Texas Original Application for
AP-147-3
PRINT FORM
CLEAR FORM
(Rev.8-11/16)
Coin-Operated Machine
General Business License, Import License and/or
Repair License and Tax Permit(s)
Page 1
• Please read instructions.
• Type or print.
• Do NOT write in shaded areas.
The application for calendar year
1. Texas Comptroller's taxpayer number ........................................................................................
2. Check the type(s) of license(s) applied for:
1 - General
2 - Import
3 - Repair
3. Legal name of owner (sole owner, partnership, corporation or other name)
4. Mailing address (street number and name, P.O. Box or rural route and box number)
City
State
ZIP code
County
Business email address
(
)
-
5. Enter the daytime phone number of the person primarily responsible for filing tax returns. .......................
-
-
6. Enter your Social Security number if you are a sole owner. ...................................................................................
-
7. Enter your Federal Employer Identification Number (FEIN), if any. ..............................................................................
3
8. If you are incorporating an existing business, enter the taxpayer number of the existing business. .....................
9. Enter your taxpayer number for reporting any Texas tax OR your Texas
Vendor Identification Number if you now have or have ever had one. .......................................................................
10. Indicate how your business is owned.
1 - Sole owner
2 - Partnership
3 - Texas corporation
7 - Limited partnership
Foreign corporation
Other (explain) ________________________________________________________
Charter, file or COA date
State
Texas Secretary of State file number or COA no.
month
day
year
11. If this business is a corporation, enter ....................................
Home state
Identification number
12. If your business is a limited partnership, enter the home state and identification number. ........
All applicants MUST complete the Texas Coin-Operated Machine Ownership Statement, Form AP-138.
13. Office address in Texas where records will be maintained:
(Use street and number or directions; use 9-1-1 address, if possible. The P.O. Box or rural route number are NOT acceptable.)
City
State
ZIP code
County
The individual responsible for keeping records must be an owner, partner, officer, trustee, receiver or principal member of the business and must
be listed in the Texas Coin-Operated Machine Ownership Statement, Form AP-138. Occupations Code §2153.153(c).
14. Trade name of business
Business phone (area code and number)
(
)
-
15. Location of business
(If business location address is a rural route and box number, provide directions or use 9-1-1 address, if possible.)
City
State
ZIP code
County
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2
3
4
5
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