"Firm Registration Form" - Texas

Firm Registration Form is a legal document that was released by the Texas Board of Professional Engineers and Land Surveyors - a government authority operating within Texas.

Form Details:

  • The latest edition currently provided by the Texas Board of Professional Engineers and Land Surveyors;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Texas Board of Professional Engineers and Land Surveyors.

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Download "Firm Registration Form" - Texas

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Office Use Only
Firm #
SURVEYING
TEXAS BOARD OF PROFESSIONAL LAND
12100 Park 35 Circle, Building A, Suite 156, MC-230, Austin TX 78753
Entity #
www.txls.texas.gov
Phone: 512 239-5263 Fax: 512 239-5253
Receipt #
FIRM REGISTRATION FORM
State law requires that a person engaging in the Practice of Surveying in this State under any business title other than the real name of
one or more persons authorized to engage in public or state land surveying, whether individually or as an association, partnership, or
corporation, shall file with the Texas Board of Professional Land Surveying, in the manner prescribed by the Board, a certificate
stating the full name and place of residence of each person engaging in the practice and the place, including the street address, city and
zip code, where the practice or business is principally conducted. Mark N/A when appropriate. Any changes to the business are to be
reported to the board including closure. Mail the form to the Board office at the address noted above with a $32.11 fee. Each location
(branch office) offering land surveying services has to be registered and pay the fee by completing the Branch Registration Form. The
fee must be in the form of a check or money order (no cash) made payable to the Texas Board of Professional Land Surveying.
Firm’s Legal Name:
1.
DBA (if applicable):
Mailing Address:
Physical Address:
Address
City
County
State
Zip
Telephone:
Fax:
E-mail:
Subsidiary and/or Branch Office offering land surveying services.  None or Number:
2.
**Complete Branch Registration Form for each Subsidiary and/or Branch Office**
3A.
Name(s) and title(s) of Managing Owner(s) _________________________________________________________________
Contact E-mail Address _______________________________________________ Telephone ________________________
3B.
Name(s) and title(s) of Partner(s), Officer(s) or Director(s) of firm: _____________________________________________
____________________________________________________________________________________
4.
Name(s) of full time Registered Professional Land Surveyors employed at this location:
Full Name of Surveyor
RPLS #
Residence Address
Telephone Number
**Affirmation of employment to be signed and sealed by each RPLS who is an employee of firm (use page 2 for RPLS signature and seal)**
Signature of Remitter __________________________________________________________________
Print Name _________________________________________________________________________
Position with Firm___________________________________ Amount Enclosed _______________Date_______________________
Firm is required to renew its registration and pay the designated fee prior to January 1 of each year to offer land surveying services in the
next year. If a firm branch does not renew its registration and pay the designated fee prior to January-1-of each year, the firm’s branch
registration will be deemed expired. Any surveying services offered without a valid renewed registration is in violation of the Professional
Land Surveying Practices Act and subject to sanctions and penalty fees provided for under the Act or as promulgated by the Board
Reference: Land Surveying Practices Section 10171.352 and Section 1071.353, also Board Rules §661.55, §661.56, §661.57
Please attach additional information regarding branch offices, directors and surveyors as needed.
1
Office Use Only
Firm #
SURVEYING
TEXAS BOARD OF PROFESSIONAL LAND
12100 Park 35 Circle, Building A, Suite 156, MC-230, Austin TX 78753
Entity #
www.txls.texas.gov
Phone: 512 239-5263 Fax: 512 239-5253
Receipt #
FIRM REGISTRATION FORM
State law requires that a person engaging in the Practice of Surveying in this State under any business title other than the real name of
one or more persons authorized to engage in public or state land surveying, whether individually or as an association, partnership, or
corporation, shall file with the Texas Board of Professional Land Surveying, in the manner prescribed by the Board, a certificate
stating the full name and place of residence of each person engaging in the practice and the place, including the street address, city and
zip code, where the practice or business is principally conducted. Mark N/A when appropriate. Any changes to the business are to be
reported to the board including closure. Mail the form to the Board office at the address noted above with a $32.11 fee. Each location
(branch office) offering land surveying services has to be registered and pay the fee by completing the Branch Registration Form. The
fee must be in the form of a check or money order (no cash) made payable to the Texas Board of Professional Land Surveying.
Firm’s Legal Name:
1.
DBA (if applicable):
Mailing Address:
Physical Address:
Address
City
County
State
Zip
Telephone:
Fax:
E-mail:
Subsidiary and/or Branch Office offering land surveying services.  None or Number:
2.
**Complete Branch Registration Form for each Subsidiary and/or Branch Office**
3A.
Name(s) and title(s) of Managing Owner(s) _________________________________________________________________
Contact E-mail Address _______________________________________________ Telephone ________________________
3B.
Name(s) and title(s) of Partner(s), Officer(s) or Director(s) of firm: _____________________________________________
____________________________________________________________________________________
4.
Name(s) of full time Registered Professional Land Surveyors employed at this location:
Full Name of Surveyor
RPLS #
Residence Address
Telephone Number
**Affirmation of employment to be signed and sealed by each RPLS who is an employee of firm (use page 2 for RPLS signature and seal)**
Signature of Remitter __________________________________________________________________
Print Name _________________________________________________________________________
Position with Firm___________________________________ Amount Enclosed _______________Date_______________________
Firm is required to renew its registration and pay the designated fee prior to January 1 of each year to offer land surveying services in the
next year. If a firm branch does not renew its registration and pay the designated fee prior to January-1-of each year, the firm’s branch
registration will be deemed expired. Any surveying services offered without a valid renewed registration is in violation of the Professional
Land Surveying Practices Act and subject to sanctions and penalty fees provided for under the Act or as promulgated by the Board
Reference: Land Surveying Practices Section 10171.352 and Section 1071.353, also Board Rules §661.55, §661.56, §661.57
Please attach additional information regarding branch offices, directors and surveyors as needed.
1
MUST BE SIGNED AND SEALED BY SURVEYOR FOR FIRM REGISTRATION
Affirmation of employment to be signed and sealed by each RPLS who is employed by firm:
I hereby certify under penalty of perjury that I _________________________________________, Registered Professional Land
Surveyor No. __________________ am employed full time by herein named Firm. I hereby acknowledge this statement by affixing
my Registered Professional Land Surveyor seal hereto.
I hereby certify under penalty of perjury that I _________________________________________, Registered Professional Land
Surveyor No. __________________ am employed full time by herein named Firm. I hereby acknowledge this statement by affixing
my Registered Professional Land Surveyor seal hereto.
I hereby certify under penalty of perjury that I _________________________________________, Registered Professional Land
Surveyor No. _________________ am employed full time by herein named Firm. I hereby acknowledge this statement by affixing
my Registered Professional Land Surveyor seal hereto.
Please attach additional information regarding branch offices, directors and surveyors as needed.
2
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