TEXAS PACKAGE STORES ASSOCIATION APPLICATION FOR MEMBERSHIP
Schedule of Dues
Date : ______________________ Number of Stores : ___________
No . of Stores : |
Dues : |
1 |
$ 100 |
2 – 4 |
$ 125 per Store |
5 – 9 |
$ 150 per Store |
10 and over |
$ 175 per Store |
You must join for all stores you have .
I hereby make application for membership in the Texas Package Stores Association and enclose my check in the amount of $_________________ or have completed the Credit Card Information Form .
Select payment method : [ ] Check [ ] Credit Card
Trade Name :
Corp ./ Owner Name :
Address :
City , State , Zip :
County :
Work Phone : Cell :
E-mail :
By signing below , I certify that the package stores for which application is made are :
1 . licensed as package stores by the State of Texas , and 2 . at least 51 % owned by Texas citizens ( i . e . 51 % owned by individuals who are residentially domiciled in the State of Texas , and who have continuously been residentially domiciled in the State of Texas for the immediately preceding year ).
Membership to be represented by :
Title : Signature of applicant :
( Must be a member or employee of your firm )
Printed name and Title of person signing :
This form may be returned by mail to TPSA , 1122 Colorado St ., Suite 313 , Austin , TX 78701 or scanned and emailed to information @ texaspackage . com . Thank you !
Dues payments to TPSA are not deductible as charitable contributions under the Internal Revenue Code . Because a significant portion of TPSA dues are used to lobby the legislature in issues important to package stores , TPSA dues are generally not deductible under Internal Revenue Code . Consult your tax advisor for complete information .
28-2020 TPSA Program