Local Government Officer Conflicts Disclosure Statement

If applicable, please complete the following Conflicts Disclosure Statement for a local government officer:

This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session. 

This is the notice to the appropriate local governmental entity that the following local government officer has become aware of facts that require the officer to file this statement in accordance with Chapter 176, Local Government Code.

Click here to download a CIS form.
Electronic Signature