TEXAS ETHICS COMMISSION
PERSONAL FINANCIAL STATEMENT EXTENSION REQUEST FORM


This form must be completed and submitted by 5:00 PM CDT on April 30 to qualify for the extension

(For Texas Ethics Commission Filers Only)

Due Date with Extension: June 30, 2015
Due Date without Extension: April 30, 2015

COMPLETE THE FOLLOWING:

Filer's Account Number:

   (If you do not know the account number, enter zeros.)
Filer Name:

Address:
City, State, ZIP Code:    


 Check here if this is a change of address
Filer's Agency, Office,
or Position:


Filer's Email Address:  


(An email address is required in order to receive an electronic confirmation of your extension request. Only one email address may be entered. If you do not have an email address, enter N/A.)
   Check here to receive email reminders about this filing deadline.  Reminders will be sent to the email address provided above.
Person Requesting Extension:
Phone Number of Person
Requesting Extension:

  

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