Personal Services Affidavit – Dallas, TX

The Personal Services Affidavit is a notarized sworn statement, printed by the City of Dallas Development Services Department as "Personal Service Use Affidavit," that accompanies an Application for Certificate of Occupancy (CO) for a business located or proposed to be located in Dallas, Texas.

The form is labeled "Exhibit 1 to Application for Certificate of Occupancy." The person signing, called the affiant, swears that the information is based on personal knowledge and is true and correct. The affidavit covers:

• whether the business will offer services that require a state or local license, permit or certification;
• who owns the business, with percentages of ownership;
• whether the affiant is the sole or majority owner;
• where notices will be sent by U.S. mail and email, and a daytime telephone number;
• whether the business will use a mattress, padded table, cot, couch or similar furniture that accommodates a prone or near-prone resting position;
• whether it will provide services to individual customers in a private room or area outside the view of other customers;
• whether it will contain an on-site shower.

The affiant agrees that the Building Official will suspend or revoke the business's CO if the Building Official determines the CO was issued based on false, incomplete or incorrect information in the CO application, which includes this affidavit. The form is not a permit or a CO itself; it supports the CO application.

The affidavit is completed by the person applying for a Certificate of Occupancy for a business located, or proposed to be located, in Dallas, Texas. The form is part of that application, and the person who signs is the affiant who swears to the answers.

Details the form attaches to the signer:

• Question 3 asks the affiant to state whether they are the sole owner or a majority owner of the business or of the corporate entity that owns it.
• A sole owner gives a driver's license or state ID number and state of issue as evidence of sole ownership.
• A majority owner of a corporate entity states that the entity is registered with the Texas Secretary of State and in good standing, and attaches a copy of its most recent Secretary of State report filing.
• The signature block asks for a printed name and a title, if any.

The form names no other signer or representative. Because it is sworn, the affiant must be able to answer from personal knowledge.

The affidavit is submitted as part of the application for a Certificate of Occupancy, so it is due whenever that application is filed for a business located or proposed to be located in Dallas. The form prints no separate due date.

The statements stay relevant after filing: the affiant agrees that the Building Official will suspend or revoke the business's CO if it was issued based on false, incomplete or incorrect information in the CO application, including this affidavit. Complete every answer before the notary swears you in, because the affidavit is signed under oath.

The form is Exhibit 1 to the Application for Certificate of Occupancy, so it goes in with that application; it names no separate channel of its own.

• Where it is printed: Development Services Department, 320 E Jefferson Blvd, Dallas TX 75203, telephone (214) 948-4480. Contact the department for how and where to file the CO application.
• What goes in with it: the signed and notarized affidavit, plus proof of license, permit or certification if you answered Will on question 1, or a copy of the corporate entity's most recent Secretary of State report filing if you are a majority owner (question 4).

Have the notary complete the "Subscribed and sworn to" block before you file. FillingPDF lets you fill out and download the PDF; submission follows the channels above.