Form 803 - Professional Association Annual Statement - Texas Secretary Of State Page 2
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27. The names and addresses of all officers are:
NAME
ADDRESS
OFFICE TITLE
(Include city, state, and zip code)
President
Vice President
Secretary
Treasurer
Officer must be a licensed member named in item 5. All offices must be filled; one person may hold all offices in a one-person association.
8. All members are licensed to perform the type of professional service for which the association is
formed; or, if applicable, each member is licensed to perform professional services falling within the
scope of practice of the practitioner.
The undersigned signs this document subject to the penalties imposed by law for the submission of a
materially false or fraudulent instrument.
Date:
Signature of authorized officer
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