Texas Business License Application Form 2012

Tda.state. tx. us/spcs submit your renewal online Hearing Impaired 800 735-2988 voice RENEWAL APPLICATION FOR BUSINESS LICENSE Name of Company TPCL Business Telephone No. Business Fax No. Bus Email Location Address Street City County State Zip Mailing Address Street or P O Box ---Important Note--- I understand that my email address is required for the Texas Department of Agriculture to keep me informed of critical information including licensing and regulatory updates renewal invoices and other important communications. Type of Ownership Sole Proprietor Partnership Corporation List name and address of all other persons who hold more than 10 ownership of this business Name County State I CERTIFY THAT I HAVE NOT DEFAULTED ON A LOAN GUARANTEED BY THE TEXAS GUARANTEED STUDENT LOAN CORPORATION. SIGNATURE OF BUSINESS LICENSE HOLDER REQUIRED DATE Name of Responsible Certified Applicator License No. Late 1-30 days past due Delinquent 31-60 days past due of licenses Business Renewal Fee 224 336 if Late 448 if Delinquent Cert Applicator Renewal Fee 100. COMMISSIONER TODD STAPLES TEXAS DEPARTMENT OF AGRICULTURE STRUCTURAL PEST CONTROL SERVICE P. O. BOX 12847 AUSTIN TEXAS 78711-2847 Phone 512 305-8250 or 866-918-4481 Fax 888-232-2567 Internet Address www. Failure to provide an email address may result in my not receiving time-sensitive information that could affect my compliance with state regulations thereby resulting in monetary penalties. The Structural Pest Control Service performs criminal history searches on all license applicants and licensees including those applying for renewal of an existing license. At minimum criminal history information is sought from the Texas Department of Public Safety. This process may delay agency action on a license application if the applicant s criminal history reveals an arrest for conviction of or a plea of guilty to a criminal offense. If an applicant s or licensee s criminal history reveals a conviction or plea of guilty to a criminal offense which relates to the occupation of structural pest control the applicant will be asked to submit additional information to demonstrate the applicant s current fitness to be licensed* Failure to submit the requested information submission of false or misleading information or failure to demonstrate current fitness to be licensed may result in denial of the application or revocation of an existing license. 150 if Late 200 if Delinquent Technician Renewal Fee 76. 114 if Late. 152 if Delinquent Total Enclosed Make Check Payable to Texas Department of Agriculture Disclosure of Social Security Number is mandatory under Tx. Failure to provide an email address may result in my not receiving time-sensitive information that could affect my compliance with state regulations thereby resulting in monetary penalties. The Structural Pest Control Service performs criminal history searches on all license applicants and licensees including those applying for renewal of an existing license. The Structural Pest Control Service performs criminal history searches on all license applicants and licensees including those applying for renewal of an existing license. At minimum criminal history information is sought from the Texas Department of Public Safety. This process may delay agency action on a license application if the applicant s criminal history reveals an arrest for conviction of or a plea of guilty to a criminal offense.