Free 00-985 Assignment of Right to Refund - Texas

File Size: 19.8 kB
Pages: 1
Date: October 10, 2005
File Format: PDF
State: Texas
Category: Tax Forms
Author: Steve Mittel
Word Count: 312 Words, 2,726 Characters
Page Size: Letter (8 1/2" x 11")

Download 00-985 Assignment of Right to Refund ( 19.8 kB)

Preview 00-985 Assignment of Right to Refund
To the Comptroller of Public Accounts for the State of Texas (hereinafter "Comptroller"): (1) My name is ______________________________________ , and I am a duly authorized representative of __________________________________________ (the "Assignor"). By executing this Assignment of Right to a Refund ("Assignment"), the Assignor assigns all rights and interest to the tax refund herein described that the Assignor may have to ______________________________ (the "Assignee"), subject to the limitation noted herein. The Assignee's Taxpayer Number is ____________________ (if permitted in Texas). (2) Assignor hereby assigns the Assignee (check whichever is applicable): _____ a. The right to file a request for a refund and to receive the refund. _____ b. The right to receive the refund only. (3) The tax refund that is the subject of this Assignment is described as follows: Tax Type: ________________________________________ Period: __________________________________________ Transactions: __________________________________________________________________________ ________________________________________________________________ (Attach schedule, if necessary.) Other specific limitations: _________________________________________________________________ (4) The Assignor understands that the Comptroller may require both parties to provide documents or information necessary for the Comptroller to verify the validity of the refund claim and/or to transfer any verified amount to the Assignee. (5) By executing this Assignment, the Assignor affirms that the Assignor has neither previously claimed a refund nor taken a credit on a return for taxes that are subject of this Assignment, and further affirms that the Assignor will not claim a refund or a credit for those taxes in the future. Executed _______ day of _________________ , 20 ____ .

Assignor Entity Name

Assignor Taxpayer Number

Print or type the name of person authorizing assignment

Relationship to entity (i.e., President, Treasurer)

Signature of person authorizing assignment


Area code/daytime phone number

Under Ch. 559, Government Code, you are entitled to review, request, and correct information we have on file about you, with limited exceptions in accordance with Ch. 552, Government Code. To request information for review or to request error correction, contact us at the Texas Comptroller's office
Form 00-985 (Rev.9-05/2)