Oklahoma Tax Commission Form COP-20001 Application To Purchase Coin-Operated Device Decal(s) for Period Ending June 30, 2025. This form is used to purchase decals ONLY! It is NOT used to apply for a permit or license. Visit OkTAP at tax.ok.gov to apply for a permit or license. This form is for decals purchased from July 1, 2024 through June 30, 2025 expiring June 30, 2025. |
COP 20001 Revised 6-2024 Coin-Operated Device Decal Order Form This form is used to purchase decals ONLY! It is NOT used to apply for a permit or license. Visit OkTAP at tax.ok.gov to apply for a permit or license. ___________________________________ __________________2025 Mailing Address Change Coin Device Account Number Decal Expiration Year ____________________________________________________________________ ___________________________________ Owner’s Name FEIN/SSN ____________________________________________________________________ ___________________________________ Mailing Address (REQUIRED) Telephone Number ____________________________________________________________________ City, State, ZIP ____________________________________________________________________ Physical Address (REQUIRED) ____________________________________________________________________ City, State, ZIP Annual Decals: Decal Type Number of Decals Rate Total Due 1 A. _____________________ x $ 75.00 = ........................................................................... 1 2 B. _____________________ x $ 10.00 = ............................................................................ 2 3 C. _____________________ x $ 15.00 = ........................................................................... 3 4 D. _____________________ x $ 5.00 = ........................................................................... 4 5 E. _____________________ x $ 2.00 = ........................................................................... 5 Seasonal Decals: Decal Type Number of Decals Number of Periods Rate Total Due 6 SA. _____________________ x ________________ x $7.50 = ................................... 6 7 SB. _____________________ x _________________ x $1.00 = .................................... 7 8 SC. _____________________ x ________________ x $1.50 = ................................... 8 9 SD. _____________________ x ________________ x $0.50 = ................................... 9 10 SE. _____________________ x ________________ x $0.20 = ................................. 10 Inclusive dates of events: _____________________ to _________________________ Penalty for Type A, C, D, SA, SC and SD Decal Sealed Machines: Number of Machines Rate Penalty Due 11a ______________________ x $100.00 = ............................................11a Penalty for Type B, E, SB and SE Decal Sealed Machines: Number of Machines Rate Penalty Due 11b ______________________ x $10.00 = ..............................................11b Penalty Total: Total Penalties Due 12 Total Penalties Due (Add lines 11a and 11b) .....................................................................................12 Grand Total: Grand Total Due 13 Grand Total Due (Add lines 1-10 and line 12) .................................................................................... 13 Signature: ______________________________________ Date: __________________ The information contained in this order form and any attachments is true and correct to the best of my knowledge. |
COP-20001 - Page 2 Coin-Operated Device Decal Order Form Instructions for completing Coin-Operated Device Decal Order Form Annual Decals: July 1 through June 30 A. Music, Amusement or Vending (25 cents or more) B. Vending (less than 25 cents) C. Bulk Vending (25 cents or more) with 2-5 mechanisms D. Bulk Vending (25 cents or more) E. Bulk Vending (less than 25 cents) Seasonal Decals: Number of Periods = Months in Operation SA. Music, Amusement or Vending (25 cents or more) SB. Vending (less than 25 cents) SC. Bulk Vending (25 cents or more) with 2-5 mechanisms SD. Bulk Vending (25 cents or more) SE. Bulk Vending (less than 25 cents) Sealed Machines Penalty: Decals A, C, D, SA, SC and SD = $100.00 penalty per machine. Decals B, E, SB and SE = $10.00 penalty per machine. Grand Total Due: Add lines 1-10 and line 12 (Total Penalties Due). Complete any address changes in the space provided. If mailing address change, place an ‘X’ in the Mailing Address Change box. This form cannot be used for any changes in ownership. Those changes require completion of the Oklahoma Business Registration Packet A found at tax.ok.gov. Sign and date Coin-Operated Device Decal Order Form. Decals may be purchased at the Oklahoma City Tax Commission office, or mail completed form and payment to: Oklahoma Tax Commission PO Box 26850 Oklahoma City, OK 73126-0850 A decal must be firmly affixed to each coin-operated device placed in operation or on location, and must be visible to and readable by the public. |