ESBD_553793_1787773812081_05. Texas Family Code Schedule.docx

DOCX document 37 KB Posted

Attached to
TopoDOT LiDAR Processing Software
Solicitation number
601440000051864
Issued by
Texas

About this file

This is a Texas Family Code Schedule certification document for Solicitation No. 601440000051864 related to a TopoDOT LiDAR Processing Software procurement in Texas. The schedule serves as an eligibility certification requirement under Texas Family Code Section 231.006, which addresses child support obligations. 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 organization. The document requires respondent signature and title, with completion and return of the schedule mandatory for response consideration.

Failure to sign and return the completed schedule may result in the response being deemed non-responsive and ineligible for award. The schedule incorporates Federal Privacy Act protections, with Social Security numbers collected solely for identifying individuals who may owe child support obligations. All information provided is maintained confidential to the extent permitted under Texas Family Code Section 231.302(e). Respondents certifying inaccurate information acknowledge that the resulting contract may be terminated and payment withheld. Respondents not meeting the ownership criteria threshold may check an applicable box indicating the schedule is not applicable to their entity.

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Text version

TEXAS FAMILY CODE SCHEDULE

SOLICITATION NO. 601440000051864

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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