Form AP-111 "Texas Motor Fuels Tax Continuous Bond" - Texas

What Is Form AP-111?

This is a legal form that was released by the Texas Comptroller of Public Accounts - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2013;
  • The latest edition provided by the Texas Comptroller of Public Accounts;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AP-111 by clicking the link below or browse more documents and templates provided by the Texas Comptroller of Public Accounts.

ADVERTISEMENT
ADVERTISEMENT

Download Form AP-111 "Texas Motor Fuels Tax Continuous Bond" - Texas

Download PDF

Fill PDF online

Rate (4.7 / 5) 27 votes
AP-111
PRINT FORM
CLEAR FORM
(Rev.9-13/8)
Texas Motor Fuels Tax Continuous Bond
• Please read instructions.
• Type or print.
• Do not write in shaded areas.
1. Fuel type (Separate bonds must be submitted for each fuel type)
Gasoline
Diesel Fuel
Compressed Natural Gas (CNG)/Liquefied Natural Gas (LNG)
2. Applicant name
3. Federal Employer ID or Social Security number
4. Mailing address (P.O. Box or street number)
City
State
ZIP code
County
Surety/Security Information
5. Legal name of surety company
6. Mailing address of surety company
City
State
ZIP code
County
7. Surety company Federal Employer Identification Number
8. Does surety company have a Taxpayer Number for reporting
If “Yes,”
any Texas tax OR a Texas Vendor Identification Number?
YES
NO
enter number
9. Bond beginning effective date
Bond number
Bond amount
10. Bond Conditions
KNOW ALL PERSONS BY THESE PRESENTS:
That the applicant as PRINCIPAL and the named bonding company as SURETY, duly authorized and qualified to do business as a surety
company in the State of Texas, are held and firmly bound to THE STATE OF TEXAS in the sum of $ __________________ payable at Austin,
Texas, and for the payment of which we bind ourselves, our heirs, executors, and assigns, jointly and severally.
This bond is conditioned upon the principal being issued or having applied for a license pursuant to the provision of TEX. TAX CODE ANN.
Sec. __________________________ .
If PRINCIPAL complies with the provisions of the cited statute and pays to the State of Texas, through the Comptroller of Public
Accounts, at Austin, Texas, all taxes including penalty, interest, and costs accruing under the cited statute, this obligation shall be null
and void. Otherwise, it remains in full force and effect.
This bond shall be continuous in form from the effective date and shall be automatically extended from calendar year to calendar year. It
shall constitute a new and separate obligation, in the amount of the sum named herein, for each calendar year while the bond is in force.
This bond is not invalidated by recovery on this bond, the execution of any new bonds, or the renewal of a license. In addition, this bond
shall not be invalidated by the revocation, renewal or issuance of a license, but a new bond may be demanded if a new license is issued or
renewed. The State of Texas shall have the right to sue on and otherwise enforce the obligations of this bond without exhausting its remedies
against PRINCIPAL’s property or assets, and PRINCIPAL need not be made a party to such suit.
11. In witness whereof we have set our hands and seal this _______ day of ______________________ , _________ .
SEAL
SURETY
12.
Principal or authorized agent
Title
AP-111
PRINT FORM
CLEAR FORM
(Rev.9-13/8)
Texas Motor Fuels Tax Continuous Bond
• Please read instructions.
• Type or print.
• Do not write in shaded areas.
1. Fuel type (Separate bonds must be submitted for each fuel type)
Gasoline
Diesel Fuel
Compressed Natural Gas (CNG)/Liquefied Natural Gas (LNG)
2. Applicant name
3. Federal Employer ID or Social Security number
4. Mailing address (P.O. Box or street number)
City
State
ZIP code
County
Surety/Security Information
5. Legal name of surety company
6. Mailing address of surety company
City
State
ZIP code
County
7. Surety company Federal Employer Identification Number
8. Does surety company have a Taxpayer Number for reporting
If “Yes,”
any Texas tax OR a Texas Vendor Identification Number?
YES
NO
enter number
9. Bond beginning effective date
Bond number
Bond amount
10. Bond Conditions
KNOW ALL PERSONS BY THESE PRESENTS:
That the applicant as PRINCIPAL and the named bonding company as SURETY, duly authorized and qualified to do business as a surety
company in the State of Texas, are held and firmly bound to THE STATE OF TEXAS in the sum of $ __________________ payable at Austin,
Texas, and for the payment of which we bind ourselves, our heirs, executors, and assigns, jointly and severally.
This bond is conditioned upon the principal being issued or having applied for a license pursuant to the provision of TEX. TAX CODE ANN.
