ESBD_422233_1747927438582_Exhibit G.3 - Application for Texas Identification Number.pdf

PDF 624 KB Posted

Attached to
TMD Region 2 Sewer Maintainence
Solicitation number
TMD25-FMO-0039608
Issued by
Andrews County, Denton County, Ellis County, Texas

About this file

The document is an Application for Texas Identification Number (Form AP-152), which is a standard state administrative form used for registering a business or individual for tax and payment purposes with the Texas Comptroller's office. The form is designed to capture key identifying information for entities seeking to do business with state agencies, including ownership type, taxpayer identification details, and contact information.

The form provides multiple options for identifying the type of business entity, including individual recipients, sole ownership, partnerships, corporations (Texas and out-of-state), professional associations, governmental entities, and other classifications. It requires the applicant to specify their Texas Identification Number type (such as Employer Identification Number, Social Security Number, or Individual Taxpayer Identification Number), and includes sections for mailing address, telephone contact, and optional payment assignment information. The form is intended to establish a standardized method for the state to track and process payments and tax reporting for businesses and individuals engaging with Texas government agencies.

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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

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IntUse2: AGENCY USE ONLY
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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 .