Free Conflict of Interest Affidavit - Texas

50-229 (Rev. 6-92/2)

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CONFLICT OF INTEREST AFFIDAVIT
STATE OF TEXAS COUNTY OF __________________________ Before me, the undersigned authority, on this day personally appeared ____________________________________ , who, being by me duly sworn, on oath deposed and said: My name is ________________________________________ . I am a member of the Appraisal Review Board for the ______________________________________________________ County Appraisal District. I own substantial interest in _______________________________________________________________________________________________ . The nature and extent of this substantial interest is as follows:
[Choose one: A.) 10% or more of the voting stock or shares; in (name of business entity); B.) ownership of 10 percent or more or $15,000 or more of the fair market value of (name of business entity); C.) 10% of more of my gross income from the previous year was from (name of business entity); D.) ownership of $2,500 or more of the fair market value of (identify real estate).]

____________________________________________________

Date ___________________________________

SUBSCRIBED AND SWORN TO before me this the _________ day of _________________________ , __________ .
Notary Public, State of Texas Commission expires

___________________________________________________

____________________________________

50-229 (Rev. 6-92/2)

CONFLICT OF INTEREST AFFIDAVIT
STATE OF TEXAS COUNTY OF __________________________ Before me, the undersigned authority, on this day personally appeared ____________________________________ , who, being by me duly sworn, on oath deposed and said: My name is ________________________________________ . I am a member of the Appraisal Review Board for the ______________________________________________________ County Appraisal District. I own substantial interest in _______________________________________________________________________________________________ . The nature and extent of this substantial interest is as follows:
[Choose one: A.) 10% or more of the voting stock or shares; in (name of business entity); B.) ownership of 10 percent or more or $15,000 or more of the fair market value of (name of business entity); C.) 10% of more of my gross income from the previous year was from (name of business entity); D.) ownership of $2,500 or more of the fair market value of (identify real estate).]

____________________________________________________

Date ___________________________________

SUBSCRIBED AND SWORN TO before me this the _________ day of _________________________ , __________ .
Notary Public, State of Texas Commission expires

___________________________________________________

____________________________________