Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) FORM COR-PTY CORRECTION AFFIDAVIT FOR POLITICAL PARTY REPORT REGARDING FUNDS FROM CORPORATIONS AND LABOR ORGANIZATIONS 2 Total pages filed: 1 ACCOUNT # OFFICE USE ONLY Date Received 3 POLITICAL PARTY NAME 4 POLITICAL PARTY CHAIR FIRST MI LAST Date Hand-delivered or Postmarked 5 ORIGINAL REPORT TYPE January 15 8th day before primary election July 15 50th day before general election Amount Receipt # Date Processed 6 ORIGINAL PERIOD COVERED Month Day Year Month Day Year Date Imaged THROUGH 7 EXPLANATION OF CORRECTION 8 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 Political Party Chair 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 PTY-CORP Needed To Report And Explain Corrections www.ethics.state.tx.us Revised 09/01/2007 American LegalNet, Inc. www.FormsWorkFlow.com Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) CORRECTION AFFIDAVIT FOR POLITICAL PARTY REPORT REGARDING FUNDS FROM CORPORATIONS AND LABOR ORGANIZATIONS 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 #. The first time the party filed a FORM PTY-CORP, the Ethics Commission assigned the party 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. Political Party Name. Put the political party’s name here. Enter the name in the same way as on the report you are correcting. 4. Political Party Chair. Put the chair’s full name here. 5. Original Report Type. Mark the type of report you are correcting. 6. 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. 7. Explanation of Correction. Attach any part of Form PTY-CORP (Political Party Report Regarding Funds From Corporations and Labor Organizations) 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. 8. Affidavit. The chair of the political party should read the affidavit before signing. The chair must sign the affidavit in the presence of an individual authorized to take oaths. If signed before a notary public, the affidavit must include the notary’s signature and seal. www.ethics.state.tx.us Revised 09/01/2007 American LegalNet, Inc. www.FormsWorkFlow.com