HomeMy WebLinkAboutBrashear_Ercel - P&Z 05.02.2011 CDSi i i1 NiAreldZIOP
Section 176.003 of the Local Government Code requires certain local government officers to file this form. A
"local government officer" is defined as a member of the governing body of a local governmental entity; a
director, superintendent, administrator, president, or other person designated as the executive officer of the
local governmental entity; or an employee of a local governmental entity with respect to whom the local
governmental entity has, in accordance with Section 176.005, extended the requirements of Sections 176.003
and 176.004. This form is required to be filed with the records administrator of the local governmental entity
not later than 5 p.m. on the seventh business day after the date on which the officer becomes aware of the
facts that require the fling of this statement.
A local government officer commits
an offense
if
the officer
knowingly violates Section 176,003, Local
Government Code. An offense under
this section
is
a Class C
misdemeanor.
Please refer to chapter 176 of the Local Government Code for detailed information regarding the requirement
to file this form.
The following numbers correspond to the numbered boxes on the other side.
1. Name of Local Government Officer. Enter the name of the local government officer filing this statement.
2. Office field. Enter the name of the office held by the local government officer filing this statement.
3. Name of person described by Sections 176.002(a) and 176.003(a), Local Government Code. Enter
the name of the person described by Section 176.002, Local Government Code with whom the officer has an
employment or other business relationship as described by Section 176.003(a), Local Government Code.
4. Description of the nature and extent of employment or business relationship with person named
in item 3. Describe the nature and extent of the employment or other business relationship with the person
in item 3 as described by Section 176.003(a), Local Government Code.
5. List gifts accepted, excluding gifts described by Section 176.003(a -1), if aggregate value of the
gifts accepted from person named in item 3 exceed $250. List gifts accepted during the 12 -month period
(described by Section 176.003(a), Local Government Code) by the local government officer or family member
of the officer, excluding gifts described by Section 176.003(a -1), from the person named in item 3 that in the
aggregate exceed $250 in value.
6. Affidavit. Signature of local government officer.
Adopted 06129/2007