Form Ap-154-2 - Texas Application For Petroleum Product Delivery Fee Permit Page 4
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4Texas Application for
AP-154-4
(Rev.8-11/10)
Petroleum Product Delivery Fee Permit
Page 3.
19. Legal name of owner (same as Item 1)
Fee payer number (same as Item 7)
Bonding Requirements - A bulk facility operator may be required to post a bond equal to two times the highest fees that will or may be expected
to accrue during a reporting period. The minimum bond is $30,000 and maximum bond is $600,000. If you are currently not required to provide a
bond for Texas Motor Fuels Tax(es), and you are in good standing for other Texas tax(es), then no bond is required for Petroleum Product Delivery
Fees at the time of application unless the Comptroller determines that a bond is needed to protect the interests of the state.
If no bond is required, skip to Item 31.
$
20. Enter an estimate of your monthly fee collections
21. Check the type of surety/security that will secure the permit applied for. (Complete only the Items that are indicated for the type checked.)
$
$
Amount
Letter of Credit
Amount
Cash deposit
$
(Assignment of Certificate of Deposit must be attached.)
Certificate of deposit assignment
Amount
Surety bond (Complete Items 22 - 28.)
22. Legal name of surety company authorized and qualified to do business in the State of Texas
23. Mailing address of surety company
City
State
ZIP code
County
24. Surety company's Federal Employer Identification (FEI) Number
25. Does surety company have a taxpayer number for reporting
If "YES,"
YES
NO
any Texas tax OR a Texas Vendor Identification Number?
enter number
26. Bond beginning effective date
27. Bond / Certificate of Deposit / Letter of Credit number
28. Bond amount
$
29. • Applicant as PRINCIPAL and surety company as SURETY, their heirs, executors and assigns, are liable to the State of Texas
for $ ______________________.
• Bond is security for a Petroleum Product Delivery Fee Permit. (Texas Water Code sec. 26.3574 (q) )
• The bond will be extended from calendar year to calendar year as a new and separate obligation for each calendar year or portion
of a calendar year, and it will remain in full force until the principal pays to the Comptroller of Public Accounts at Austin, Texas, all fees,
penalties, interest and costs due under the permit applied for.
• Bond will not be invalidated if the Comptroller recovers on the bond, a new bond is issued or if the permit is revoked, renewed or a new
permit is issued.
• The Comptroller may demand a new bond if a new permit is issued or an old one renewed.
• The Comptroller may enforce the obligations of this bond, including filing suit, without exhausting remedies against the principal’s
assets. Principal does not need to be made a party to any lawsuit.
30. Signed this ____________ day of _______________________ , 20 ______ .
Fee payer authorized representative
sign
here
Surety authorized representative
sign
here
31. The sole owner, all general partners, corporation president, vice-president, secretary or treasurer
Date of application
or an authorized representative must sign this application. Representative must submit a written
power of attorney with this 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 partner or officer
Partner or officer
sign
here
Type or print name and title of partner or officer
Partner or officer
sign
here
Type or print name and title of partner or officer
Partner or officer
sign
here
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.
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