Free Acrobat - Fill in the blank - Texas

Form 2207--General Information
(Declination of Remuneration by Elected or Appointed Officer)

The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant code provisions. This form and the information provided are not substitutes for the advice and services of an attorney.

Commentary A declination of remuneration is effective on the date it is filed with the office of the secretary of state. A declination filed before a person has qualified for office may not be revoked during the term of office to which the person is appointed or elected. A declination filed after an officer has qualified for office, however, may be revoked at any time. Instructions for Form · Officer Information: Provide the name and address of the officer or prospective officer. A document on file with the secretary of state is a public record subject to public access and disclosure. When providing address information, use a business or post office box address rather than a residence address if privacy concerns are an issue. · Statement of Declination: State the office for which remuneration is declined and select the box next to the appropriate statement indicating whether the officer declines all remuneration associated with the office or specific remuneration. If the officer declines specific remuneration, list the items of specific remuneration declined in the space provided. · Execution: The officer must sign and date the form before an individual authorized to administer an oath. · Delivery Instructions: The statement may be mailed to the Statutory Documents Section, P.O. Box 13550, Austin, Texas 78711-3550 or delivered to the James Earl Rudder Office Building, 1019 Brazos, Austin, Texas 78701.
Revised 06/09

Form 2207

1

Form #2207

Rev. 06/2009

This space reserved for office use

Submit to: SECRETARY OF STATE Statutory Documents Section P O Box 13550 Austin, TX 78711-3550 512-463-6334 512-463-0873 - Fax Filing Fee: None

DECLINATION OF
REMUNERATION BY ELECTED
OR APPOINTED OFFICER


Officer Information
Name:
Address:
Street City State Zip

Statement of Declination
Office for which remuneration is declined: I decline all remuneration associated with the above-named office.
I decline the following specific remuneration for the above-named office:

(Examples of specific types of remuneration include salary, compensatory per diem, reimbursement for expenses, longevity pay, or fees.)

Execution
Date:
Signature of OFFICER or PROSPECTIVE OFFICER

State of County of

)

) day of
Notary Public Signature

Sworn to and subscribed before me this (seal)

, 20

.

Print

Reset

Form 2207

2