ESBD_531634_1782421717317_05. Texas Family Code Schedule.docx

DOCX document 38 KB Posted

Attached to
Manitou Cloud Services
Solicitation number
601440000053644
Issued by
Travis County, Austin City, Texas

About this file

This is a Texas Family Code Schedule form for Solicitation No. 601440000053644 related to the State of Texas. The document serves as a certification of eligibility to receive state grants, loans, or payments on state contracts, with compliance required under Texas Family Code Section 231.006 regarding child support obligations. Respondents must provide names and Social Security numbers for all individuals or business entities holding at least twenty-five percent ownership interest in the submitting entity. The form must be completed, signed, and returned with the response submission. Failure to sign and return this page may result in the response being deemed non-responsive.

Respondents certify that they and any named individuals or business entities are eligible to receive specified payments, acknowledging that the contract may be terminated and payment withheld if the certification is inaccurate. Social Security numbers are required under Texas Family Code Sections 231.006(c) and 231.302(c)(2) for identification of persons who may owe child support obligations. The information will be kept confidential to the fullest extent permitted by Section 231.302(e) of the Texas Family Code. Alternatively, respondents not meeting ownership criteria under Texas Family Code Section 231.006 may check a box indicating the schedule is not applicable and submit accordingly.

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Text version

TEXAS FAMILY CODE SCHEDULE

SOLICITATION NO. 601440000053644

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.
NameSocial Security Number
Click or tap here to enter text.XXX-XX-Click or tap here to enter text.
NameSocial Security Number
Click or tap here to enter text.XXX-XX-Click or tap here to enter text.
NameSocial 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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