Form 28-100 - Texas Oyster Sales Fee Report
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1
2b.
28-100
(Rev.4-08/5)
TEXAS OYSTER SALES FEE REPORT
DO NOT WRITE IN SHADED AREAS
You have certain rights under Chapters 552 and 559, Government Code, to review, request, and correct
80100
a. T Code
information we have on file about you. Contact us at the address or toll-free number listed on this form.
c. Taxpayer number
d. Filing period
f. Due date
e.
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.
If you are no longer in business or your business name
and/or location has changed, refer to the Business
Changes instructions on the back of this form.
h.
i.
REMINDER
COLUMN A
COLUMN B
COLUMN C
Total pounds
Number of barrels
Number of containers
Even if you do not handle or accept oysters from any harvest boat(s) in a specific
handled
(Column A
300)
over 110 lbs.
.
month, you must still file a report with $0.00 due.
.
ROUNDED TO
WHOLE NUMBERS ONLY
WHOLE NUMBERS ONLY
2 DECIMAL PLACES
Location name and address
Outlet number
Certificate number
Location name and address
Outlet number
Certificate number
Location name and address
Outlet number
Certificate number
Location name and address
Outlet number
Certificate number
80180
j.
1. Total number of barrels (Column B total from ALL locations) (Rounded to 2 decimal places)
1.
2. Fee amount due (Multiply the amount in Item 1 x $1.00)
2.
3. Total number of containers over 110 Lbs. (Column C total from ALL locations) (WHOLE NUMBERS ONLY)
3.
4. Overweight penalty due (Multiply the amount in Item 3 x $5.00)
4.
5. Total fee and overweight penalty due (Item 2 plus Item 4)
5.
* * * DO NOT DETACH * * *
28-100 (Rev.4-08/5)
6. Late penalty (See instructions on back)
6.
7. Interest due (See instructions on back)
7.
8. TOTAL AMOUNT DUE AND PAYABLE (Item 5 plus Item 6 and Item 7)
8.
Taxpayer name
k.
l.
T Code
Taxpayer number
Period
I declare that the information in this document and all attachments is true and correct
to the best of my knowledge and belief.
Authorized agent
Preparer's name (Please print)
Make the amount in Item 8 payable to STATE COMPTROLLER. Our
mailing address is P.O. Box 149361, Austin, TX 78714-9361.
Daytime phone
Date
(Area code & number)
If you have any questions regarding Oyster Sales Fee, contact the Texas State
Comptroller's field office in your area or call (800) 252-5555, toll free, nationwide.
The Austin number is (512) 463-4600.
111 A
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