ESBD_560137_1789679191515_05. Texas Family Code Schedule.docx

DOCX document 38 KB Posted

Attached to
TopoDOT LiDAR Processing Software
Solicitation number
601440000054497
Issued by
Texas

About this file

This is a Texas Family Code Schedule document associated with solicitation number 601440000054497 for the State of Texas, specifically related to a TopoDOT LiDAR Processing Software contract opportunity. The schedule serves as a certification form requiring respondents to attest to their eligibility to receive state payments and acknowledge that the contract may be terminated and payment withheld if the certification is inaccurate. Respondents must provide the names and Social Security numbers of any individual or business entity holding at least twenty-five percent ownership interest in the business entity submitting the response, with space provided for up to three owners. The schedule must be signed and returned with the response, and failure to do so may result in the response being deemed non-responsive.

The document is a compliance requirement under Texas Family Code Section 231.006 relating to child support obligations. Respondents who do not meet the ownership criteria specified in the code may check a box indicating that the schedule is not applicable. The Social Security numbers collected are used to identify persons that may owe child support and will be kept confidential to the fullest extent allowed under Texas Family Code Section 231.302(e). This schedule is mandatory for all responses and must be signed by an authorized representative with a date of submission.

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Text version

TEXAS FAMILY CODE SCHEDULE

SOLICITATION NO. 601440000054497

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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