Conflict Of Interest Statement Filed With Texas Ethics Commission By Lobbyist
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Conflict Of Interest Statement Filed With Texas Ethics Commission By Lobbyist Form. This is a Texas form and can be use in Ethics Commission Statewide.
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Texas Ethics Commission
P.O. Box 12070
Austin, Texas 78711-2070
(512) 463-5800
(TDD 1-800-735-2989)
FORM CI-TEC
CONFLICT OF INTEREST STATEMENT FILED WITH
TEXAS ETHICS COMMISSION BY LOBBYIST
Total pages filed:
ACCOUNT #
OFFICE USE ONLY
Name of Lobby
Registrant
The following disclosure is filed as required by Section 305.028 of the Government
Code. I hereby notify the Texas Ethics Commission that I have become aware of a
conflict described by Section 305.028, Government Code, and that I have notified the
following affected client(s) as required by law:
(Filer: The law requires you to file this statement with the Texas Ethics Commission not later than the
10th day after you become aware of the conflict.)
HD / PM
Name and Address of Notified Client
Name and Address of Notified Client
Name and Address of Notified Client
Name and Address of Notified Client
Name and Address of Notified Client
Name and Address of Notified Client
Signature of Lobby Registrant
Date
Attach Additional Copies Of This Form As Needed
www.ethics.state.tx.us
Revised 09/01/2003
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