Form SPC-401 "Structural Pest Control Services Commercial Business License Application" - Texas

What Is Form SPC-401?

This is a legal form that was released by the Texas Department of Agriculture - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 15, 2018;
  • The latest edition provided by the Texas Department of Agriculture;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form SPC-401 by clicking the link below or browse more documents and templates provided by the Texas Department of Agriculture.

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Download Form SPC-401 "Structural Pest Control Services Commercial Business License Application" - Texas

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(877) 542-2474
(512) 463-7476
Hearing impaired: (800) 735-2988 voice
www.TexasAgriculture.gov
Texas Department of Agriculture
SPC-401
Structural Pest Control Services
Commercial Business License Application
1
BUSINESS TYPE
TDA USE ONLY
Corporation
Limited Liability Co.
Client No.
Account No.
Limited Partnership
General Partnership
Date (mm/dd/yy)
Initials
Sole Proprietorship
Cooperative
2
APPLICANT 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 only)
Is this a temporary ID?
Yes
No
Federal Taxpayer ID No. (out-of-state businesses only)
Social Security No. (Sole Proprietor only)
-
-
1
RESPONSIBLE PERSON INSTRUCTIONS
Please list the full legal name (no aliases or nicknames) of the primary individual responsible for management and
oversight of the business, as indicated:
For a corporation, limited liability company, cooperative, or other entity: the president, CEO, or manager (or
functional equivalent with title);
For a limited or general partnership: the managing partner (or functional equivalent with titled);
For a sole proprietorship: the owner;
For any other type of business: the general manager (or functional equivalent with title).
2
RESPONSIBLE OFFICER, PARTNER, MANAGER, OR OWNER
Mr.
Mrs.
First Name
M. I.
Last Name
Ms.
Phone No.
E-mail
(
)
-
Ext.
3
RESPONSIBLE PERSON MAILING ADDRESS
Address
City
State
Zip
This application 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.)
Structural Pest Control Services Business Application
Revised 05/15/18
Pesticide
(877) 542-2474
(512) 463-7476
Hearing impaired: (800) 735-2988 voice
www.TexasAgriculture.gov
Texas Department of Agriculture
SPC-401
Structural Pest Control Services
Commercial Business License Application
1
BUSINESS TYPE
TDA USE ONLY
Corporation
Limited Liability Co.
Client No.
Account No.
Limited Partnership
General Partnership
Date (mm/dd/yy)
Initials
Sole Proprietorship
Cooperative
2
APPLICANT 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 only)
Is this a temporary ID?
Yes
No
Federal Taxpayer ID No. (out-of-state businesses only)
Social Security No. (Sole Proprietor only)
-
-
1
RESPONSIBLE PERSON INSTRUCTIONS
Please list the full legal name (no aliases or nicknames) of the primary individual responsible for management and
oversight of the business, as indicated:
For a corporation, limited liability company, cooperative, or other entity: the president, CEO, or manager (or
functional equivalent with title);
For a limited or general partnership: the managing partner (or functional equivalent with titled);
For a sole proprietorship: the owner;
For any other type of business: the general manager (or functional equivalent with title).
2
RESPONSIBLE OFFICER, PARTNER, MANAGER, OR OWNER
Mr.
Mrs.
First Name
M. I.
Last Name
Ms.
Phone No.
E-mail
(
)
-
Ext.
3
RESPONSIBLE PERSON MAILING ADDRESS
Address
City
State
Zip
This application 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.)
Structural Pest Control Services Business Application
Revised 05/15/18
Pesticide
Structural Pest Control Services Business Application
Page 2 of 3
1
PERSON TO CONTACT FOR LICENSE-RELATED MATTERS
Mr.
Mrs.
First Name
M. I.
Last Name
Ms.
___
Title
Primary Phone
(
)
-
Ext.
Secondary Phone (optional)
Fax (optional)
(
)
-
Ext.
(
)
-
Ext.
E-mail
2
MAILING ADDRESS
Address
City
State
Zip
County
1
FACILITY INFORMATION
Facility Name
2
PHYSICAL ADDRESS OF THE BUSINESS
Address (No P.O. Box)
City
State
Zip
County
Directions to physical address if the above location is difficult to find
1
RESPONSIBLE CERTIFIED APPLICATOR INFORMATION
Printed name of responsible Certified Applicator
TDA License No.
Signature of responsible Certified Applicator
LICENSE FEE FOR BUSINESS
$300
Total Number of Apprentices ____@$125.00 EACH
Attach the applications of all apprentices to this application. If applicable, technicians and certified
$____
applicators must submit separate applications for license change or renewal along with appropriate
fees.
Total Remitted
$____
Structural Pest Control Services Business Application
Revised 05/15/18
Structural Pest Control Services Business Application
Page 3 of 3
You must complete ALL licensing activity within one year of the application date. An incomplete
application shall become void on the one-year anniversary of submission. A void application will not be
processed. SPCS application fees are non-refundable.
1
SIGNATURE
The applicant, by signature below, or by signature of a duly authorized agent, certifies and acknowledges that: (1)
all information provided in this application is true and correct; (2) any misrepresentation or false statement made in
connection with this application, whether intentional or not, will constitute grounds for denial, revocation, or non-
renewal of any license requested or issued as a result of this application and/or assessment of monetary
administrative penalties; and (3) if applying as an individual, this application may be denied and that any license
issued pursuant to this application may be suspended, revoked, or denied renewal due to delinquency in payment of
a guaranteed student loan or for failure to pay child support. If signed by an agent (including employee) of the
applicant, the person signing certifies that he or she is authorized to make the preceding certifications on behalf of
the applicant.
Applicant Name (print)
Title
Applicant Signature
Date (mm/dd/yyyy)
/
/
Mail to:
Texas Department of Agriculture
P.O. Box 12076
Austin, TX 78711-2076
Additional items that will be required to be sent to the SPCS in order to complete the application process:
- request your insurance agent to forward a current and complete certificate of
insurance coverage to TDA. The form ALS-1101 may be obtained from the SPCS website click on the link to
"forms." All information on the ALS-1101 MUST match the business registration exactly.
the SPT-430 form or use the online registration system. For previously licensed individuals that are changing
from one company to another, or for individuals that want to add an additional license for another location,
complete and submit the SPT-002, license change form. These forms may be obtained from the SPCS website
through the link to "forms."
Structural Pest Control Services Business Application
Revised 05/15/18
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