ESBD_547465_1786126958636_05. Texas Family Code Schedule.docx

DOCX document 37 KB Posted

Attached to
Video Detection System
Solicitation number
601310000102756
Issued by
Texas

About this file

This is a Texas Family Code Schedule form required for Solicitation No. 601310000102756 related to a Video Detection System contract opportunity in Texas. The document serves as a certification of eligibility to receive state grants, loans, or payment on state contracts, specifically addressing child support obligation compliance under Texas Family Code Section 231.006. Respondents must complete the form 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 includes three designated fields for owner information with corresponding Social Security numbers, or respondents may indicate that the schedule is not applicable if ownership criteria are not met.

The document emphasizes that completion and signature are mandatory, with failure to return the signed schedule potentially resulting in the response being deemed non-responsive. Respondents must acknowledge that the contract may be terminated and payment withheld if the certification is inaccurate. The form includes a Federal Privacy Act Notice explaining that Social Security number disclosure is required under Texas Family Code Sections 231.006(c) and 231.302(c)(2) for child support verification purposes, with confidentiality protections outlined under Section 231.302(e) of the Texas Family Code.

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Text version

TEXAS FAMILY CODE SCHEDULE

SOLICITATION NO. 601310000102756

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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