ESBD_File_347991_Exhibit G.3 - Application for Texas Identification Number.pdf
PDF 624 KB Posted
- Attached to
- Decatur Readiness Center Sewer Install Project
- Solicitation number
- TMD24-FMO-0033479
- Issued by
- Wise County, Texas
About this file
This document is an Application for Texas Identification Number, which is required by the Texas Comptroller's office for payees to receive payments from the state. The application collects information such as the payee's name, mailing address, telephone number, Texas Taxpayer Number (if applicable), and ownership type. The ownership types listed include Texas Limited Partnership, Texas Corporation, Professional Association, Professional Corporation, Individual Recipient, Sole Ownership, Partnership, Out-of-State Corporation, Governmental Entity, State Agency/University, Financial Institution, Foreign, and Other. The application also includes options for payment assignment and provides a space for comments.
The related state and local contract opportunity is for the Decatur Readiness Center Sewer Install Project in Decatur, Texas, which is located in Wise County and Denton City. The Texas Military Department (TMD) is seeking bids from contractors to disconnect and decommission an existing septic tank, and install a new sewer line for the Decatur Readiness Center.
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Text version
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code
| Payee | Information | (Please type or print) | ||||||||
| 4. | Name | of | payee | (Individual | or | business | to | be | paid) |
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
| 2. | Texas | Identification | Number | (TIN) | - | Indicate the type of number you are providing to be used for your TIN |
| Employer | Identification | Number | (EIN) | (9 digits) |
(SSN)Social Security number (9 digits)
Individual Taxpayer Identification Number (ITIN) (9 digits)
| Comptroller's | assigned | number | (FOR | STATE | AGENCY | USE | ONLY) | (11 digits) | |
| Current | Texas | Identification | Number | (FOR | STATE | AGENCY | USE | ONLY) | (11 digits) |
| 3. | Are | you | currently | reporting | any | Texas | tax | to | the | Comptroller's |
| office | such | as | sales | tax | or | franchise | tax? | YES | NO |
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)
| S | - | Sole | Ownership | (Individual | owning | a | business): | If | checked, |
| enter | the | owner's | name | and | Social | Security | number | (SSN) |
P - Partnership: If checked, enter two partner's names and
| Social | Security | numbers | (SSN). | If | a | partner | is | a | corporation, | use |
| the | corporation's | Employer | Identification | Number | (EIN). |
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
Se ct io n
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| IntUse2: AGENCY USE ONLY |
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| IntUse1: AGENCY USE ONLY |
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| IntUse3: AGENCY USE ONLY |
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| Item2a9: 742884783 |
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File details come from the government source that posted it. Updated .