In the realm of Texas's security services, the PSB-23 form serves as a crucial document for filing complaints pertaining to equipment and property issues within the industry. Administered by the Texas Department of Public Safety Private Security Bureau, this form is integral for companies licensed under this governing body to formally report incidents where property, provided to an employee, has not been returned following the conclusion of their employment. The detailed form requires comprehensive information about the company filing the complaint, including its name, license number, and contact details, ensuring a clear communication channel is established. Additionally, it mandates the inclusion of specifics about the individual in question, such as their name, social security number, address, and the employment period, to accurately identify the subject of the complaint. A list is to be included, detailing the unreturned items, which underscores the form’s role in documenting specific grievances. The form culminates in a declaration by the affiant, affirming the truthfulness of the information provided, which is further validated by a notary public. This procedural approach emphasizes the importance of formal documentation and serves as a reminder that such matters are taken seriously, contingent on the attachment of evidence proving the employee's receipt of the equipment in question. This system underscores a structured mechanism for addressing and potentially resolving disputes pertaining to company property, thereby illustrating the form's importance within the Texas private security sector.
| Question | Answer |
|---|---|
| Form Name | Form Psb 23 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | PSB 23 psb 22 form |
Texas Department of Public Safety
Private Security Bureau
PO Box 4087, Austin, Texas
www.txdps.state.tx.us
EQUIPMENT AND PROPERTY COMPLAINT FORM
(REFER TO RULE 35.13)
Company Name: _____________________________________________ Company License Number: __________
Company Address: _____________________________________________________________________________
Number & Street |
City |
State |
Zip |
Company Telephone: ______________________ |
Company Fax: __________________________ |
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Area code + Number |
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Area code + Number |
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Name of Licensed Manager: _____________________________________________________________________
Email: _______________________________________________________________________________________
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Subject of Complaint: __________________________________________________________________________
Last NameFirst Name
Subject Social Security Number: __________________________________________________________________
Address of Subject: ____________________________________________________________________________
Number & StreetCityStateZip
Telephone Number of Subject: ________________________________________________________________
Area code + Number
Date of Employment: ______________________ |
Date of Termination: ____________________ |
List the items that have not been returned: |
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1. |
6. |
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2. |
7. |
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3. |
8. |
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4. |
9. |
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5. |
10. |
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Rev. 01/09 |
Page 1 of 2 |
Texas Department of Public Safety
Private Security Bureau
PO Box 4087, Austin, Texas
www.txdps.state.tx.us
The above statements are true and correct
________________________________________
Affiant, _________________________________
SWORN TO AND SUBSCRIBED before me on the __________ day of ____________________,
A.D.__________.
______________________________________________
Notary Public, State of Texas
Notary’s printed name:
_______________________________________________
My commission expires: __________________________
NOTE: This complaint will not be accepted or investigated without documentation of the employee’s receipt of the
equipment. Such documentation must be attached to this complaint.
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Rev. 01/09 |
Page 2 of 2 |