Mineral Wells, TX · Palo Pinto County
Conflict of Interest Questionnaire
This questionnaire is for a vendor or other person with a business relationship with a local governmental entity who must disclose relevant relationships.
What this form is
The Conflict of Interest Questionnaire is filed by a vendor or other person doing business with a local governmental entity when the filer meets the requirements described on the form. It asks for the filer’s name, the local government officer’s name, and information about income, employment, ownership, and business relationships. The form says to file it with the entity’s records administrator within the stated timeframe.
Who needs it
A vendor or other person with a business relationship with a local governmental entity who meets the filing requirements needs to complete this questionnaire.
How to submit it
File the completed questionnaire with the local governmental entity’s records administrator no later than the seventh business day after becoming aware of facts requiring the filing.
About notarization
No notary is required; the person doing business with the entity signs and dates the questionnaire, attaching additional pages as necessary.
How to submit this form
- 1
Download The Questionnaire
Download the Conflict of Interest Questionnaire PDF.
- 2
Complete The Questionnaire
Provide the requested filer, officer, income, employment, ownership, and business relationship information.
- 3
Attach Additional Pages
Attach additional pages as necessary to provide information for each officer.
- 4
Sign And Date The Form
The person doing business with the entity signs and dates the questionnaire.
- 5
File With The Records Administrator
File it with the local governmental entity’s records administrator within the timeframe stated on the form.
Frequently asked questions
- Who files the Conflict of Interest Questionnaire?
- A vendor or other person with a business relationship with a local governmental entity files it if they meet the requirements stated on the questionnaire.
- What information does the questionnaire ask for?
- It asks for the filer’s name, the local government officer’s name, and information about income, employment, ownership, and business relationships.
- Do I need a notary for the Conflict of Interest Questionnaire?
- No. The person doing business with the entity signs and dates the questionnaire; additional pages may be attached as necessary.
- How do I submit the Conflict of Interest Questionnaire?
- File it with the local governmental entity’s records administrator no later than the seventh business day after becoming aware of facts requiring the filing.
Need something notarized?
This Conflict of Interest Questionnaire doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.