ESBD_535601_1783616312807_04. Texas Family Code Schedule.docx

DOCX document 38 KB Posted

Attached to
Wavetronix SmartSensors
Solicitation number
601310000102310
Issued by
Tarrant County, Texas

About this file

This is a Texas Family Code Schedule form required for Solicitation No. 601310000102310 related to the Wavetronix SmartSensors contract opportunity in Texas. The document serves as a certification and eligibility verification instrument for respondents bidding 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 business entity. The form requires respondent certification that all parties named in the solicitation are eligible to receive contract payment and acknowledges that the contract may be terminated and payment withheld if the certification is inaccurate.

The schedule emphasizes compliance with Texas Family Code Section 231.006, which relates to child support obligations and eligibility to receive state grants, loans, or contract payments. Respondents who do not meet the ownership criteria specified under Texas Family Code Section 231.006 may check a box indicating the schedule is not applicable. The form requires a signature, printed name, title, and date from an authorized representative and must be returned with the response submission. The document explicitly states that failure to sign and return this page may result in the response being considered non-responsive. Social Security numbers collected through this form are kept confidential to the fullest extent allowed under Texas Family Code Section 231.302(e) and are used exclusively to identify persons owing child support obligations.

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TEXAS FAMILY CODE SCHEDULE

SOLICITATION NO. 601310000102310

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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