If you make a false statement on this form, you could be found guilty of a Class A misdemeanor or a state jail felony under Penal Code Section 37.10.
I, , swear or affirm the following:
- that each fact contained in this request is true and correct;
- that I authorize to submit and receive electronic documents in a format acceptable by the selected tax official in accordance with Tax Code Section 1.085; and
- that I have read and understand the Notice Regarding Penalties for Making or Filing an Application Containing a False Statement.
- that I have read and understand the Notice Regarding Penalties for Making or Filing an Application Containing a False Statement.
Please enter your name, sign, and date