HomeMy WebLinkAboutDensmore_Robyn - TASB 12.06.2016 COITexas Association of School Boards
P.O. Box 400 • Austin, Texas 78767-0400 • 512.467.0222
12007 Research Blvd. • Austin, Texas 78759-2439 • www.tasb.org
Serving Texas Schools Since 1949
December 6, 2016
City of Georgetown
City Hall
113 E. 8th St.
Georgetown, Texas 78626
Dear Administrator:
Enclosed please find a completed Conflict of Interest Questionnaire (CIQ) for filing
relating to Robyn Densmore, a local governmental official with your entity. The Texas
Association of School Boards, Inc. (TASB) makes this filing pursuant to Chapter 176 of
the Texas Local Government Code. Please do not hesitate to call me at (512) 467-0222
if you have any questions.
Sincerely,
Ifeoma Ibekwe
Assistant General Counsel
Enclosure
cc: Robyn Densmore
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
OFFICEUSEONLY
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who
Date Received
has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the
vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity not later
than the 7th business day after the date the vendor becomes aware of facts that require the statement to be
filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An
offense under this section is a misdemeanor.
11 Name of vendor who has a business relationship with local governmental entity.
Texas Association of School Boards, Inc. (TASB), a 501(c)(3) non-profit corporation.
2
Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated
completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which
you became aware that the originally filed questionnaire was incomplete or inaccurate.)
3 Name of local government officer about whom the information is being disclosed.
Robyn Densmore - Records Coordinator for the City of Georgetown
Name of Officer
4 Describe each employment or other business relationship with the local government officer, or a family member of the
officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer.
Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form
CIQ as necessary.
A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income,
other than investment income, from the vendor?
Ex7yes 71 No
B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction
of the local government officer or a family member of the officer AND the taxable income is not received from the
local governmental entity?
Yes Fx_1 No
5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or
other business entity with respect to which the local government officer serves as an officer or director, or holds an
ownership interest of one percent or more.
Nathan Desnmore is employed by TASB and the husband of Robyn Densmore, the Records Coordinator for the City of
Georgetown. Robyn Densmore exercises discretion in planning, recommending, selecting, or contracting with vendors
and contractors. TASB is reporting this relationship as required by Tex. Loc. Gov. Code 176.006.
6
❑Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts
as described in Section 176.003(a) 2)(B), excluding gifts described in Section 176.003(a-1).
7
12.2.2016
Signature f Yindor doing business with the governmental entity Date
Form provided by Texas Vice Commission www.eth ics.state.tx.us Revised 11/30/2015