Revised 12/5/2019
www.ethics.state.tx.us
CANDIDATE MODIFIED
REPORTING DECLARATION
FORM
CTA
PG
2
This appointment is effective on the date it is filed with the appropriate filing authority.
11 CANDIDATE
NAME
Signature of Candidate
MODIFIED
REPORTING
DECLARATION
Year of election(s) or election cycle to
which declaration applies
I do not intend to accept more than $500 in political contributions or
make more than $500 in political expenditures (excluding filing fees)
in connection with any future election within the election cycle.
I understand that if either one of those limits is exceeded, I will be
required to file pre-election reports and, if necessary, a runoff
report.
•• This declaration must be filed no later than the 30th day before
the first election to which the declaration applies. ••
COMPLETE THIS SECTION ONLY IF YOU ARE
CHOOSING MODIFIED REPORTING
•• The modified reporting option is valid for one election cycle only. ••
(An election cycle includes a primary election, a general election, and any related runoffs.)
12
•• Candidates for the office of state chair of a political party
may NOT choose modified reporting. ••
Forms provided by Texas Ethics Commission
TEC Filers may send this form to the TEC electronically at treasappoint@ethics.state.tx.us
or mail to
Texas Ethics Commission
P.O. Box 12070
Austin, TX 78711-2070
Non-TEC Filers must file this form with the local filing authority
DO NOT SEND TO TEC
For more information about where to file go to:
https://www.ethics.state.tx.us/filinginfo/QuickFileAReport.php