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AP-101-2 PRINT FORM CLEAR FIELDS
(Rev.1-15/17) Texas Application
Page 1
for Direct Payment Permit
• Please read instructions. • Type or print. • Do not write in shaded areas.
1. Taxpayer's Agreement - The applicant, in consideration of the issuance of a Direct Payment Permit by the State of Texas ac-
cording to the provisions of the law, agrees and affirms:
a. that applicant is a responsible person annually purchasing at least $800,000 worth of taxable items for use and not for
resale (complete Item 19);
b. that the accounting method used will clearly distinguish between taxable and nontaxable purchases (complete Item 20);
c. that upon the issuance of a Direct Payment Permit to the applicant, the applicant will accrue and pay to the State of Texas
all taxes which are or may in the future be due by virtue of the State, Local, Metropolitan Transit Authority, City Transit
Department, County and Special Purpose District Sales and Use Tax Acts. The tax is due on all taxable purchases; and,
unless the tax is paid to the seller, it must be reported on the Texas Direct Payment Return. All taxes due will be paid
monthly on or before the 20th day of the month following each monthly reporting period;
d. that the Direct Payment Exemption Certificate will not be issued for taxable items purchased for resale;
e. to report all taxable purchases on the direct payment return and waive any claim for discounts for taxes paid. No taxable
purchases may be reported on a sales and use tax return;
f. upon request, to make available at any time to the Comptroller's office the books, papers, records and equipment of the
applicant's business;
TAXPAYER'S AGREEMENT
g. to cooperate with the Comptroller's office in the examination of the books, papers, records and equipment of the applicant
and in the investigation of the applicant's activities, business and accounting methods; and
h. to fully disclose to the Comptroller's office in this agreement or upon acquisition, whichever occurs first, the nature and
extent of the ownership or control which the applicant has in the business from which the applicant makes purchases
pursuant to the Direct Payment Permit.
Legal cite: Tex. Tax Code Ann. Sec. 151.419
Type or print name of sole owner, partner or officer Sole owner, partner or officer
2. Legal name of owner (Sole owner, partnership, corporation or other name)
3. Mailing address (Street and number, P.O. Box or rural route and box number)
City State ZIP code County
4. If you are a sole owner, enter your home address IF it is different from the address above. (Street and number, city, state, ZIP code)
4a. Enter the phone number of the person primarily responsible for filing tax returns (Area code and number).
TAXPAYER IDENTIFICATION
5. Enter your Social Security number if you are a sole owner ............................................................................
6. Enter your Federal Employer Identification Number (FEIN), if any. ........................................................................
7. Enter your taxpayer number for reporting any Texas tax OR your Texas
Vendor Identification Number if you now have or have ever had one. ...............................................................
8. Indicate how your business is owned.
1 - Sole owner 3 - Texas corporation 7 - Limited partnership
2 - Partnership 6 - Foreign corporation Other (explain)
File number Month Day Year
9. If your business is a Texas corporation,
enter the file number and date. ......................................................................................
10. If your business is a foreign corporation, enter home state, home state registration number, Texas file number and date.
OWNERSHIP Home state Home state registration number Texas file number Month Day Year
State Number
11. If the business is a limited partnership, enter the home state
and identification number. ............................................................................................................
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