Form 3009—General Information
(Amended Statement Regarding Membership Totals and Cost)
The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant code
provisions. This form and the information provided are not substitutes for the advice and services of an
attorney.
Commentary
A health spa certificate holder must amend its Health Spa Registration Application no later than the 90
th
day after the day on which a change in the information provided in the registration application occurs.
This form is designed for amending the Health Spa Registration Application to reflect a change in the
total number of and amount paid for prepaid memberships. A certificate holder amending its Health Spa
Registration Application to reflect a change in the total number of and amount paid for prepaid
memberships is also responsible for any resulting changes to the amount of security required.
Instructions for Form
• Identifying Information: The certificate holder is the person who holds the health spa
registration certificate. The certificate holder’s name must match the name on the health spa
registration application. The affiant is the person swearing to or affirming the contents of the
Amended Statement Regarding Membership Totals and Cost. The health spa is the health spa
for which the amended statement is being filed.
• Statement: Enter the total number of all prepaid memberships and the total amount paid for all
prepaid memberships.
• Execution: The affiant must sign and date the notice before a notary public or other official who
has authority to administer an oath.
•
Delivery Instructions: The form may be mailed to Registrations Unit, P.O. Box 13193, Austin,
st
Texas 78711-3193 or delivered to the James Earl Rudder Office Building, 1019 Brazos, 1
Floor, Austin, Texas 78701.
Revised 12/2014
Form 3009
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