ESBD_515674_1778786619009_06. Texas Family Code Schedule.docx
DOCX document 38 KB Posted
- Attached to
- Secure Document Destruction
- Solicitation number
- 601440000053037
- Issued by
- Texas
About this file
This is a Texas Family Code Schedule certification form required by the State of Texas for solicitation number 601440000053037, establishing eligibility requirements for receiving state grants, loans, or payments on state contracts. Respondents must complete the schedule by providing names and Social Security numbers of all individuals or business entities holding at least twenty-five percent ownership interest in the submitting entity, or certify that the schedule is not applicable if ownership criteria are not met. The form must be signed and returned with the response submission, as failure to do so may result in the response being deemed non-responsive.
The schedule implements Texas Family Code Section 231.006 requirements regarding child support obligations, with Social Security numbers collected under federal privacy protections to identify individuals who may owe child support obligations. Respondents certify that they and any named individuals or entities are eligible to receive the specified payment and acknowledge that the contract may be terminated and payment withheld if the certification is inaccurate. Social Security numbers will be kept confidential to the fullest extent allowed under Texas Family Code Section 231.302(e).
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Text version
TEXAS FAMILY CODE SCHEDULE
SOLICITATION NO. 601440000053037
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 Name Click or tap here to enter text.
Title Click or tap to enter a date.
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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