Fillable Human-trafficking-partnership-application Application for Certificate of Recognition

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Human-trafficking-partnership-application Application for Certificate of Recognition

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Application for Certificate of Recognition
(Texas Businesses Against Trafficking)
The attached application, including the information provided in the application, is a public record and subject to
public access and disclosure. Do not include information that may be confidential or a trade secret.
Commentary
Texas Businesses Against Trafficking, the human trafficking prevention business partnership program
established under Section 405.023 of the Texas Government Code, recognizes that corporations and
private entities can contribute to the efforts of federal, state, and local officials engaged in combatting
human trafficking and in prosecuting human trafficking crimes. This application process is designed to
identify and recognize those corporations and private entities that have implemented zero tolerance
policies toward human trafficking and have taken voluntary steps to promote public awareness of human
trafficking.
Any corporation or private entity that engages in a for-profit activity may submit an application for
participation in the partnership and for a certificate of recognition. A corporation is defined by rule as a
domestic or foreign for-profit corporation, limited partnership, limited liability company, professional
association, or cooperative association that is governed under the Texas Business Organizations Code,
federal law, or the law of another state or nation. A private entity includes a bank, trust company, savings
and loan association, insurance company, railroad company, or other organization that engages in a for-
profit activity through its employees.
A certificate of recognition issued to an eligible participating corporation or private entity is valid for three
years and can be renewed for an additional term by the participating entity. There is no processing fee for
making an application.
Instructions for Form
A document on file with the secretary of state is a public record subject to public access and
disclosure. When providing address or telephone information, use a business or post office
box address rather than a residence address if privacy concerns are an issue.
• Applicant Information: Provide the full legal name of the applicant and its principal office address.
The principal office address does not need to be in Texas. The contact point is the individual to whom
any correspondence may be addressed regarding the application or documentation provided. The
contact point is not required to be the person who signed the application.
• Business Information: Completion of this section is not required, but optional. However, the
information provided may be useful to the secretary of state when developing a database of best
practices for combating a nd preventing human trafficking within certain industries or businesses.
• Attachments: If the space provided is not sufficient, provide additional information or documentation
as a separate attachment to the form. Do not include digital, video or electronic attachments. If
applicant provides employee training on human trafficking or other information in a digital or
electronic format, a print-out or transcript of the material should be provided.
• Execution: The application must be signed by a person who is authorized to sign on behalf of the
applicant. Generally, a corporate officer is authorized to sign on behalf of a corporate entity.
• Delivery Instructions: The completed form may be mailed to P.O. Box 13193, Austin, Texas 78711-
3193; or delivered to the James Earl Rudder Office Building, 1019 Brazos, Austin, Texas 78701. The
secretary of state will issue a certificate of recognition on filing a completed and approved application.
Revised 08/2019
1
This space reserved for office use
APPLICATION FOR
CERTIFICATE OF
RECOGNITION
Rev. 08/2019
Submit to:
SECRETARY OF STATE
Registrations Unit
P O Box 13193
Austin, TX 78711-3193
512-475-0775
512-475-2815 - Fax
The undersigned applicant seeks to participate in the Texas Businesses Against Trafficking program
established by §405.023 of the Government Code and requests recognition for its contributions to the
efforts of federal, state, and local officials engaged in combatting human trafficking and in prosecuting
human trafficking crimes. The voluntary steps and measures taken by the applicant to prevent and
combat human trafficking, as demonstrated by the information and documentation provided, qualify
the applicant for membership in the partnership and for a certificate of recognition.
Applicant Information
1. Business Name:
Provide the full legal name of corporation or private entity
2. Address:
Street City State Zip Code
3. Contact Point:
First Name Last Name Job Title
Contact Address: Same as above Contact's mailing address is different and shown below:
Street City State Zip Code
Work Phone: Email address:
Business Information (optional)
Type of Business: Retail Service Manufacturing
Average Number of Employees: Number of Locations in Texas:
Markets Served by Applicant: Local National International
Briefly Describe Applicant's Main Products/Services:
Eligibility
4. Has applicant adopted a Zero Tolerance Policy towards human trafficking that includes:
(A) Complying with all applicable federal and state human trafficking laws and regulations?
No Yes
(B) Reviewing the business's supply lines, supplies, agents, subcontractors, other inputs, and business
related facilities to assess areas that might be vulnerable to human trafficking and taking appropriate
action to address negative findings, including but not limited to, adopting language in supplier contracts
2
regarding the corporation or private entity’s human trafficking policies, and encouraging the supplier to
abide by these same policies?
No Yes Not Applicable
(C) Prohibiting employees from withholding identity or immigration documents, such as a passport
or driver's license, from a worker and encouraging agents and subcontractors to adopt similar policies?
No Yes Not Applicable
(D) A prohibition against the expenditure of any business funds for the purpose of patronizing a
business that is part of the commercial sex industry?
No Yes
(E) A prohibition against using any business resources to engage in sexual conduct that violates state
or federal law or to operate a business that is part of the commercial sex industry?
No Yes
Provide additional supporting documentation, as necessary
:
5. Has applicant taken measures to ensure compliance with the Zero Tolerance Policy, including:
(A) Implementing mandatory training for all employees, aimed at recognizing and addressing human
trafficking?
No Yes
Provide information about the training used and attach copies, if available:
(B) Providing information about applicant’s Zero Tolerance Policy to employees and informing
employees about possible consequences for not complying with policy?
No Yes
Provide additional information or documentation, as needed:
3
6. Has applicant participated in a minimum of one public awareness or education campaign within the
12 months prior to submission of the application?
No Yes If yes, list the date of the campaign(s).
Describe the campaign and how it raised awareness of human trafficking within applicant’s
community or supported federal, state, or local efforts to combat/prosecute human trafficking. Attach
any additional documentation as needed.
Describe applicant’s participation in the campaign. Attach any additional documentation as
needed.
7. By seeking membership in the Texas Businesses Against Trafficking program, applicant agrees to
share its best practices in combatting human trafficking. Describe below applicant’s best practices.
Attach additional supporting documentation as needed.
Agreements for Continued Participation
As a participant in the Texas Businesses Against Trafficking program, applicant agrees to the following
activities for the duration of the partnership. Please check each box to certify the applicant’s agreement.
Applicant agrees to participate in at least one public awareness or education campaign each year for
the duration of the partnership.
Applicant agrees to assist the secretary of state in enhancing awareness of and encouraging
participation in the partnership.
Applicant agrees to share any additional best practices with the secretary of state for the duration of
the partnership.
Certification of Applicant
I certify that I have reviewed the preceding statements and any attached supporting documentation
provided, and to the best of my knowledge, the information provided is true, accurate, and complete. I
also certify that I have the authority to execute this application on behalf of the applicant.
4
)
)
Execution
Date:
Signature of Authorized Person
Printed or typed name and capacity/title
State of
County of
Sworn to and subscribed before me this day of , 20
(seal)
Notary Public Signature
5
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Human-trafficking-partnership-application Application for Certificate of Recognition

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Completed 2 July 2020

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