Sec. __________________________ .
If PRINCIPAL complies with the provisions of the cited statute and pays to the State of Texas, through the Comptroller of Public
Accounts, at Austin, Texas, all taxes including penalty, interest, and costs accruing under the cited statute, this obligation shall be null
and void. Otherwise, it remains in full force and effect.
This bond shall be continuous in form from the effective date and shall be automatically extended from calendar year to calendar year. It
shall constitute a new and separate obligation, in the amount of the sum named herein, for each calendar year while the bond is in force.
This bond is not invalidated by recovery on this bond, the execution of any new bonds, or the renewal of a license. In addition, this bond
shall not be invalidated by the revocation, renewal or issuance of a license, but a new bond may be demanded if a new license is issued or
renewed. The State of Texas shall have the right to sue on and otherwise enforce the obligations of this bond without exhausting its remedies
against PRINCIPAL’s property or assets, and PRINCIPAL need not be made a party to such suit.
11. In witness whereof we have set our hands and seal this _______ day of ______________________ , _________ .
SEAL
SURETY
12.
Principal or authorized agent
Title
Form AP-111 (Back)(Rev.9-13/8)
Instructions for Completing
Texas Motor Fuel Continuous Bond
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 phone numbers listed on this form.
Who May Complete Bond –
General Instructions –
Any license holder required to post a bond to
• Please type or print only in white areas.
guarantee the payment of fuels taxes may
• Complete each item carefully.
complete and submit this bond.
• Do NOT use dashes when entering a Federal
Employer Identification Number or Social Security
Number.
Bonding Requirements –
Specific Instructions –
Gasoline – A supplier, permissive supplier,
distributor, importer, exporter, distributor/aviation
Item 8 – If the surety company has both a Texas
fuel dealer, blender or exporter/blender shall post a
Taxpayer Number and a Texas Vendor Identification
bond equal to two times the maximum amount of
Number, enter only the Vendor Identification Number.
tax that could accrue on tax-free gasoline
Use only the first 11 digits of the number.
purchased or acquired during a reporting period.
The minimum bond is $30,000. The maximum bond
Item 10 – Bonds must be written in accordance with
is $600,000.
the applicable provisions of law for the type of fuel
which this bond will cover. The amount of the bond
Diesel Fuel – A supplier, permissive supplier,
and the applicable section number of the law must
distributor, importer, exporter, distributor/aviation
be entered for this bond to be effective. Section
fuel dealer, blender, importer/bonded user or
numbers are as follows:
exporter/blender shall post a bond equal to two
times the maximum amount of tax that could
GASOLINE TAX, sec. 162.111(b)
accrue on tax-free diesel fuel purchased or
DIESEL FUEL TAX, sec. 162.212(b)
acquired or sold during a reporting period. The
CNG/LNG TAX, sec. 162.361(b)
minimum bond is $30,000. The maximum bond
is $600,000.
Item 11 – This bond must be dated and signed by an
authorized agent of the surety company.
Dyed Diesel Fuel Bonded User – A dyed diesel
fuel bonded user shall post a bond equal to two
Item 12 – This bond form must be signed by the
times the maximum amount of tax that could
principal or authorized agent to be effective.The autho-
accrue on tax-free diesel fuel purchased or acquired
rized agent must also attach their power of attorney.
during a reporting period. The minimum bond is
$10,000. The maximum bond is $600,000.
Mail the completed bond to this address:
Compressed Natural Gas (CNG)/Liquefied
Comptroller of Public Accounts
Natural Gas (LNG) – A CNG/LNG dealer shall post
111 E. 17th Street
a bond equal to two times the maximum amount of
Austin, TX 78774-0100
tax that could accrue on CNG or LNG produced,
purchased, acquired, sold or delivered during a
Whom to Contact for Assistance –
reporting period. The minimum bond is $30,000.
For assistance with any fuels tax question, please
The maximum bond is $600,000.
contact the Texas Comptroller of Public Accounts at
1-800-252-1383 or 512-463-4600.
Disclosure of your social security number is required and authorized under law, for the purpose of tax administration and identification
of any individual affected by applicable law. 42 U.S.C. §405(c)(2)(C)(i); Tex. Govt. Code §§403.011 and 403.078. Release of information
on this form in response to a public information request will be governed by the Public Information Act, Chapter 552, Government Code,
and applicable federal law.
Page of 2