Fee Payment Form And Instructions Texas

ADVERTISEMENT

T
D
S
H
S
EXAS
EPARTMENT OF
TATE
EALTH
ERVICES
P.O. Box 149347
Austin, Texas 78714-9347
1-888-963-7111
DAVID L. LAKEY, M.D.
TTY: 1-800-735-2989
COMMISSIONER
Fee Payment Form and Instructions:
The Texas Tier Two Chemical Inventory Report for calendar year 2012 is due between January 1 and March 1 of
2013. The Texas Tier Two Program requires the use of the 2012 Tier2 Submit software to file your report.
Please email your submission to:
T2Sdatafiles@dshs.state.tx.us
You will need to mail in your fee payment with the Fee Payment Form provided at the bottom of this letter to the
CASH RECEIPTS address. Please verify and make needed changes to the name and address on the payment form.
You will need to give your unique TXT2 Number and some additional information on the form below. Also, please
type your TXT2 Number on:
(1) the subject line of your email,
(2) the check/money order memo line, and
(3) the State Fields screen in the Tier2 Submit software.
Resource Information:
Email:
tiertwohelp@dshs.state.tx.us
Phones: (512) 834-6603
Web:
(800) 452-2791 (Toll Free in Texas)
After you have submitted your Tier Two report, please take the short survey on our website:
FEE QUESTIONS? O
ur Fee Calculators on the left hand side of our website or located on the Fee Information
mail out.
Fee Payment Form – Texas Tier Two Chemical Reporting Program
Make check payable to: Texas Department of State Health Services – ZZ109-180
TXT2 No.: 68687 Total: $ 100.00 Check No.:_________ No. of facilities: 08
Owner/Operator: Hidalgo County, Texas
Submitter Name: Martin Ramirez, County Environmental Compliance Coordinator
Contact Phone No.: 956-2929-7000 ext. 4082
X
□
Address Change:
Mailing
Payment for report year(s):
200
9
□ 2010 □ 20
11
2012
Hidalgo County Environmental Compliance Office
th
1212 S. 25
St., Suite B
Edinburg, TX 78542-7223
CASH RECEIPTS – MC 2005
DSHS – TIER TWO CHEMICAL REPORTING PROGRAM
PO BOX 149347
AUSTIN, TX 78714-9347
An Equal Employment Opportunity Employer and Provider

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Net Profit License Fee Return Form And Instructions - City Of Bowling Green Net Profit License Fee Return Form And Instructions - City Of Bowling Green Financial
Instructions For Form It-204-ll - Limited Liability Company/limited Liability Partnership Filing Fee Payment Form Instructions For Form It-204-ll - Limited Liability Company/limited Liability Partnership Filing Fee Payment Form Financial
Form Vp-2 - Miscellaneous Fee Payment Voucher General Instructions - 2009 Form Vp-2 - Miscellaneous Fee Payment Voucher General Instructions - 2009 Financial
Instructions For Form It-204-ll - Limited Liability Company/limited Liability Partnership Filing Fee Payment Form - 1998 Instructions For Form It-204-ll - Limited Liability Company/limited Liability Partnership Filing Fee Payment Form - 1998 Financial
Form It-204-ll - Partnership, Limited Liability Company, And Limited Liability Partnership Filing Fee Payment Form - 2013 Form It-204-ll - Partnership, Limited Liability Company, And Limited Liability Partnership Filing Fee Payment Form - 2013 Financial
Form It-204-ll - Partnership, Limited Liability Company, And Limited Liability Partnership Filing Fee Payment Form - 2012 Form It-204-ll - Partnership, Limited Liability Company, And Limited Liability Partnership Filing Fee Payment Form - 2012 Financial
Instructions - Oil & Gas Conservation Fee Return Forms And Schedules Instructions - Oil & Gas Conservation Fee Return Forms And Schedules Financial
Form Ifta-21-v - Payment Voucher And Instructions For International Fuel Tax Agreement (ifta) Licenses And Decals Renewed Electronically Form Ifta-21-v - Payment Voucher And Instructions For International Fuel Tax Agreement (ifta) Licenses And Decals Renewed Electronically Life
Form Or-706-v - Oregon Estate Transfer Tax Payment Voucher And Instructions Form Or-706-v - Oregon Estate Transfer Tax Payment Voucher And Instructions Financial
Form Il-501 - Payment Coupon And Instructions - 2012 Form Il-501 - Payment Coupon And Instructions - 2012 Financial

Related Categories

Parent category: Legal
Download
Go