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Conflict Of Interest Statement Filed With Texas Ethics Commission By Lobbyist CI-TEC - Texas

Conflict Of Interest Statement Filed With Texas Ethics Commission By Lobbyist Form. This is a Texas form and can be used 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) CONFLICT OF INTEREST STATEMENT FILED WITH TEXAS ETHICS COMMISSION BY LOBBYIST ACCOUNT # Total pages filed: FORM CI-TEC 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.) Name and Address of Notified Client 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 Signature of Lobby Registrant Date Attach Additional Copies Of This Form As Needed www.ethics.state.tx.us Revised 09/01/2003 American LegalNet, Inc. www.FormsWorkFlow.com
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