Fillable Form 50-229 - Conflict Of Interest Affidavit printable pdf download

Form 50-229 - Conflict Of Interest Affidavit

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P r o p e r t y T a x

Conflict of Interest Affidavit

Form 50-229

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: (initial all that apply)

____

I own 10 percent or more of the voting stock or shares of the above-referenced business entity.

____

I own 10 percent or more or $15,000 or more of the fair market value of the above-referenced business entity.

____

Funds I received from the above-referenced business entity exceed 10 percent of my gross income for the previous year.

____

I have an interest in the above-referenced real property and the interest is an equitable or legal ownership with a fair market value of $2,500 or

more.

____

I am related in the first degree by consanguinity or affinity to a person who has a substantial interest in above referenced business or real property.

__________________________________________

__________________________________

Date

_______

_______________

_______

SUBSCRIBED AND SWORN TO before me this the

day of

__________________________________________

_____________________________________

Notary Public, State of Texas

Commisision expires