1001 Preston Street, Suite 100 ● Houston, Texas 77002 ● (713) 274-8000 ● www.hctax.net
By signing below, I certify that the information provided on this Special Inventory Tax Information
Request Form is true and correct. I acknowledge and understand that furnishing false information
on this form is a CRIMINAL OFFENSE, and I could be found guilty of a Class A misdemeanor or a state
jail felony under section 37.10, Texas Penal Code.
Special Inventory Tax Dealer-Agent Information Form
Please complete and return this form to SITDept@hctx.net , mail to the Harris County Tax
Assessor-Collector, P.O. Box 3486, Houston, Texas 77253-3486, or fax to 713-368-2029.
Enter Dealer #: _________________________
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