________

____________________________________

Signature of Property Owner or Authorized Representative

Date

* If the property owner is a company or other legal entity (not an individual), the Federal Tax I.D. Number is to be provided. Disclosure of your social security number (SSN) may

be required and is authorized by law for the purpose of tax administration and identification of any individual affected by applicable law. Authority: 42 U.S.C. § 405(c)(2)(C)(i);

Tax Code Section 11.43(f). Except as authorized by Tax Code Section11.48(b), a driver’s license number, personal identification certificate number, or social security number

provided in this application for an exemption filed with your county appraisal district is confidential and not open to public inspection under Tax Code Section 11.48(a).

** An email address of a member of the public could be confidential under Government Code Section 552.137; however, by including the email address on this form, you are

affirmatively consenting to its release under the Public Information Act.

comptroller.texas.gov/taxes/property-tax

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50-113 • 12-17/16