SOUTH TEXAS BUSINESS ALLIANCE

SOUTH TEXAS BUSINESS ALLIANCE
Company Name*
Store Name (DBA)
Company Type*
Sole proprietorship, Partnership, Corporation, and S corporation
Store Contact Email*
example@example.com
Store Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mailing Address

Street Address

Street Address Line 2

CityState

Zip Code
Federal Tax ID*
Nine-digit number assigned by the IRS
Sales Tax ID*
Taxpayer ID is an eleven digit number assigned by the Texas Comptroller.
Owner - 1 First Name - Last Name*

First NameLast Name
Owner -1 will be The Point of Contact and Decision Maker for this Account with STBA
Business Owner- 1 Title*
Business Owner Title
Owner 1 Ownership %*
Owner 1 Mobile Phone*
Owner 1 Driver License Number or State Issued Id Number*
Owner 1 State Issued -Driver License Number or State Issued Id*
Owner - 2 First Name - Last Name

First NameLast Name
Owner 2 Title
Business Owner- 2 Title
Owner 2 Ownership %
Owner 2 Mobile Phone
Owner 2 Driver License Number or State Issued Id Number
Owner 2 State Issued -Driver License Number or State Issued Id
Owner - 3 First Name - Last Name

First NameLast Name
Owner 3 Title
Owner 3 Title
Owner 3 Ownership %
Owner 3 Mobile Phone
Owner 3 Driver License Number or State Issued Id Number
Owner 3 State Issued -Driver License Number or State Issued Id
Owner - 4 First Name - Last Name

First NameLast Name
Owner 4 Title
Owner 4 Title
Owner 4 Ownership %
Owner 4 Mobile Phone
Owner 4 Driver License Number or State Issued Id Number
Owner 4 State Issued -Driver License Number or State Issued Id
Owner - 5 First Name - Last Name

First NameLast Name
Owner 5 Title
Owner 5 Ownership %
Owner 5 Mobile Phone
Owner 5 Driver License Number or State Issued Id Number
Owner 5 State Issued -Driver License Number or State Issued Id
Business Authorized Representative

Store Authorized Representative must be one of the owners of the company and have mandate to execute the documents
Store Authorized Representative

First NameLast Name
Authorized Representative Phone Number
Please enter a valid phone number.
Store Supervisor Information
Store Supervisor Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Store Supervisor Driver License Number or State Issued Id Number*
Store Supervisor Driver License Number or State Issued Id Number
State Issued -Driver License Number or State Issued Id*
Store Bank Account Information
Bank Name
Bank Holder Name
Bank Account Number
Routing Number
Bank phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Store Bank Account Information
Void Check - File Upload*

Void Check - File Upload
Cancelof
Texas Sales & Use Permit
Sales Tax Permit - File Upload*

Sales Tax Permit - File Upload
Cancelof
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Signature*

Clear
Should be Empty:

SOUTH TEXAS BUSINESS ALLIANCE

Owner -1 will be The Point of Contact and Decision Maker for this Account with STBA

Business Authorized Representative

Store Supervisor Information

Store Bank Account Information

Store Bank Account Information

Texas Sales & Use Permit