Irving, TX · Dallas County

No notary required

Local Government Officer Conflicts Disclosure Statement Form CIS

This statement notifies the local governmental entity of a conflict involving a vendor and is filed by a local government officer.

What this form is

The form is used when a local government officer becomes aware of facts requiring a conflicts disclosure statement. It asks for the officer’s name and office, the vendor’s name, details of business or family relationships, and qualifying gifts. The officer signs the form and completes either the affidavit option or the unsworn declaration.

Who needs it

A local government officer who becomes aware of facts requiring a conflicts disclosure statement files this form with the local governmental entity’s records administrator.

How to submit it

File the completed form with the records administrator of the local governmental entity. The document does not provide an address, email, or portal.

About notarization

A notary is not required if the officer uses the unsworn declaration; the form also offers an optional affidavit sworn before an officer administering an oath.

How to submit this form

  1. 1

    Download The Form

    Download the Local Government Officer Conflicts Disclosure Statement Form CIS.

  2. 2

    Complete The Statement

    Enter the officer and vendor information, describe relevant relationships, and list qualifying gifts.

  3. 3

    Complete The Signature Option

    Sign the statement and complete either the affidavit option or the unsworn declaration.

  4. 4

    File With The Records Administrator

    File the completed form with the records administrator of the local governmental entity.

Frequently asked questions

Do I need a notary for the Local Government Officer Conflicts Disclosure Statement?
No. The form offers an unsworn declaration that does not require a notary. It also provides an optional affidavit to be sworn before an officer administering an oath.
How do I submit the conflicts disclosure statement?
File the completed form with the records administrator of the local governmental entity. The document does not list an address or online submission method.
What information does the form request?
It asks for the officer’s name and office, the vendor’s name, information about relevant business or family relationships, and details of qualifying gifts.
Who files this statement?
A local government officer who becomes aware of facts requiring a conflicts disclosure statement files it with the records administrator of the local governmental entity.

Need something notarized?

This Local Government Officer Conflicts Disclosure Statement Form CIS doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.