Form Ap-147-3 - Texas Original Application For Coin-Operated Machine General Business License, Import License And/or Repair License And Tax Permit(S) Page 5

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Texas Original Application for
AP-147-5
(Rev.8-11/16)
Coin-Operated Machine
General Business License, Import License and/or
Repair License and Tax Permit(s)
Page 3
• Please read instructions.
• Type or print.
• Do NOT write in shaded areas.
Legal name (same as Item 3)
17. For each machine OWNED, list the serial number/inventory I.D. number, make, machine type and indicate whether each machine is exhibited or displayed on location.
MACHINE SERIAL
MACHINE MAKE
EXHIBITED OR
MACHINE TYPE CODE
NUMBER/INVENTORY
OR
DISPLAYED ON
(Use letter codes from Item 18)
I.D. NUMBER
MANUFACTURER
LOCATION
YES
NO
1.
YES
NO
2.
YES
NO
3.
YES
NO
4.
YES
NO
5.
YES
NO
6.
YES
NO
7.
YES
NO
8.
YES
NO
9.
YES
NO
10.
YES
NO
11.
YES
NO
12.
YES
NO
13.
YES
NO
14.
YES
NO
15.
YES
NO
16.
YES
NO
17.
YES
NO
18.
YES
NO
19.
YES
NO
20.
YES
NO
21.
YES
NO
22.
YES
NO
23.
YES
NO
24.
YES
NO
25.
YES
NO
26.
YES
NO
27.
YES
NO
28.
YES
NO
29.
YES
NO
30.
For additional inventory, complete Coin-Operated Machine Inventory Supplement for General Business License Holders, Form AP-145,
or a computer printout of all numbered inventory may be used. If you use a computer printout, you MUST complete Items 18-20.
18. Enter the number of each type of music, skill or pleasure coin-operated machine that is exhibited or displayed in all locations.
– A –
– B –
– C –
– D –
– E –
– F –
PHONOGRAPHS
POOL TABLES
PINBALL GAMES
VIDEO GAMES
DARTS
OTHER

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