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LOCAL GOVERNMENT OFFICER - CONFLICTS DISCLOSURE STATEMENT




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 filing 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.

Conflicts Disclosure Statement - CIS Form (Click CIS Form to download)
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