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Fillable Printable Correction Affidavit for Political Committee

Fillable Printable Correction Affidavit for Political Committee

Correction Affidavit for Political Committee

Correction Affidavit for Political Committee

Revised 04/27/2015
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Remember To Attach Any Part Of The Campaign Finance Report Form
Needed To Report And Explain Corrections
Check ONLY if applicable:
Signature of officer administering oathPrinted name of officer administeringTitle of officer administering oath
AFFIX NOT ARY ST AMP / SEAL ABOVE
Sworn to and subscribed before me, by the said ___________________________________________________, this the ______________ day of
_______________________________, 20_________, to certify which, witness my hand and seal of office.
I swear, or affirm, under penalty of perjury, that this corrected
report is true and correct.
Semiannual report s: I swear, or af firm, that the original report was
made in good faith and without an intent to mislead or to
misrepresent the information contained in the report.
Other reports: I swear, or affirm, that I am filing this corrected
report not later than the 14th business day after the date I learned
that the report as originally filed is inaccurate or incomplete. I swear,
or affirm, that any error or omission in the report as originally filed
was made in good faith.
Signature of Campaign Treasurer
8
AFFIDAVIT
2
CORRECTION/AMENDMENT AFFIDAVIT
FOR POLITICAL COMMITTEE
FORM
COR-PAC
OFFICE USE ONL Y
Date Processed
Receipt #
Date Hand-delivered or Date Postmarked
Amount $
Date Imaged
3
COMMITTEE NAME
TREASURER NAME
4
1
Filer ID (Ethics Commission Filers)
Total pagesfiled:
ORIGINAL REPORT
TYPE
5
January 15
Dissolution Report
Runoff
10th day after campaign treasurer
termination
Other (specify _________________________
July 15
30th day before election
8th day before election
THROUGH
Month Day YearMonth Day Year
6
ORIGINAL PERIOD
COVERED
7
EXPLANA TION OF CORRECTION
Date Received
Revised 04/27/2015
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
CORRECTION/AMENDMENT AFFIDAVIT
FOR POLITICAL COMMITTEE
All Reports:A filer who files a corrected report must submit a correction affidavit. The affidavit must identify
the information that has changed.
Reports filed with Texas Ethics Commission:A corrected report (other than a report due 8 days before
an election or a special report near election) filed with the Ethics Commission after its due date is not
considered late for purposes of late-filing penalties if: (1) any error or omission in the report as originally filed
was made in good faith, and (2) the person filing the report files a corrected report and a good-faith affidavit
not later than the 14th business day after the date the person learns that the report as originally filed is
inaccurate or incomplete.
Semiannual Reports: Effective September 1, 2011, a semiannual report (due January 15 or July 15) that is
amended/corrected
before the eighth day after the original report was filed is considered to have been filed
on the date the original report was filed. A semiannual report that is amended/corrected
on or after the eighth
day after the original report was filed is considered to have been filed on the date the original report was filed
if: (1) the amendment/correction is made before any complaint is filed with regard to the subject of the
amendment/correction; and (2) the original report was made in good faith and without intent to mislead or
misrepresent the information contained in the report.
Attach additional pages as necessary.
INSTRUCTIONS FOR COMPLETING THIS FORM
The following numbers correspond to the numbered boxes on the other side.
1. Filer ID. If you file with the Ethics Commission, you should have received a letter acknowledging receipt of
your campaign treasurer appointment and assigning you an Filer ID. Put that number in this box. If you do not
file with the Ethics Commission, skip this box.
2. Total Pages Filed. After completing this form and any attachments, count the number of pages. Enter
that number in this box. Each side of a two-sided form counts as a page. In other words, this form is two
pages.
3. Committee Name. Put the committee's full name here. Enter your name in the same way as on the report
you are correcting.
4. Treasurer Name. Put the treasurer's full name here.
5. Original Report Type. Mark the type of report you are correcting.
6. Original Period Covered. Enter the period covered by the report you are correcting. The year is important
because filers sometimes correct reports years after filing the original.
7. Explanation of Correction. Attach any part of the campaign finance report form needed to report and
explain corrections. Explain why there was an error on the original report. Also explain what information is
being corrected and how the new information is different from the information on the original report. (Use
additional p ages if you need more space.) You may also use this area to request a waiver or reduction of a
late-filing penalty and state the basis of your request.
8. Affidavit. Read the affidavit before signing. You must sign the affidavit in the presence of an individual
authorized to take oaths. If signed before a notary public, the affidavit must include the notary’s signature and
seal.
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