b.
TEXAS OFF-ROAD, HEAVY DUTY DIESEL EQUIPMENT SURCHARGE RETURN a. T Code 50100
c. Taxpayer number d. Filing period
DO NOT WRITE IN SHADED AREAS
e.
f. Due date
g. Name and mailing address (Make any necessary name or address changes below.)
h.
Blacken this box if your mailing address has changed. Show changes by preprinted information. Blacken this box if you are no longer in business, and enter the date you went out of business below. Month Day
1. 2.
Year
i.
j.
SECTION I -- For sales, rentals and leases entered into prior to July 1, 2003 1. SALES, RENTALS, AND LEASES -
Enter the total amount (not including the surcharge or sales tax) of all sales, leases and rentals 1. of off-road, heavy-duty diesel equipment with 50 or more horsepower (Whole dollars only). 2. TAXABLE AMOUNT - Enter the total TAXABLE AMOUNT including sales, leases, and rentals of off-road, heavy-duty diesel equipment made during the reporting period. This 2. amount is the total sales made LESS any deductions. (Whole dollars only)
.00
.00
3.
3. SURCHARGE DUE FOR SALES, RENTALS AND LEASES PRIOR TO JULY 1, 2003 Multiply Item 2 by 1.0% (.010)
SECTION II -- For sales, rentals and leases entered into July 1, 2003 and after 4. SALES, RENTALS, AND LEASES -
Enter the total amount (not including the surcharge or sales tax) of all sales, leases and rentals 4. of off-road, heavy-duty diesel equipment with 50 or more horsepower. (Whole dollars only) 5. TAXABLE AMOUNT - Enter the total TAXABLE AMOUNT including sales, leases and rentals of off-road, heavy-duty diesel equipment made during the reporting period. This 5. amount is the total sales made LESS any deductions. (Whole dollars only)
.00
.00
6.
6. SURCHARGE DUE FOR SALES, RENTALS AND LEASES JULY 1, 2003 AND AFTER Multiply Item 5 by 2.0% (.020)
SECTION III -- For equipment used July 1, 2003 and after 7. USE SURCHARGE - Enter the amount subject to use surcharge (Whole dollars only) 8. SURCHARGE DUE FOR USE JULY 1, 2003 AND AFTER Multiply Item 7 by 2.0% (.020)
7.
.00
8. 9. 10. 11. 12.
9. AMOUNT DUE (Sum of Items 3, 6, and 8) 10. TIMELY DISCOUNT - If you are filing your return and paying the surcharge on or before the due date, multiply Item 9 by .005. 11. PRIOR PAYMENTS - If you requested that a prior payment and/or an overpayment be applied
to this specific period, the amount, as of the date of this return, is preprinted in Item 11.
12. NET SURCHARGE DUE (Subtract Items 10 and 11 from Item 9.)(Dollars and cents)
01-142 (Rev.12-07/3)
5% of the amount in Item 12. If more than 30 days late, enter 10% of the amount in Item 12. Minimum penalty $1.) NOTE: An additional $50 penalty will be assessed when more than two returns are received with a postmark later than the due date. (TEX. TAX CODE ANN. SEC. 151.7031) 14. Interest due - If any surcharge is unpaid 61 days after the due date, enter interest on the amount in Item 12. Calculate interest at the rate published online at www.window.state.tx.us or call the Comptroller toll free at (877) 447-2834, for the applicable interest rate.
13. Penalty due - If report is filed or surcharge is paid after the due date, enter penalty. (If 1-30 days late, enter
13. 14. 15.
15. TOTAL AMOUNT DUE AND PAYABLE (Sum of Items 12, 13 and 14.)
Taxpayer name T Code Taxpayer number Period
k.
l.
50020
Make the amount in Item 15 payable to: STATE COMPTROLLER Mail to: COMPTROLLER OF PUBLIC ACCOUNTS P.O. Box 149361 Austin, Texas 78714-9361
I declare that the information in this document and any attachments is true and correct to the best of my knowledge and belief. Taxpayer or duly authorized agent Daytime phone Date
If you have any questions regarding the Off-Road, Heavy-Duty Diesel Equipment Surcharge, you may contact the Texas State Comptroller's field office in your area or call (800) 252-5555, toll free, nationwide. The local number in Austin is (512) 463-4600.
111 A
Form 01-142 (Rev.12-07/3) (Back)
INSTRUCTIONS FOR COMPLETING THE TEXAS OFF-ROAD, HEAVY DUTY DIESEL EQUIPMENT SURCHARGE RETURN
WHO SHOULD FILE If you sell, lease or rent off-road, heavy-duty diesel equipment with 50 or more horsepower, you are required to charge a surcharge on the sale, lease, rental or use amount. This is in addition to the regular sales and/or use tax. WHEN TO FILE Returns must be filed or postmarked on or before the 20th day of the month following the end of each reporting period. If the due date falls on a Saturday, Sunday or legal holiday, the next business day will be the due date. INSTRUCTIONS FOR FILING AN AMENDED RETURN To obtain blank forms to file an amended return, go to the Comptroller website at www.window.state.tx.us or call (800) 252-5555, toll free, nationwide. The Austin number is (512) 463-4600. Forms are also available at the Comptroller Field Office nearest you, OR you may photocopy the original return, write "AMENDED RETURN" at the top, strike through Item a, strike through those figures which have changed, and write the new figures on the return. Remember to sign and date the amendment. GENERAL INSTRUCTIONS Please do not write in shaded areas. If any preprinted information on this return is incorrect, OR if you do not qualify to file this return, contact the Comptroller's office. Enter "0" if the amount is zero. If any amounts entered are negative, bracket them as follows:
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