ESBD_365033_1719423208708_Exhibit G.3 - Application for Texas Identification Number.pdf

PDF 624 KB Posted

Attached to
Drone Storage Lockers
Solicitation number
TMD24-SAD-0035359
Issued by
Travis County, Texas

About this file

This document is an Application for Texas Identification Number form. It is used by the Texas Comptroller's office to collect payee information, including name, mailing address, Texas taxpayer number, ownership type, and payment assignment details. The form is required for individuals or businesses to receive payments from the state of Texas. Key details include the option to provide an Employer Identification Number (EIN), Social Security Number (SSN), or Individual Taxpayer Identification Number (ITIN) as the Texas Identification Number, and the requirement to indicate if the payee is currently reporting any Texas taxes. The form also collects ownership information, such as whether the payee is a Texas corporation, partnership, or sole proprietorship.

The related state and local contract opportunity is for the Texas Military Department's procurement of five (5) drone storage lockers, as detailed in the attached Invitation for Bid (IFB) packet. The contract is for the state of Texas, and no additional details are provided about the project scope, timeline, or bid submission requirements.

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Text version

SIC

code

PayeeInformation(Please type or print)
4.Nameofpayee(Individualorbusinesstobepaid)

5. Mailing address where you want to receive payments

6. (Optional)

7. (Optional)

8. (Optional)

9. City State ZIP code

10.

Payee telephone number (Area code and number)

Security type code ( 0, 1, 2 )

Zone code

2.TexasIdentificationNumber(TIN)-Indicate the type of number you are providing to be used for your TIN
EmployerIdentificationNumber(EIN)(9 digits)

(SSN)Social Security number (9 digits)

Individual Taxpayer Identification Number (ITIN) (9 digits)

Comptroller'sassignednumber(FORSTATEAGENCYUSEONLY)(11 digits)
CurrentTexasIdentificationNumber(FORSTATEAGENCYUSEONLY)(11 digits)
3.AreyoucurrentlyreportinganyTexastaxtotheComptroller's
officesuchassalestaxorfranchisetax?YESNO

Enter the number indicated

If "YES," enter Texas Taxpayer Number

1. Is this a new account? YES Mail Code 000 NO Enter Mail Code Agency number Complete Sections 1 - 5 Complete Sections 1, 2 & 5

For Comptroller's use only

11. Ownership Codes - Check only one code by the appropriate ownership type that applies to you or your business.

L - Texas Limited Partnership:

If checked, enter the

Texas File Number

Owner's name

T - Texas Corporation:

If checked, enter the Texas File Number

SSN / ITIN (9 digits) A - Professional Association:

If checked, enter the Texas File Number

If checked, enter the exas File Number

C - Professional Corporation:

T

Name

SSN / ITIN / EIN (9 digits)

Name

SSN / ITIN / EIN (9 digits)

I - Individual Recipient (not owning a business)

S-SoleOwnership(Individualowningabusiness):Ifchecked,
entertheowner'snameandSocialSecuritynumber(SSN)

P - Partnership: If checked, enter two partner's names and

SocialSecuritynumbers(SSN).Ifapartnerisacorporation,use
thecorporation'sEmployerIdentificationNumber(EIN).

O - Out-of-State Corporation

G - Governmental Entity

U - State agency / University

F - Financial Institution

R - Foreign (out of U.S.A.)

N - Other: If checked, explain.

12. Payment Assignment? YES NO Note: A copy of the assignment agreement between payees must be attached.

Assignee name

Assignee TIN Assignment date

13. Comments Authorized signature (Applicant or authorized agent) Date

14.

Agency name Prepared by Phone (Area code and number)

15.

AP-152

(Rev.8-21/18)

Application for Texas Identification Number

• See instructions on back

Se ct io n

Se ct io n

Se ct io n

Se ct io n

Se ct io n

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SIC1:
IntUse2: AGENCY USE ONLY
STC:
ZC1:
IntUse1: AGENCY USE ONLY
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IntUse3: AGENCY USE ONLY
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File details come from the government source that posted it. Updated .