Benbrook, TX · Tarrant County
Conflict of Interest Questionnaire
Vendors use this questionnaire to disclose specified business or family relationships, income, and gifts connected to a local government officer.
What this form is
A vendor with a business relationship with a local government entity uses this questionnaire to disclose specified connections with a local government officer or the officer’s family. The form asks about employment and business relationships, taxable income, gifts, and family relationships, and allows additional pages as needed. It states that a completed questionnaire must be filed with the appropriate records administrator when the stated filing conditions apply.
Who needs it
A vendor with a business relationship with a local governmental entity files this form when one or more of the conditions described on it apply.
How to submit it
File the completed questionnaire with the records administrator of the local governmental entity. The form states a filing deadline based on when the vendor becomes aware of facts requiring the statement.
About notarization
This document is signed and dated without a notary; the form says to attach additional pages as necessary, and the signer just signs and dates it.
How to submit this form
- 1
Download The Questionnaire
Download the Conflict of Interest Questionnaire.
- 2
Complete The Form
Answer the questions about the vendor’s relationships, income, and gifts, and provide the requested names and descriptions.
- 3
Gather Additional Pages
Attach additional pages as necessary to describe the relationships requested on the form.
- 4
Sign And Date
The vendor doing business with the governmental entity signs and dates the questionnaire.
- 5
File With The Records Administrator
File the completed questionnaire with the records administrator of the local governmental entity.
Frequently asked questions
- Who files the Conflict of Interest Questionnaire?
- A vendor doing business with a local governmental entity files it when the business relationship and other conditions described on the form apply.
- What information does the questionnaire ask for?
- It asks about relationships with a local government officer or family member, taxable income, gifts, and certain business relationships involving an entity where the officer has a role or ownership interest.
- Do I need a notary for the Conflict of Interest Questionnaire?
- No. The form has a vendor signature and date line but no notary block; the signer just signs and dates it. Attach additional pages if necessary.
- How do I submit the Conflict of Interest Questionnaire?
- File the completed questionnaire with the records administrator of the local governmental entity. The form states when the filing deadline applies.
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.