ESBD_412432_1745331075613_04. Texas Family Code Schedule 601340000060972.pdf

Revised: September 27, 2023

1 - 1

TEXAS FAMILY CODE SCHEDULE

SOLICITATION NO. 601340000060972

Ineligibility to Receive State Grants or Loans or Receive Payment on State Contracts Respondent shall fill out the appropriate information, sign and return the schedule.

Under Family Code §231.006, relating to child support obligations, Respondent and any other individual or business entity named in this solicitation are eligible to receive the specified payment and acknowledge that this contract may be terminated and payment withheld if this certification is inaccurate. Any response submitted under this solicitation shall contain the names and social security numbers of person or entity holding at least a twenty-five percent ownership interest in the business entity submitting the response.

Respondents meeting the ownership must complete the following:

XXX-XX-

Name Social Security Number

XXX-XX-

Name Social Security Number

XXX-XX

Name Social Security Number

If respondent does not meet the ownership criteria under Texas Family code - Section 231.006, check the box below, sign and return the schedule.

This Schedule is not applicable

FEDERAL PRIVACY ACT NOTICE: This notice is given pursuant to the Federal Privacy Act. Disclosure of your Social Security (SSN) is required under Section 231.006(c) and Section 231.302(c)(2) of the Texas Family Code. The SSN will be used to identify persons that may owe child support. The SSN will be kept confidential to the fullest extent allowed under Section 231.302(e), Texas Family Code.

Signature

Title

THIS PAGE MUST BE RETURNED WITH THE RESPONSE. FAILURE TO SIGN AND RETURN THIS

PAGE MAY RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE.