Free Refund Claim Form--Residential Use of Electricity for RV Parks and Campground Facilities - Texas

01-158 (9-08)

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CLEAR FIELDS

REFUND CLAIM FORM--RESIDENTIAL USE OF ELECTRICITY FOR RV PARKS AND CAMPGROUND FACILITIES
a. Taxpayer number b. Due date

c. Taxpayer name

You have certain rights under Chapters 552 and 559, Government Code, to review, request and correct information we have on file about you. Contact us at the address or numbers listed on the bottom of this form.
d. Meter number ID

Mailing street address

City

State

ZIP code

WHO MAY FILE THIS FORM RV parks or campground facilities that had residents staying 30 days or more in the past year. WHEN TO FILE A claim for refund of sales tax paid must be filed for each separate calendar or fiscal year during which there was a predominant residential use of electricity. Predominant residential use means that tenants staying in the RV park or campground longer than 30 days consume over 50% of electricity measured through the meter(s) applicable to the refund claim as calculated using the formula as shown below. The claim must be submitted on or before the fourth anniversary of the earliest month tax was due or paid within the year for which the claim was made. You may file only one claim per fiscal or calendar year. You must keep complete records to support all the information on site rental stays claimed. We may request copies of documentation during an audit on any information used to perfect this claim. Records should be retained for four years. TO FILE A REFUND CLAIM FORM Send this signed refund claim form stating the amount to be refunded and the basis for the refund. Include a copy of the invoice or receipt showing the amount of tax you paid. If tax was actually paid to the Comptroller by another entity such as your retail electric provider, you will also need to submit a completed Assignment of Right to Refund (Form 00-985), found online at www.window.state.tx.us. If you have more than ten invoices or receipts, you should also provide a schedule of overpaid taxes. The schedule must show the period for each invoice, the amount of state and local taxes for each city, county, special purpose district and transit authority, and the identity of the service provider who collected the tax from you. To see a sample refund schedule, go online at www.window.state.tx.us/taxinfo/taxforms/01-911.pdf. If you ask someone else (such as an accountant, attorney or consultant) to file a refund request on your behalf, the Comptroller's office must have your written authorization before we can work with that person on your claim. An authorization form (Form 01-137) is available upon request. Send the request to [email protected]. You can get a tax refund only if the four-year statute of limitations has not expired.

1. Do you own or represent a campground facility that has residents who have resided there for at least 30 days? .......................
· If the answer is "NO," you are not eligible for a refund based on residential use of electricity. Legal name of reporting entity
m m d d y y

YES

NO

Texas taxpayer or FEI number
m m d d y y

2a. Begin date (Enter mm/dd/yy format.) ................

2b. End date (Enter mm/dd/yy format.) ...............

3. Qualifying residential days (For the period indicated in Item 2a and 2b.) .......................................................... 3.
· Enter the total number of site rental days associated with residential stays.

4. Total number of rental days at facility (For period above.) .............................................................................. 4.
· Enter the total number of site rental days for the whole facility.

5. Percentage of residential use (Divide Item 3 by Item 4.) ................................................................................. 5.
Print or type name Daytime phone (Area code and number)

Mail refund requests along with supporting documentation to: COMPTROLLER OF PUBLIC ACCOUNTS ATTN: Sales Tax Refunds Verification Section 111 E. 17th Street Austin, TX 78774-0100

I declare that the information in this document and any attachments is true and correct to the best of my knowledge and belief.
Officer, director, member, owner or other authorized agent Date

If you have any questions, you may contact the Texas State Comptroller's field office in your area or call (800) 252-1381, toll free nationwide. The Austin number is (512) 463-4545.