Blank Texas Ap 168 PDF Template
Form Example
Texas Application for Customs Broker License
General Information
Who May Submit This Application
If you have been licensed by the United States Customs Service, you may submit this application to receive your Texas Customs Broker License. You must include a copy of your United States Customs Broker’s license.
Definitions
United States Customs Broker - A person licensed by the United States Customs Service to act as a custom house broker.
Texas Customs Broker License - The license issued to the United States Customs Broker, to allow the broker to issue export certifications. A license is required for each business location.
Authorized Employee - “Authorized employee” means an employee of a customs broker:
(A)who is authorized by the broker to perform customs transactions on behalf of the broker;
(B)who is compensated by the broker with a regular salary or wages;
(C)who is under the direct control and supervision of the broker; and
(D)from whose salary or wages the broker is required to and actually does deduct and withhold a tax under federal law. Business Location - Each place of business of the broker where export certification forms are fully or partially prepared. Export Certification Stamp - Stamp that is affixed to the export certification form.
Broker Fees
Broker Annual License Fees (The Customs Broker License expires on December 31 of each calendar year).
License must be renewed on or before December 31 of each year.
Annual License Fee Schedule |
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1st Quarter (January - March) |
$300.00 |
3rd Quarter (July - September) |
$150.00 |
2nd Quarter (April - June) |
$225.00 |
4th Quarter (October - December) |
$ 75.00 |
NOTE: A license fee is due for each business location where export certifications will be issued.
Bond Fee
The amount of the bond or security required is $5,000. (The Comptroller may require Brokers to post additional $1,000 bond or security for each location, if the Comptroller considers it necessary to ensure payment of tax, penalty and fine amounts.)
Stamp Fee
The Comptroller shall charge $1.60 for each stamp.
For Assistance
If you have any questions about this application, or any other related matter, contact your nearest Texas State Comptroller’s office. You may also call (800)
General Instructions
•Please type or print.
•Do not separate pages.
•Fill in all blanks and answer all questions completely and fully.
•Completed application and payment (made payable to State Comptroller) should be mailed to:
Comptroller of Public Accounts
111 E. 17th St.
Austin, TX
NOTE: No export certifications may be issued until you provide a copy of your United States Customs Broker’s License, this application has been approved and your Texas Customs Broker License has been issued.
FEDERAL PRIVACY ACT - 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.
You have certain rights under Ch.559, Government Code, to request, review and correct information we have on file about you. Contact us at the address or phone numbers listed on this form.
Texas Application for
Customs Broker License
• Please read instructions. |
• Type or print. |
• Do NOT write in shaded areas. |
Page 1 |
1.Licensed Customs Broker Agreement - The applicant, in consideration of the issuance of the Texas Customs Broker License, agrees and affirms:
a.that the applicant is a responsible Licensed Customs Broker issuing valid export certifications for merchandise being exported from the United States;
b.that the export certifications will not be used in a manner that violates a provision of the Tax Code or the Comptroller’s rules;
c.that a copy of the applicant’s United States Customs Broker’s license is provided to the Texas Comptroller of Public Accounts at the time of application;
d.that the Comptroller of Public Accounts may suspend or revoke a Texas Customs Broker’s license to issue export certifications under this section for good cause;
e.to properly document the issuance of export certifications and stamps, and to purchase new stamps as described in the Comptroller’s rules;
f.that upon request, the licensed Customs Broker will make records available to the Comptroller or his authorized representative in the State of Texas and will cooperate with the Comptroller or his authorized representative in the examination of the records;
g.that copies of each employee’s power of attorney to issue export certifications in the name of the applicant are included;
h.information in this document and any attachments is true and correct to the best of my knowledge and belief; and
i.I understand that computer system passwords are confidential. I will not disclose (to any person) any password(s) which I am given or devise, and I will not write down such password(s) or post them where they may be viewed by others. I understand that I am responsible for any computer transactions performed as a result of access authorized by use of any passwords that I receive or devise. I agree to abide by all written conditions and restrictions imposed by the Comptroller’s Information Security Office. I agree NOT to attempt to circumvent the Comptroller’s computer security system. I understand that use of a password not issued specifically to me or to a group of which I am a member is expressly prohibited. I also understand that failure to observe these restrictions may constitute a Breach of Computer Security, and that such an offense may constitute a
Type or print name of licensed customs broker |
Broker, officer or authorized agent |
Date of application |
WARNING. You may be required to obtain an additional permit or license from the State of Texas or from a local governmental entity to conduct business. A listing of links relating to acquiring licenses, permits, and registrations from the State of Texas is available online at http://www.Texas.gov. You may also want to contact the municipality and county in which you will conduct business to determine any local governmental requirements.
