AP-118-4
PRINT FORM
CLEAR FORM
(Rev.4-12/16)
Texas Application for
• Type or print.
Manufactured Housing Sales Tax Permit
Page 2
• Do NOT write in shaded areas.
13. Legal name of owner (same as Item 1)
14. Enter the business trade name and location where your records are maintained.
Trade name
Street address of location where records are maintained
Business phone (area code and number)
City
State
ZIP code
County
15. Texas Department of Housing and Community Affairs — Manufactured Housing Division license number
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
18. Enter the former owner’s legal name. If known, enter the former owner’s address and telephone number.
Legal name of former owner
Phone (area code and 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
managing director, or an authorized representative must sign this application. Representative
Month
Day
Year
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.
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
WARNING. You may be required to obtain an additional permit or license from the State of Texas or from a local governmental entity
to conduct business. A listing of links relating to acquiring licenses, permits, and registrations from the State of Texas is available
online at You may also want to contact the municipality and county in which you will conduct business to
determine any local governmental requirements.
Field office number
E.O. name
User ID
Date