Texas Funeral Service Commission Commercial Embalming Facility Application Form (Page 5 of 5) in pdf

Texas Funeral Service Commission Commercial Embalming Facility Application Form Page 5

ADDENDUM

FRANCHISE TAX

Texas Administrative Code Section 203.13 requires any corporate applicant for a license or

permit issued by the Texas Funeral Service Commission to certify in writing that its franchise

taxes are current, that the corporation is exempt from payment of the franchise tax, or that it is an

out-of-state corporation that is not subject to the Texas franchise tax.

If you certify corporate ownership on the application, the certification below must be completed

and returned with the application.

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FRANCHISE TAX CERTIFICATION

I hereby certify that _______________________________, the corporation listed as the

Name of Corporation

owner of _______________________________________, in the city of _____________,

Name of Commercial Embalming Facility

Texas is:

Current on the payment of its Texas franchise tax



Exempt from payment of the Texas franchise tax



An out-of-state corporation that is not subject to the Texas franchise tax



Name & Title of Corporate Officer: ________________________________________________

Franchise Tax ID Number: _______________________________________________________

I understand that any false statement as to the corporate franchise tax status on this certification

is ground for disciplinary action. I hereby state under oath that the statements contained herein

are true and correct to the best of my knowledge.

____________________________________

Signature

Subscribed and sworn to before me this ________________day of _______________________ 20______.

____________________________________

(SEAL)

Notary Public in and for the State of Texas

My commission expires_______________

Texas Funeral Service Commission Commercial Embalming Facility Application Form Page 5