2. Legal name of applicant as registered with the United States Customs Service |
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For Comptroller's use only |
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00991 |
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Tax type/reason |
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Reference no. |
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3. Mailing address where you will receive mail from the Texas Comptroller of Public Accounts |
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Street and number, P.O. Box or rural route |
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Taxpayer number |
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XAMAST |
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County code |
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Master phone num |
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add/change |
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4. Enter your Social Security number if you are a sole owner |
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XUMAST |
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Secondary mailing |
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address |
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5. |
Enter your Federal Employer Identification Number (FEIN), if any |
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XAADDR |
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Secondary mailing |
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6. |
Daytime phone where applicant may be reached (area code and number) |
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address change |
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XUADDR |
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7. Enter the number of the license issued by the United States Customs Service |
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Tax type |
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• 092 |
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8. Enter your Texas taxpayer number for reporting any Texas tax or your |
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County code |
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Texas Vendor Identification Number if you now have or have ever had one |
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9. Enter your email address |
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10. If your business is a corporation, list all principal officers. (Attach additional sheets as necessary.)
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Phone (area code and number) |
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Home address |
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ZIP code |
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SSN or FEIN |
Email address |
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Name |
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Title |
Phone (area code and number) |
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Home address |
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SSN or FEIN |
Email address |
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Texas Application for
Customs Broker License
• |
Please read instructions. |
• Type or print. |
• Do NOT write in shaded areas. |
Page 2 |
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11. |
Legal name of applicant (same as Item 2) |
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Texas Customs Broker license number |
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Complete the following information for each active business location where export certifications will be issued.
(Attach additional sheets as necessary.) |
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Outlet/location |
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12. |
Business name |
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XALOCA |
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Location number |
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13. |
Business location (street and |
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County code |
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T X |
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ICL/OCL |
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14. |
Is your business located inside the boundaries of an incorporated city? |
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YES |
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NO |
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15. |
First business date |
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Add responsibility |
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16. |
Business phone (area code and number) |
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XASTAT |
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17. |
Business name |
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Outlet/location |
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XALOCA |
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18. |
Business location (street and |
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Location number |
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City |
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T X |
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County code |
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19. |
Is your business located inside the boundaries of an incorporated city? |
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YES |
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NO |
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ICL/OCL |
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20. |
First business date |
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Y or N |
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Add responsibility |
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21. |
Business phone (area code and number) |
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XASTAT |
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22. |
Business name |
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Outlet/location |
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Location number |
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23. |
Business location (street and |
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24. |
Is your business located inside the boundaries of an incorporated city? |
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25. |
First business date |
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Y or N |
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Add responsibility |
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26. |
Business phone (area code and number) |
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XASTAT |
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27. |
Business name |
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XALOCA |
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Location number |
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28. |
Business location (street and |
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29. |
Is your business located inside the boundaries of an incorporated city? |
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YES |
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NO |
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ICL/OCL |
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30. |
First business date |
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Y or N |
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Add responsibility |
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31. |
Business phone (area code and number) |
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XASTAT |
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Texas Application for
Customs Broker License
• |
Please read instructions. |
• Type or print. |
• Do NOT write in shaded areas. |
Page 3 |
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32. |
Legal name of applicant (same as Item 2) |
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Texas Customs Broker license number |
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Complete the following information for every employee authorized to issue certifications. A power of attorney is required for each employee authorized to issue certifications. Include any officers that will issue certificates. (Attach additional sheets as necessary.)
33. |
Name of employee (first name, middle initial, last name) |
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34. |
Social Security number |
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XAMAST |
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35. Home address (street and number, P.O. Box or rural route) |
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City |
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County/Country |
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State/Province |
ZIP/Postal code |
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36. |
Beginning date |
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taxpayer no. |
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37. |
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38. |
Phone number |
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address |
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39. |
Name of employee (first name, middle initial, last name) |
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40. |
Social Security number |
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41. Home address (street and number, P.O. Box or rural route) |
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XAMAST |
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County/Country |
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State/Province |
ZIP/Postal code |
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42. |
Beginning date |
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taxpayer no. |
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ADD |
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43. |
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44. |
Phone number |
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45. |
Name of employee (first name, middle initial, last name) |
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46. |
Social Security number |
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XAMAST |
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47. Home address (street and number, P.O. Box or rural route) |
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State/Province |
ZIP/Postal code |
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48. |
Beginning date |
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Related Party |
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taxpayer no. |
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49. |
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50. |
Phone number |
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51. |
Name of employee (first name, middle initial, last name) |
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52. |
Social Security number |
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53. Home address (street and number, P.O. Box or rural route) |
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XAMAST |
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County/Country |
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State/Province |
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54. |
Beginning date |
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Employee |
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taxpayer no. |
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55. |
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56. |
Phone number |
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address |
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57. |
Name of employee (first name, middle initial, last name) |
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Social Security number |
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XAMAST |
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59. Home address (street and number, P.O. Box or rural route) |
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60. |
Beginning date |
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Employee |
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Related Party |
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taxpayer no. |
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ADD |
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61. |
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62. |
Phone number |
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address |
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(area code and number) ( |
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More PDF Templates
Income Based Apartments Mckinney - Inadequate applications will not be processed, highlighting the importance of complete submissions.
