✯
A
T E
X
S
Comptroller
of Public
Accounts
FORM
ENTERPRISE OR DEFENSE READJUSTMENT PROJECT - INVOICES OR CONTRACTS
Taxpayer or Vendor ID number
Period of claim
01-125
(Rev.6-02/3)
Taxpayer or Vendor name and mailing address
DATE
INVOICE / CONTRACT
NUMBER
DESCRIPTION OF EQUIPMENT / MATERIALS
DOLLAR AMOUNT
(Not including sales tax)
TOTAL AMOUNT
$
$
NOTE: List only invoices or contracts on which Texas state sales and use tax has been paid.
Attach additional pages if necessary and enter the grand total of all pages on the final page
Begin date Sept. 1,
End date Aug. 31,
/
Type of claim
ENTERPRISE
Period
ANNUAL
SEMI-ANNUAL
DEFENSE READJUSTMENT
VENDOR NAME
DESCRIPTION OF PURCHASES