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<br />~= AP-152-2 Page 1. orlAm¡nro_au&8onl)' <br />'QÐ - ($-89) <br />TEXAS APPLICATION FOR PAYEE IDENTIFICATION NUMBER <br />. PIN Status Code L.J Authorization Code <br />. TYPE OR PRfNT . Shaded areas for state agency use only <br /> <br />1. Is this a new account? [K) YES Mail Code 000 D NO Enter Mail Code 1 I I I <br /> <br />PAYEE IDENTIFICATION NUMBER (PIN) - The PIN is used as an .account number" in the State's accounting system. The number you <br />provide in this section will be used to report payments to the IRS. if applicable. . <br /> <br />~ 2. Indicate the type of number you are providing to be used for your PIN <br />¡::: [XI 1- Federal Employer's Identification (FE!) Number Enter the number indicated <br />~ D 2 - Social Security Number <br />en D3-Comptroller'sass!gnednumber 1714,6 10,0 121213 18, 1 I <br /> <br />3. D Check this box if the payee is to be notified of the assigned Payee Identification Number by mail at the. address entered' below. <br /> <br />PAYEE INFORMATION <br />4. N8me 01 f)8Y" (indvki181 or bu8lnaa1o be peId} <br />I City of San Marcos I <br /> <br />s. M8IIing 8dd.... where you want to ~ payments <br />- I 630 E. Hopkins' I <br /> <br />6. (0ptiQna1) <br /> I <br />7. (OpIional) <br />= I I <br />z 8. (OpliOMl) <br />g j I <br />@ 9. Ci1y Slate ZIP Code Coun1y <br />cIJ San Marcos I ~ I 78666 I I Hays I <br /> <br />10. SIC Code I I I 1 I I Security Type Code U (0,1, 2) I Zone Code I Iii <br /> <br />. . 1511121/1315131-141414.41 <br />11. Payee telephone number during business hours (Area code and number) ------ -- I <br /> <br />12. Are you currently reporting any Texas tax other than unemployment (e.g.. sales tax. franchise tax)? DYES D NO <br /> <br />If*YES," enter Texas Taxpayer Number -.--.---J I I 1 I I I 1 I 1 I I <br /> <br />13. OWNERSHIP CODES - Check only one code by the appropriate ownership type that applies to you or your business, and enter any <br />required additional information for that type. . . <br />D J,- Individual recipient (not owning, a business) <br />1. D E -Stateemployee Itchecked,enteremploying~gencym mber---..-__---_. I I I I <br />: D S - Sole ownership of business If checked, ,enter the owner's name and Social Security Number (SSN) <br />Owner's name SSN --- \2 I I I 1 I 1 I 1 I I <br />Dp - Partnership If checked, enter two partner's names and Social Security Numbers ($SN). If aparlner ¡sa corporation, use the <br />corporation's Federal Employer's IdentifICation (FE!) Number. <br />- Name. SSN/FElu_1 I I I I I I 1 1 I I I <br />S Name SSNIFEI -..I 1 I I I I I I I I 1 I <br />~ 0 T. Texas Corporation Ifchecked,enterTexascharterNumberun_--_u___1 , I I I r I ' I I I <br />D A-ProfessionalAssociation 'Ifchecked,enterTexasCharterNumber--__uu___--1 I , I I 1 I I I I I <br />Dc- Professional Corporation If checked, enter Texas Charter Number -----.------.1 I I I I 1 I I 1 I I <br />Do, - Out-of-state corporation <br />IX] G - Governmental entity <br />D U - State agency I University <br />D F - Financial institution <br />. D R- Foreign (out of U.S.A.) <br />D N - Other If checked, explain <br />