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If retired, please indicate former occupation.
Do you have a personal financial interest, direct or indirect, in any matter pending before such officer or employee, or the city council, or a department, agency, commission, or board of which the city official (applicant) is (or may be) a member? If yes, such disclosure will not preclude an individual from serving on a board. If appointed, a form disclosing such interest must be completed and the individual will need to abstain from any discussion or vote on the matter presented before the board or commission. For further information, see Code of Ordinance, Chapter 2, Sec. 2.03.008.
The submittal and execution of the Responsibilities of Board and Commission Members is a requirement of the application process.
I hereby certify that the foregoing and any attached statements are true, accurate, and complete. I agree that any misstatement, misrepresentation, or omission of fact may result in my disqualification for appointment. I also understand that this application is subject to disclosure under the Texas Public Information Act.
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