ESBD_507599_1776363165762_5. Texas Family Code Schedule.docx
DOCX document 38 KB Posted
- Attached to
- Traffic Paint
- Solicitation number
- 601330000046594
- Issued by
- Johnson County, Beaumont City, Texas
About this file
This is a Texas Family Code Schedule form for Solicitation No. 601330000046594, required by the State of Texas to establish eligibility for state grants, loans, and contract payments. Respondents must complete the schedule to certify compliance with child support obligations under Texas Family Code Section 231.006. The form requires submission of names and Social Security numbers for any individual or business entity holding at least twenty-five percent ownership interest in the responding business entity. Completion and return of this schedule with the response is mandatory, as failure to sign and return the page may result in the response being deemed non-responsive.
The schedule serves as a compliance verification mechanism whereby respondents acknowledge that the contract may be terminated and payment withheld if the certification is inaccurate. Social Security numbers are collected solely to identify persons that may owe child support obligations and will be kept confidential to the fullest extent allowed under Texas Family Code Section 231.302(e). Respondents who do not meet the ownership criteria specified in Texas Family Code Section 231.006 may check a box indicating that the schedule is not applicable, sign the form, and return it with their response.
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Text version
TEXAS FAMILY CODE SCHEDULE
SOLICITATION NO. 601330000046594
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:
| Click or tap here to enter text. | XXX-XX-Click or tap here to enter text. |
| Name | Social Security Number |
| Click or tap here to enter text. | XXX-XX-Click or tap here to enter text. |
| Name | Social Security Number |
| Click or tap here to enter text. | XXX-XX-Click or tap here to enter text. |
| Name | Social Security Number |
If the 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 Click or tap here to enter text.
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.
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