Small Business Enterprise (SBE) Program Renewal Application
Renewal application must be completed and signed by the managing small business owner.
Mail your renewal application and required documentation to the address below or Send by Email
Texas Department of Transportation Civil Rights Division
125 E. 11th Street, Austin, TX 78701-2483
For questions, contact the Civil Rights Division at (512) 416-4700.
Please check the appropriate box for the following items:
If yes, include names of new owner(s) and ownership percentage below.
If yes, include names of new primary owner(s) and management.
Name of New Primary Owner(s)
Management Function(s)
(for new primary owners)
% of Ownership
(for new owner(s))
Attach federal tax returns (and requests for extensions) filed by the firm and affiliates with related schedules.
Firm's Gross Receipts for the Previous Three Years
(Tax Form 1120 #1a, Tax Form 1040 Schedule C#1, or Tax Form 1065, #1A, whichever applies)
Year Ending
Exact Gross Receipts($)
$
Attach Tax Return of 3 years button
Current Affiliate Firms
If there are any affiliates or subsidiaries of the SBE firm or owners, you must provide these firms' gross receipts and submit complete copies of these firm(s) Federal tax returns. Affiliation is defined in 49 C.F.R. §26.5 and 13 C.F.R. Part 121.
Affiliate Firm Name
# of Employees
Gross Receipts for Last Tax Year
Title with Affiliate Firm
Percentage of Ownership
I swear (or affirm) that there have been no changes in the circumstances of
affecting its ability to meet the size requirements of the Texas Department of Transportation (TxDOT) SBE Program, and the United States Small Business Administration's size standards for the North American Industry Classification Code, as provided by 13. CFR §121.201, that is designated as the principal business of the firm. There have been no material changes in the information provided with this firm's application for SBE certification, except for any changes which we have provided written notice to TxDOT. I/we declare under penalty of perjury under the laws of the United States that the information provided in this form and supporting documents is true and correct. Providing false information on this governmental record is a violation of Texas Penal Code §37.10 and could result in criminal penalties.
The Texas Department of Transportation maintains the information collected through this form. With few exceptions, you are entitled on request, to be informed about the information that is collected about you. Under §552.021 and §552.023 of the Texas Government Code, you also are entitled to receive and review the information. Under §559.004 of the Government Code, you are also entitled to have us correct information about you that is incorrect.