Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 FORM CORRECTION AFFIDAVIT FOR CANDIDATE FOR SPEAKER OF THE TEXAS HOUSE OF REPRESENTATIVES 1 3 SPEAKER CANDIDATE NAME 2 Total pages filed: ACCOUNT # 1-800-325-8506 COR-SPK OFFICE USE ONLY Date Received ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ORIGINAL REPORT TYPE ○ 4 LAST ○ NICKNAME MI ○ FIRST ○ TITLE SUFFIX Date Hand-delivered or Date Postmarked January 1 September 1 March 1 November 1 May 1 Day before regular session convenes July 1 Day before special session convenes Receipt # Amount Legal Totals Date Processed 5 ORIGINAL PERIOD COVERED Month Day Month Year Day Year Date Imaged THROUGH 6 EXPLANATION OF CORRECTION 7 AFFIDAVIT I swear, or affirm, under penalty of perjury, that this corrected report is true and correct. Check ONLY if applicable: I swear, or affirm, that I am filing this corrected report not later than the 14th business day after the date I learned that the report as originally filed is inaccurate or incomplete. I swear, or affirm, that any error or omission in the report as originally filed was made in good faith. Signature of Speaker Candidate AFFIX NOTARY STA M P / SEAL ABOVE Sworn to and subscribed before me by _____________________________________ this the ______ day of _________________, 20 _____, to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Remember To Attach Any Part Of Form SPK Needed To Report And Explain Corrections Revised 09/01/2007 American LegalNet, Inc. www.FormsWorkflow.com Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1-800-325-8506 CORRECTION AFFIDAVIT FOR CANDIDATE FOR SPEAKER OF THE TEXAS HOUSE OF REPRESENTATIVES All Reports: A filer who files a corrected report must submit a correction affidavit. The affidavit must identify the information that has changed. Reports filed with Texas Ethics Commission: A corrected report (other than a report due 8 days before an election or a special report near election) filed with the Ethics Commission after its due date is not considered late for purposes of late-filing penalties if: (1) any error or omission in the report as originally filed was made in good faith, and (2) the person filing the report files a corrected report and a good-faith affidavit not later than the 14th business day after the date the person learns that the report as originally filed is inaccurate or incomplete. Attach additional pages as necessary. INSTRUCTIONS FOR COMPLETING THIS FORM The following numbers correspond to the numbered boxes on the other side. 1. Account #. You should have received a letter from the Texas Ethics Commission acknowledging receipt of your campaign treasurer appointment and assigning you an account number. Put that number in this box. 2. Total Pages Filed. After completing this form and any attachments, count the number of pages. Enter that number in this box. Each side of a two-sided form counts as a page. In other words, this form is two pages. 3. Speaker Candidate Name. Put your full name here. Enter your name in the same way as on the report you are correcting. 4. Original Report Type. Mark the type of report you are correcting. 5. Original Period Covered. Enter the period covered by the report you are correcting. The year is important because filers sometimes correct reports years after filing the original. 6. Explanation of Correction. Attach any part of Form SPK (Candidate For Speaker of the Texas House of Representatives: Statement of Contributions, Loans, and Expenditures) needed to report and explain corrections. Explain why there was an error on the original report. Also explain what information is being corrected and how the new information is different from the information on the original report. (Use additional pages if you need more space.) You may also use this area to request a waiver or reduction of a late-filing penalty and state the basis of your request. Revised 09/01/2007 American LegalNet, Inc. www.FormsWorkflow.com