ZZ113120BUSINESS INFORMATION FORM TEXAS DEPARTMENT OF STATE HEALTH SERVICES RADIATION MACHINE SOURCE GROUP Mail Code 2835 P.O. Box 149347 Austin, Texas 787149347Phone #: (737) 2187110 Fax #: (512).

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How to fill out the Forms & Publications - Texas Vaccines For Children - DSHS online

Filing the Forms & Publications for the Texas Vaccines For Children through the Department of State Health Services can be a straightforward process. This guide will walk you through each step to ensure you complete the form accurately and efficiently.

Follow the steps to complete your form correctly.

  1. Click the ‘Get Form’ button to access the form and open it in your designated editor.
  2. Indicate whether you are submitting a new application or a billing address change by selecting the appropriate option.
  3. Enter your Current Registration or Certification number in the provided field.
  4. Input the Legal Name of Business in the designated box and, if applicable, include your Doing Business As (DBA) name.
  5. Provide the Billing Phone Number where relevant contact can be made.
  6. Fill in your Business Phone Number in the respective section.
  7. Complete the Billing Address, including Street, City, State, and Zip Code.
  8. If your Mailing Address is the same as the Billing Address, check the provided box. Otherwise, enter the Mailing Address details.
  9. Select your Authorization to Conduct Business in Texas by checking only one option and attach the required documentation as per the category selected.
  10. Ensure the SIGNEE's title and printed name are noted, including the required signature and date.
  11. Review the entire form for completeness and accuracy before submitting it.
  12. Once all fields are filled and verified, save your changes, and prepare to download, print, or share the form as necessary.

Start completing your application online today to ensure timely processing.

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