ESBD_511013_1777491307430_Attachment G.4 - Application for Texas Identification Number.pdf
PDF 624 KB Posted
- Attached to
- Statewide Road Base
- Solicitation number
- TMD26-FMO-0038415
- Issued by
- Bastrop County, Texas
About this file
This is an Application for Texas Identification Number (AP-152 form) used by the State of Texas Comptroller's office to register payees for state payments. The form collects essential payee information including name, mailing address, and contact details, along with the type of tax identification number being provided, such as an Employer Identification Number (EIN), Social Security Number (SSN), Individual Taxpayer Identification Number (ITIN), or a Comptroller's assigned number. The application determines whether the account is new or existing and requires payees to indicate their current tax reporting status with the Comptroller's office, such as sales tax or franchise tax obligations.
The form includes section requirements for ownership classification, with eleven ownership codes available to identify the type of entity applying, ranging from individual recipients and sole proprietorships to corporations, partnerships, governmental entities, and foreign entities. Additional fields address payment assignment options, requiring documentation of assignment agreements if applicable. The form must be completed by the applicant or authorized agent with signature and date, and includes agency-specific fields for internal tracking, including mail codes, agency numbers, SIC codes, security type codes, and zone codes. No specific pricing terms, contract awards, or service deliverables are included in this registration document, as it serves solely as an identification and payment setup mechanism for state procurement transactions.
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Text version
SIC
code
| Payee | Information | (Please type or print) | ||||||||
| 4. | Name | of | payee | (Individual | or | business | to | be | paid) |
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. | Texas | Identification | Number | (TIN) | - | Indicate the type of number you are providing to be used for your TIN | |
| Employer | Identification | Number | (EIN) | (9 digits) |
(SSN)Social Security number (9 digits)
Individual Taxpayer Identification Number (ITIN) (9 digits)
| Comptroller's | assigned | number | (FOR | STATE | AGENCY | USE | ONLY) | (11 digits) | |
| Current | Texas | Identification | Number | (FOR | STATE | AGENCY | USE | ONLY) | (11 digits) |
| 3. | Are | you | currently | reporting | any | Texas | tax | to | the | Comptroller's |
| office | such | as | sales | tax | or | franchise | tax? | YES | NO |
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 | - | Sole | Ownership | (Individual | owning | a | business): | If | checked, |
| enter | the | owner's | name | and | Social | Security | number | (SSN) |
P - Partnership: If checked, enter two partner's names and
| Social | Security | numbers | (SSN). | If | a | partner | is | a | corporation, | use |
| the | corporation's | Employer | Identification | Number | (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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| Item2a9: 742884783 |
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File details come from the government source that posted it. Updated .