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Oklahoma Tax Commission
Form COP-20001
Application To Purchase Coin-Operated Device Decal(s)
for Period Ending June 30, 2024.
This form is used to purchase decals ONLY!
It is NOT used to apply for a permit or license.
Visit oktap.tax.ok.gov
to apply for a permit or license.
This form is for decals purchased
from January 2, 2024 through June 30, 2024
expiring June 30, 2024.
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COP 20001
Revised 1-2024
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.tax.ok.gov to apply for a permit or license.
___________________________________ __________________2024 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 $ 37.50 = ........................................................................... 1
2 B. _____________________ x $ 5.00 = ............................................................................ 2
3 C. _____________________ x $ 7.50 = ........................................................................... 3
4 D. _____________________ x $ 2.50 = ........................................................................... 4
5 E. _____________________ x $ 1.00 = ........................................................................... 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.
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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.
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