Team Family Entertainment LLC CIQ 4.8..22CONFLICT OF INTEREST QUESTIONNAIRE
For vendor or other person doing business with local
FORM CIQ
governmental entity
This questionnaire reflects changes made to the law by H.B. 23,84th Leg., Regular Session.
Thts questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendorwho has a business relationship as definedby Section 176 001(1-a) with a local governmental entity and the vendor meets requirements under Section 176 006(a)
By law this questionnaire must be filed with the records administrator of the local government entity not later than the 7th business day after thedate the vendor becomes aware of facts that require the statement to be filed. See Section '176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly vrolates Section 176.006, Local Government Code. An offense under this section is a
misdemeanor.
1 Name of vendor who has a business relationship with local governmental entity.
-/ € A A FA nIL? €IJT€L,T,$/N A€fITl!Check this box if you are filing an update to a previously filed questionnaire.
(The law requrres that you file an updated completed questionnaire with the appropriate filing authority not later
after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)
than the 7th business day
il Name of local government officcr about whom the information in this
Name of Officer
is being discloscd.
Describe each employment or other business relationship with the local government officer, or a lamily member olthe officer, as described by Section
176.003(a)(2)(A). Alsodescribeanyfamilyrelationshipwiththelocalgovemmentofficer. Thissection,(itcm3includingsubpartsA,B,C&D),mustbe
completed for each ollcer with whom the vendor has an employment or other business relationship as defined by Section I 76.00 1( I -a), Local Govemment Code
Attach additional pages to this Form CIQ as necessary.
A. Is the local govemment officer named in this section rcceiving or lrkely to receivc taxable income, other than investmenl income. lrom the vendor?
| | yes L__J NU
B. Is thc vendor recetving or likely to rcccive taxable income, other than invcstmcnt income. liom or at the dircction olthe local govemment officer named in
this section AND the taxable income is not received from the local governmental entity?
I lYcs I INo
C. Is the filer ofthis questionnaire employed by a corporation or other busincss entity rvith respect to which the local government olficer serves as an officer
or director, or holds an ownership ofone percent or morc?
L_J 135 L___J \o
D. Describe each employment or business and lamily relationship with the local government olficer named in this section.
4 g have no Conflict of lnterest to disclose.
j-]laAt
ffiincss with the gouernmental entrtyl Date