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BBFA EXHIBIT A

ETHICS: PROHIBITED PRACTICES

EXHIBIT A:

AFFIDAVIT DISCLOSING SUBSTANTIAL INTEREST IN A BUSINESS ENTITY OR REAL PROPERTY

STATE OF TEXAS
COUNTY OF _________________

I, ___________________________ name), as a local public official of the _________________ College District, make this affidavit and on my oath state the following:

  1. I, or a person(s) related to me in the first degree, have a substantial interest as defined in Local Government Code 171.002 in:

  • a business entity, as defined in Local Government Code 171.001, that would experience a special economic effect distinguishable from its effect on the public by a vote or decision of the board or;

  • real property for which it is reasonably foreseeable that the board’s action or my action will have a special economic effect on the value of the property distinguishable from its effect on the public.

  1. The business entity or real property is:
    ________________________________________________________________________

(name/address of business or description of property)

________________________ (“I” or name of relative and relationship) (have)(has) a substantial interest in this business entity or real property as follows: (Check all that apply)

□ Ownership of ten percent or more of the voting stock or shares of the business entity.

□ Ownership of ten percent or more of the fair market value of the business entity.

□ Ownership of $15,000 or more of the fair market value of the business entity.

□ Funds received from the business entity exceed ten percent of _________ (my, her, his) gross income for the previous year.

□ Real property is involved and ___________ (I, she, he) (have)(has) an equitable or legal ownership with a fair market value of at least $2,500.

  1. The statements in this affidavit are based on my personal knowledge and are true and correct.

Upon the filing of this affidavit with the board’s official record keeper, I affirm that I shall abstain from participation in any decision involving this business entity or real property, unless permitted according to Local Government Code 171.004(c).

Signature of official: __________________________________

Title:  ______________________________________________

Date:  ______________________________________________

STATE OF TEXAS 

COUNTY OF  _____________________________

Sworn to and subscribed before me on this________ day of ___________(month), _______(year).

___________________________________________, Notary Public, State of Texas.

Document History

Adopted: 06/2017

Revised: 9/18/2023