LOCAL GOVERNMENT OFFICER
CONFLICTS DISCLOSURE STATEMENT
FORM
CIS
(Instructions for completing and filing this form are provided on the next page.)
This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session.
OFFICE USE ONLY
This is the notice to the appropriate local governmental entity that the following local
government officer has become aware of facts that require the officer to file this statement
in accordance with Chapter 176, Local Government Code.
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Name of Local Government
DateReceived
Officer
Ronnie Cole
l:J
Office Held
Member, Grayson County Junior College District Trustee
l.:J
Name of person described
by Sections 176.002(a) and 176.003(a), Local Government
Code
Virginia Cook, Virginia Cook Realtors (Broker), 5950 Sherry Lane, Dallas, Texas 75225
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Description of the nature and extent of employment or other business relationship with person named in item 3
I work as an independent contractor for Virginia Cook Realtors as a sales associate. My income from said
agreement exceeds $2500 for the previous 12 months. Virginia Cook is an entity that will represent the college
in one or more property transactions.
List gifts accepted by the local government officer and any family member, excluding gifts described by Section
176.003(a-1), if aggregate value of the gifts accepted from person named in item 3 exceed $250 during the 12-month
period described by Section 176.003(a)(2)(8)
Date Gift Accepted
Description of Gift
Date Gift Accepted
Description of Gift
Date Gift Accepted
Description of Gift
(attach additional forms as necessary)
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AFFIDAVIT
I swearunderpenaltyof perjurythat the abovestatementis true and correct.I acknowledge
that the disclosureapplies to a family member(as defined by Section 176.001(2), Local
GovernmentCode)of this local governmentofficer. I also acknowledgethat this statement
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AFFIX
NOTARY
003(,),
MARSHA STARR
Notary PUblic. Stat~of Texas
MV COmmis-sion Expires
Oecemb~r"4. 2()1 7 •.
STAMP
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SEAL
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Signatureof Local GovernmentOfficer
ABOVE
Swornto andsubscribedbeforeme,by the said~
of ~,
Lo~1
Government Cod,
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,this the~
day
to certifywhich,witnessmy handand seal of office.
Signatureof officer administeringoath
Printednameof officer administeringoath
Title of officer administeringoath
Adopted
06/29/2007
Grayson College
091501
BBFA
(EXHIBIT)
ETHICS
CONFLICT OF INTEREST DISCLOSURES
EXHIBIT A
AFFIDAVIT DISCLOSING SUBSTANTIAL INTEREST
IN A BUSINESS ENTITY OR REAL PROPERTY
STATE OF TEXAS
COUNTY OF
Grayson
I,
Ronnie Cole
(name), as a local public official of the
Grayson County Junior
College District, make this affidavit and hereby on oath
state the following: I, or a person(s) related to me in the first degree, have a substantial interest in:
[X] a business entity, as those terms are defined in Local Government
Code Sections
a special economic effect distinguishable
from its effect on the public by a vote or decision of the Board.
171.001-171.002, that would experience
or
o
real property for which it is reasonably foreseeable that the Board's action or my action
will have a special economic effect on the value of the property distinguishable from its
effect on the public.
The business entity or real property is (name/address of business or description of property):
Virginia Cook Realtors.
("I" or name of relative and relationship)
Ronnie Cole
substantial interest in this business entity or real property as follows:
o
o
o
181
o
(have)(has) a
(check all that apply)
Ownership of ten percent or more of the voting stock or shares of the 'busi~ess entity.
Ownership of ten percent or more of the fair market value of the business entity.
Ownership of $15,000 or more of the fair market value of the business entity.
Funds received from the business entity exceed ten percent of mv gross income
for the previous year.
Real property is involved and (/, she, he) (have)(has) an equitable or legal ownership
with a fair market value of at least $2,500.
Virginia Cook Realtors has an agreement with me (Ronnie Cole) as an independent
contractor, sales associate. My income from said agreement exceeds $2500 for the
previous 12 months. As a member of the Grayson College Board of Trustees and as a
representative of the Trustees serving the Grayson College Foundation Board, I will
abstain from participating in any decision of the Grayson College Foundation involving this property. In the event that I receive any financial gain from transactions related to this property, I will donate the same amount to the Grayson College Foundation.
The statements contained herein are based on my personal knowledge and are true and correct.
DATE ISSUED: 1/24/2006
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Grayson College
091501
BBFA
(EXHIBIT)
ETHICS
CONFLICT OF INTEREST DISCLOSURES
Upon the filing of this affidavit with the Board's secretary, I affirm that I shall abstain from participation in any decision involving this business entity or real property, unless permitted according to Loc. Gov't Code Sec. 171.004(c).
Signed this;...c:::::=-.-_day of
(month),
(year).
SigC~ial
Title
STATE OF TEXAS
COUNTYOF~~=4~~=~~~
Sworn to and subs
(year).
_
_1_ day of ~
(month), ~
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!1>:~o;;~P..il;;;;;...
MAR$HA STARR
Notary Public, Sta~eer.r exas
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My Qm\missiOo Expires
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Oece~r 4, 2017.
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DATE ISSUED: 1/24/2006
UPDATE 20
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