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UH PTAC Application for Services


IMPORTANT NOTICE

This application should only be completed by the majority owner of the company (owner with the largest percentage of ownership).  If it is not completed by the majority owner, we will not be able to accept it.

You must be a registered business in the State of Texas with a place of business in one of our 32-county service areas to be eligible for our services.  Select the Service Area link above to see a list of our county service areas.

The majority owner can designate an employee (Designated Representative) to meet with a UH PTAC advisor without the majority owner present.  The Designated Representative must be a W2 employee of the business and cannot be 1099 Independent Contractors.  If you (majority owner) plan to assign a Designated Representative, provide the information required in the appropriate areas of the application.

Do not enter the majority owner’s information in the Designated Representative section of the application.

SATELLITE OFFICE NOTICE

Our main office is located in Midtown Houston (not on UH Campus) at 2302 Fannin Street.  We offer services at this location Monday - Friday.

We also offer service at four satellite office locations - Beaumont TX, Bryan TX, Conroe TX, and Rosenberg TX.  When you submit the application you can choose any office that best fits your need.

However, if you choose to meet at one of our satellite offices, please understand that we do not offer service at each location Monday - Friday.  Depending on the satellite office you select, we may be there only once or twice weekly to once monthly.

We will work to get you scheduled to meet with an advisor as soon as possible.

Required field *
Numbers only - no spaces, dashes or special characters.
Numbers only - no spaces, dashes or special characters.
Please provide data on the majority owner.
Please provide data on the majority owner.
Please provide data on the majority owner.
Please provide data on the majority owner.
Please provide data on the majority owner.
Please provide data on the majority owner.
Designated Representative must be a W-2 Employee - No 1099 Contractors
Numbers only - no spaces, dashes or special characters.
Numbers only - no spaces, dashes or special characters.
Provide the DBA Name if used
Numbers only - no spaces, dashes or special characters.
* Date Business Started / / (MM/DD/YYYY)
If you have a Dun and Bradstreet (DUNS) number please enter it here.
If you have a CAGE code, please enter it here.
*
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