Dwc 69 Form - The DWC069 assists in resolving disputes over MMI and impairment between doctors and insurance carriers.
Common mistakes
-
Incomplete Information: Many applicants fail to fill in all required fields. Each blank must be completed to ensure the application is processed without delays.
-
Missing Documentation: Some applicants neglect to include a copy of their United States Customs Broker’s license. This document is essential for the application to be considered.
-
Incorrect Payment Amount: Applicants often miscalculate the annual license fee based on the submission date. Each quarter has a different fee, and it is crucial to pay the correct amount.
-
Failure to Sign: Some individuals overlook the necessity of signing the application. A signature is required to validate the submission and affirm the accuracy of the provided information.
-
Ignoring Instructions: The instructions provided with the form must be followed closely. Ignoring details such as typing or printing and not separating pages can lead to rejection.
-
Omitting Employee Information: When listing authorized employees, applicants sometimes forget to include all required details, such as Social Security numbers and addresses. This information is critical for compliance.
Key takeaways
- Eligibility Requirement: To apply for the Texas Customs Broker License using the AP-168 form, you must already hold a valid United States Customs Broker license.
- Documentation Needed: A copy of your United States Customs Broker license must be included with your application. Without it, your application cannot be processed.
- Annual Fees: Be aware of the annual license fee schedule, which varies depending on when you submit your application. Fees range from $75 to $300 based on the quarter.
- Bond Requirement: A bond of $5,000 is required, and additional amounts may be necessary for each business location to ensure compliance with tax obligations.
- Complete the Form Accurately: Fill in all blanks and answer all questions thoroughly. Incomplete applications may delay the approval process.
- Contact for Assistance: If you have questions, reach out to the Texas State Comptroller’s office. They offer support, including Spanish-speaking assistance, to help guide you through the process.
Steps to Using Texas Ap 168
Completing the Texas AP 168 form is an important step for licensed customs brokers seeking to obtain their Texas Customs Broker License. This form requires careful attention to detail, ensuring that all necessary information is provided accurately. Below are the steps to guide you through the process of filling out the form.
- Type or Print: Make sure to type or print clearly in the spaces provided. Avoid using cursive or any unclear handwriting.
- Do Not Separate Pages: Keep all pages of the form together when submitting.
- Fill in All Blanks: Answer every question completely. Missing information can delay the processing of your application.
- Licensed Customs Broker Agreement: Read and agree to the terms listed in this section. Sign and date where indicated.
- Legal Name: Enter your legal name as registered with the United States Customs Service.
- Mailing Address: Provide a complete mailing address where you can receive correspondence from the Texas Comptroller.
- Social Security Number: If you are a sole owner, enter your Social Security number in the designated space.
- Federal Employer Identification Number (FEIN): If applicable, include your FEIN.
- Daytime Phone: Provide a daytime phone number where you can be reached.
- US Customs Service License Number: Enter the license number issued to you by the United States Customs Service.
- Texas Taxpayer Number: If you have a Texas taxpayer number, include it here.
- Email Address: Provide a valid email address for communication purposes.
- Business Information: Fill out the details for each business location where export certifications will be issued. Include business name, location, and contact information.
- Authorized Employees: List all employees authorized to issue certifications. Attach additional sheets if necessary, and include their powers of attorney.
- Review: Double-check all information for accuracy and completeness before submitting.
- Payment: Include payment for the application fee, made payable to the State Comptroller.
- Mail the Application: Send the completed form and payment to the Comptroller of Public Accounts at the address provided on the form.
Once your application is submitted, it will be reviewed. You will receive further instructions regarding the next steps after your application has been processed. Ensure that all required documents, such as your United States Customs Broker’s license, are included to avoid any delays.