(a) License application forms. License application forms may be obtained from the department, 1100 West 49th Street, Austin, Texas, 78756 or online at http://dshs.state.tx.us/license.shtm.
(b) Contents of license application. The application for licensure as a device distributor or manufacturer shall be signed and verified, submitted on a license application form furnished by the department, and contain the following information:
  (1) the name of the legal entity to be licensed, including the name under which the business is conducted;
  (2) the address of each place of business that is licensed;
  (3) if a proprietorship, the name and residence address of the proprietor; if a partnership, the names and residence addresses of all partners; if a corporation, the date and place of incorporation and name and address of its registered agent in the state and corporation charter number; or if any other type of association, then the names of the principals of such association;
  (4) the name, residence address, and valid driver license number for each individual in an actual administrative capacity which, in the case of proprietorship, shall be the managing proprietor; partnership, the managing partner; corporation, the officers and directors; or those in a managerial capacity in any other type of association;
  (5) for each place of business, the residence address of the individual in charge thereof;
  (6) a list of categories which must be marked and adhered to in the determination and payment of the fee; and
  (7) a statement verified by the applicant's signature that acknowledges the applicant has read, understood, and agrees to abide by the provisions of these sections and those of the Texas Food, Drug, and Cosmetic Act, Health and Safety Code, Chapter 431.
(c) Renewal license application. The renewal application for licensure as a device distributor or manufacturer shall be made on a license application form furnished by the department.

Source Note: The provisions of this §229.436 adopted to be effective October 18, 1994, 19 TexReg 7910; amended to be effective March 19, 1996, 21 TexReg 1887; amended to be effective March 19, 2001, 26 TexReg 2196; amended to be effective January 1, 2005, 29 TexReg 11983