Psb 01 Form PDF Details

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QuestionAnswer
Form NamePsb 01 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namestxdps psb forms search, txdps psb forms online, txdps psb forms form, txdps psb 50

Form Preview Example

Texas Department of Public Safety

MUST USE MOST CURRENT FORM

Regulatory Services Division

PRI NT CLEARLY I N BLACK I NK

www.dps.texas.gov

MAKE SURE ENTI RE CI RCLE I S FI LLED

 

COMPANY LICENSE APPLICATION

COMPANY I NFORMATI ON (CORPORATI ON, COMPANY OR SOLE PROPRI ETOR)

Under the provisions of Title 10, Chapter 1702 Occupations Code, as amended, application is hereby made for a license to offer and perform the services of an investigations company and/ or security services contractor. (NOTE: A company is responsible for continued accuracy of all information

relating to a Branch Office and for any late fees relating to the renewal of this license).

Iunderstand that the naming of companies is subject to Rule §35.41 and have also visited the PSB website to ensure that I am not utilizing another company’s name or anything similar.

PRIVATE SECURITY

EXAMPLE:

Yes No

THE ABOVE SPACE I S RESERVED FOF OFFI CE USE ONLY

Yes

No

Name of Corporation, Company or

Full Name of Sole Proprietor

Assumed Name

(I F ANY)

Mailing

Address

City

State

ZI P

(2- Digit Code)

 

 

 

 

 

Physical

 

 

Address

 

 

City

State

ZI P

(2- Digit Code)

 

 

 

 

 

I f the address you have listed is your home address, be advised that your submission of this document will constitute a waiver of the confidentiality of your address (as provided in Texas Occupations Code § 1702.085).

 

 

Business

(

)

 

 

Business

(

)

 

 

 

 

 

 

 

 

 

Phone

 

 

Fax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Business Email

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF OWNERSHI P (CHECK ONE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sole Proprietor

 

 

Corporation (I nc., Corp.)

 

 

Limited Liability Partnership (LLP)

 

 

Partnership

 

 

Limited Liability Corporation (LLC)

Limited Liability Company (LLC)

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF LI CENSE (CHECK ALL THAT APPLY)

 

 

DESCRI PTI ON

ORI GI NAL + SUBSCRI PTI ON =

FEE

 

 

 

Class A

I nvestigations Company

 

 

 

 

 

CLASS A

$350

+

$11

=

$ 3 6 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(CHECK ALL THAT APPLY)

 

 

 

 

 

 

 

(I nvestigations ONLY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class B

Guard Company

Locksmith Company

 

 

 

CLASS B

$400

+

$12

=

$ 4 1 2

 

 

 

 

 

 

( Contractor services ONLY)

 

 

 

(CHECK ALL THAT APPLY)

Alarm System Company

Security Consultant Company

 

 

 

 

 

 

 

 

 

 

 

 

 

Armored Car Company

Electronic Access Control Device

 

 

 

 

 

 

 

 

 

 

 

 

 

Courier Company

Company (I ncludes Gate Operators)

 

 

 

 

 

 

 

 

 

 

 

 

 

Guard Dog Company

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class C

I nvestigations Company

Locksmith Company

 

 

 

CLASS C (I nvestigations

$540

+

$16

=

$ 5 5 6

 

 

 

 

 

 

AND Contractor services)

 

 

 

 

 

 

 

 

(CHECK ALL THAT APPLY)

Guard Company

Security Consultant Company

 

 

 

 

 

 

 

 

 

 

 

 

 

Alarm System Company

Electronic Access Control Device

 

 

 

 

 

 

 

 

 

 

 

 

 

Armored Car Company

Company (I ncludes Gate Operators)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Courier Company

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Guard Dog Company

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please state the general nature of the service( s) you intend to provide:

Last Name of Manager

First

M.I .

Suffix

(I f Any)

PAYMENT I NFORMATI ON

I am submitting the appropriate fee(s) with this application by mail.

 

Yes

* I f yes, a PSB-50 form must be submitted with this application.

(Note: Payment must be in the form of a cashier’s check, money order or company check.)

