Texas Department Of Agriculture Public Weigher Certificate Of

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P.O. Box 12076 Austin, Texas 78711
(877) 542-2474
(512) 463-7476
Hearing impaired: (800) 735-2988 voice
(800) 735-2989 (TTY)
Texas Department of Agriculture
Public Weigher Certificate of Authority Application
RWM-702
1
TYPE OF APPLICATION
Change of Ownership – previous account number: _________________
New Business
2
BUSINESS TYPE
TDA USE ONLY
Corporation
Sole Proprietorship
Client No.
Account No.
Limited Liability Co.
Government
Limited Partnership
Organization
Date (mm/dd/yy)
Initials
General Partnership
/
/
3
CLIENT INFORMATION
Full legal business name (owner’s name if sole proprietor – no aliases)
D.B.A. (if applicable)
Comptroller Taxpayer ID No.(In-state businesses)
Federal ID No.(Out-of-state businesses and nonprofit org. )
SOLE PROPRIETORSHIP ONLY
Social Security No. (SSN - Required)
If you do not have an SSN you must a attach form
Affidavit for
Occupational License - No Social Security Number (OGC-001)
-
-
available at
Driver License No. ____________________ (if SSN is not available)
TX
State Issued ID No. ____________________ (if DL is not available)
Other
Note: Applicants must submit their original bond WITH the application for Certificate of Authority. The initiation
date of the Bond should be within two weeks of the submission of the application for Certificate of Authority.
This document becomes public record and is subject to disclosure. With few exceptions, you have the right to request
and be informed about the information that the State of Texas collects about you. You are entitled to receive and
review the information upon request. You also have the right to ask the state agency to correct any information that is
determined to be incorrect. (Reference: Government Code, Sections 552.021, 552.023, and 559.004.)
Licensing Department
Revised 1/1/16
Administrative Services Division
Occupational

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