Form 2207—General Information
(Declination of Remuneration by Elected or Appointed Officer)
The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant code
provisions. This form and the information provided are not substitutes for the advice and services of an
attorney.
Commentary
A declination of remuneration is effective on the date it is filed with the office of the secretary of state.
A declination filed before a person has qualified for office may not be revoked during the term of office
to which the person is appointed or elected. A declination filed after an officer has qualified for office,
however, may be revoked at any time.
Instructions for Form
Officer Information: Provide the name and address of the officer or prospective officer.
A document on file with the secretary of state is a public record subject to public access and
disclosure. When providing address information, use a business or post office box address
rather than a residence address if privacy concerns are an issue.
Statement of Declination: State the office for which remuneration is declined and select the box
next to the appropriate statement indicating whether the officer declines all remuneration
associated with the office or specific remuneration. If the officer declines specific remuneration,
list the items of specific remuneration declined in the space provided.
Execution: The officer must sign and date the form before an individual authorized to
administer an oath.
Delivery Instructions: The statement may be mailed to the Statutory Documents Section, P.O.
Box 13550, Austin, Texas 78711-3550 or delivered to the James Earl Rudder Office Building,
1019 Brazos, Austin, Texas 78701.
Revised 06/09
Form 2207
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Form #2207 Rev. 06/2009
Submit to:
SECRETARY OF STATE
Statutory Documents Section
P O Box 13550
Austin, TX 78711-3550
512-475-0775
512-475-2815 - Fax
Filing Fee: None
This space reserved for office use
DECLINATION OF
REMUNERATION BY ELECTED
OR APPOINTED OFFICER
Officer Information
Name:
Address:
Street City State Zip
Statement of Declination
Office for which remuneration is declined:
I decline all remuneration associated with the above-named office.
I decline the following specific remuneration for the above-named office:
(Examples of specific types of remuneration include salary, compensatory per diem, reimbursement for expenses, longevity
pay, or fees.)
Execution
Date:
Signature of OFFICER or PROSPECTIVE OFFICER
State of
)
County of )
Sworn to and subscribed before me this day of , 20 .
(seal)
Notary Public Signature
Form 2207
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