ESBD_554938_1788214969881_4. Texas Family Code Schedule.docx

DOCX document 37 KB Posted

Attached to
Truck Body and Aerial Device, Truck Mounted, Telescoping with Articulating Lower Boom
Solicitation number
601440000053988
Issued by
Texas

About this file

This is a Texas Family Code Schedule document required for Solicitation No. 601440000053988, relating to a Truck Body and Aerial Device procurement for the State of Texas. The schedule serves as a certification of eligibility to receive state grants, loans, or contract payments under Texas Family Code Section 231.006, which addresses child support obligations. Respondents must complete the form by providing the names and Social Security numbers of any individual or business entity holding at least 25 percent ownership interest in the submitting business entity. The document requires respondent certification that the information provided is accurate and acknowledges that the contract may be terminated and payment withheld if the certification proves inaccurate. Alternatively, respondents not meeting the ownership criteria may indicate that the schedule is not applicable by checking the designated box.

The form must be signed and returned with the response as a mandatory requirement; failure to sign and return the completed schedule may result in the response being deemed non-responsive and cause for rejection. Social Security numbers are collected under federal privacy protections to identify individuals who may owe child support obligations, and this information will be kept confidential to the fullest extent permitted by Texas Family Code Section 231.302(e). The schedule does not address pricing, set-asides, or other commercial terms but serves exclusively as a compliance and eligibility verification document for state contract awards.

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TEXAS FAMILY CODE SCHEDULE

SOLICITATION NO. 601440000053988

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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