50-181 (Rev. 1-00/4) [31.11 (4-82) Rule 9.3039]
APPLICATION FOR TAX REFUND
Collecting office name Present mailing address (number and street) City, town or post office, state, ZIP code Phone (area code and number) Collecting tax for: (taxing units)
To apply for a tax refund, the taxpayer must complete the following. Step 1: Owner's name and address
Owner's name
Present mailing address (number and street) City, town or post office, state, ZIP code Phone (area code and number)
Step 2: Describe the property
Legal description (or attach copy of the tax bill or tax receipt):
Address or location of property:
Account number of property: OR
Tax receipt number:
Step 3: Give the tax payment information
1. 2. 3. 4. 5.
Name of Taxing Unit from Which Refund is Requested
Year for Which Refund is Requested
Date of the Tax Payment / / / / / $ $ $ $ $
Amount of Taxes Paid $ $ $ $ $
Amount of Tax Refund Requested
Taxpayer's reason for refund (attach supporting documentation):
Step 4: Sign the form
"I hereby apply for the refund of the above-described taxes and certify that the information I have given on this form is true and correct."
sign here
Signature
Date of application for tax refund
If you make a false statement on this application, you could be found guilty of a Class A misdemeanor or a state jail felony under Texas Penal Code Section 37.10.
Step 5: Tax refund determination
This tax refund is
Approved
Disapproved
sign Authorized officer here
Collector(s) of taxing unit(s) for refund applications over (insert amount for which governing body
Date Date
sign approval is required under Section 31.11, Tax Code) here