ESBD_File_335532_ATTACHMENT G.2 Application for Texas ID #AP-152_082118.pdf

SIC

code

5. Mailing address where you want to receive payments

6. (Optional)

7. (Optional)

8. (Optional)

9. City State ZIP code

10.

Payee telephone number (Area code and number)

Security type code ( 0, 1, 2 )

Zone code

(SSN)Social Security number (9 digits)

Individual Taxpayer Identification Number (ITIN) (9 digits)

Enter the number indicated

If "YES," enter Texas Taxpayer Number

1. Is this a new account? YES Mail Code 000 NO Enter Mail Code Agency number Complete Sections 1 - 5 Complete Sections 1, 2 & 5

For Comptroller's use only

11. Ownership Codes - Check only one code by the appropriate ownership type that applies to you or your business.

L - Texas Limited Partnership:

If checked, enter the

Texas File Number

Owner's name

T - Texas Corporation:

If checked, enter the Texas File Number

SSN / ITIN (9 digits) A - Professional Association:

If checked, enter the Texas File Number

If checked, enter the exas File Number

C - Professional Corporation:

T

Name

SSN / ITIN / EIN (9 digits)

Name

SSN / ITIN / EIN (9 digits)

I - Individual Recipient (not owning a business)

P - Partnership: If checked, enter two partner's names and

O - Out-of-State Corporation

G - Governmental Entity

U - State agency / University

F - Financial Institution

R - Foreign (out of U.S.A.)

N - Other: If checked, explain.

12. Payment Assignment? YES NO Note: A copy of the assignment agreement between payees must be attached.

Assignee name

Assignee TIN Assignment date

13. Comments Authorized signature (Applicant or authorized agent) Date

14.

Agency name Prepared by Phone (Area code and number)

15.

AP-152

(Rev.8-21/18)

Application for Texas Identification Number

• See instructions on back

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