No

 

 

 

 

 

 

 

I understand that all fees submitted to Private Security are non- refundable,

are not transferable and that,

in accordance with Yes



Administrative Rule 35.77, I will have 90 days from the date the

application is

received by the Department to

turn in all required

No

documentation, supplemental information and/ or fees OR this application will be abandoned and I will be required to reapply.

 

 

 

 

 

 

 

 

 

PSB-01 (Rev. 12/ 2012)

Page 1 of 2

 

 

 

 

FORM

Name of Corporation, Company or

Full Name of Sole Proprietor

SUPPLEMENTAL I NFORMATI ON (EVI DENCE)

 

Are you applying as a Critical I nfrastructure facility?

Yes

* I f yes, you must submit form PSB-44 along with this application.

 

No

 

 

 

 

 

 

 

 

 

 

 

COMPLETE EI THER PART I . OR PART I I .

 

 

 

 

 

PART I . SOLE PROPRI ETOR ONLY (PERSON LI STED BELOW MUST REGI STER AS AN OWNER)

 

 

 

 

Last Name of

First

 

M.I .

Suffix

 

I ndividual Owner

 

(I f Any)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART I I . CORPORATI ON OR PARTNERSHI P ONLY (EACH PERSON LI STED BELOW MUST REGI STER AS AN OFFI CER, PARTNER AND/ OR SHAREHOLDER)

Officers or Partners Last Name

First

M.I .

Suffix

President or Partner

Vice President or Partner

Secretary or Partner

Treasurer or Partner

I dentify all entities (owners, partners or shareholders), in the spaces below, who own 25% or more of the company. I f there are any entities owning of less than 25% , then provide a brief, general description of the nature of the entities (i.e. “Multiple owners holding less than 1% each,” or “Corporation Z holding 15% ,” etc.). The descriptions below must provide information on 100% of the ow nership.

Percent of I nterest Last Name

First

M.I .

Suffix

%

%

%

%

%

%

%

%

%

I verify that the information provided is true and correct, and I understand that this is an official Government record and that any false statement made on this document or any other supplement provided to the Department may result in criminal prosecution.

Applicant Signature__________________________________________

Date____ / ____ / ________

This form and any attachments can be or forwarded by mail to:

Texas Department of Public Safety

Private Security MSC 0242

PO Box 15999

Austin, TX 78761 - 5999

PSB-01 (Rev. 12/ 2012)

Page 2 of 2

FORM

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1. It is critical to fill out the form psb 01 properly, hence pay close attention while filling out the parts including these fields:

The best way to complete psb 01 application part 1

2. The next part would be to fill in the following fields: TYPE OF LI CENSE CHECK ALL THAT, I nvestigations Company, Alarm System Company, Guard Company, Locksmith Company, Security Consultant Company, DESCRI PTI ON ORI GI NAL SUBSCRI, CLASS A I nvestigations ONLY, CLASS B Contractor services ONLY, Electronic Access Control Device, Locksmith Company, Security Consultant Company, CLASS C I nvestigations AND, Electronic Access Control Device, and Class C CHECK ALL THAT APPLY.

Part # 2 of submitting psb 01 application

3. This next portion is focused on Name of Corporation Company or, SUPPLEMENTAL I NFORMATI ON EVI, Are you applying as a Critical I, Yes, I f yes you must submit form PSB, COMPLETE EI THER PART I OR PART II, PART I SOLE PROPRI ETOR ONLY, Last Name of I ndividual Owner, First, Suffix I f Any, PART I I CORPORATI ON OR, Officers or Partners Last Name, First, Suffix, and President or Partner - complete these empty form fields.

PART I  SOLE PROPRI ETOR ONLY, Are you applying as a Critical I, and SUPPLEMENTAL I NFORMATI ON EVI of psb 01 application

4. Filling out I verify that the information, Applicant Signature Date, This form and any attachments can, and Texas Department of Public Safety is essential in this next stage - you should definitely devote some time and fill out each empty field!

Applicant Signature Date, I verify that the information, and This form and any attachments can in psb 01 application

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