Form 2201—General Information (Statement of Officer for Officers Not Appointed by the Governor) The attached form is designed to meet minimal constitutional filing requirements pursuant to the relevant provisions. This form and the information provided are not substitutes for the advice and services of an attorney. Commentary Article XVI, § 1 of the Texas Constitution requires all elected or appointed state and local officers to take the official oath of office found in § 1(a) and to subscribe to the anti-bribery statement found in § 1(b) before entering upon the duties of their offices. While local officers must retain the signed antibribery statement with the official records of the office, state-level officers must file the signed statement with the secretary of state before taking the oath of office required by § 1(a). This form is designed for filing the anti-bribery statement by state-level officers who were not appointed by the governor. State-level officers required to file the anti-bribery statement with the secretary of state include members of the Legislature, the Secretary of State, and all other officers whose jurisdiction is coextensive with the boundaries of the state or who immediately belong to one of the three branches of state government. Op. Tex. Att’y Gen. No. JC-0575 (2002). Questions about whether a particular officer is a state-level officer may be resolved by consulting relevant statutes, constitutional provisions, judicial decisions, and attorney general opinions. Questions regarding this form should be directed to the Statutory Documents Section at (512) 463-5705. Delivery Instructions The statement may be submitted by mail, hand delivery, or facsimile. Send submissions by mail, except for overnight mail, to P.O. Box 13550, Austin, Texas 78711-3550. Overnight mail or hand deliveries should be directed to the James Earl Rudder Office Building, 1019 Brazos, Austin, Texas 78701. Fax transmissions should be directed to (512) 475-2815. Do not fax the statement to any other fax number listed for the secretary of state. Faxed documents received after business hours, on weekends, or on holidays will be deemed received on the next business day. The statement is considered filed once it has been received by this office. Revised 06/09 Form 2201 1 American LegalNet, Inc. www.FormsWorkFlow.com Form #2201 Rev. 06/2009 Submit to: SECRETARY OF STATE Statutory Documents Section P O Box 13550 Austin, TX 78711-3550 512-463-5705 512-475-2815 - Fax Filing Fee: None This space reserved for office use STATEMENT OF OFFICER FOR OFFICERS NOT APPOINTED BY THE GOVERNOR Statement I, , do solemnly swear (or affirm) that I have not directly or indirectly paid, offered, promised to pay, contributed, or promised to contribute any money or thing of value, or promised any public office or employment for the giving or withholding of a vote at the election at which I was elected or as a reward to secure my appointment or confirmation, whichever the case may be, so help me God. Position to Which Elected/Appointed: City and/or County: Execution Under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated therein are true. Date: Signature of Officer Form 2201 2 American LegalNet, Inc. www.FormsWorkFlow.com