SECTION 35.54. What information must appear on the sworn statement required by Section 523.052(b)(2), Business & Commerce Code, for use when a person contacts a financial institution with the intent to send information through the electronic notification system?

The sworn statement form required by §523.052(b)(2), Business & Commerce Code, must include:

(1) a notice, at the top of the first page, that provides that:

(A) the customer must file a police report regarding an offense under §32.51, Penal Code; and

(B) the customer must return the completed sworn statement with either:

(i) the incident or case number of the police report; or

(ii) a copy of the police report.

(2) blanks for the customer to provide:

(A) customer's name, address, phone number, date of birth;

(B) the number and the issuing governmental entity's name for the customer's:

(i) driver's license or state issued identification card; or

(ii) if the customer does not have a driver's license or state issued identification card, other government-issued identification.

(C) the account number of any account compromised by the alleged offense and closed in response to the alleged offense;

(D) routing number for the financial institution where the account was closed;

(E) numbers or the range of numbers of any checks that have been lost, stolen, or compromised, if any;

(F) the incident or case number of the police report; and

(G) a signature before a notary public.

Source Note: The provisions of this §35.54 adopted to be effective January 3, 2008, 32 TexReg 9940; amended to be effective September 9, 2010, 35 TexReg 8102