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This questionnaire reflects changes made to the law by H.B. 23, 84th Leg.,
Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local
Government Code, by a vendor who has a business relationship as defined by
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 governmental entity not later than the 7th business day after the date
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 violates Section 176.006,
Local Government Code. An offense under this section is a misdemeanor.
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OFFICE USE ONLY |
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Date Received |
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7/13/2022
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Your name and name of vendor who has a business
relationship with local governmental entity.
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Vendor Name: |
4imprint, Inc.
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First Name: |
Shay
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Last Name: |
Freund
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Email Address:
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Bids@4imprint.com
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2. |
Check this box if you are filing an update to a previously filed questionnaire.
(The law requires that you file an updated completed questionnaire with the
appropriate filing authority not later than the 7th business day after the
date on which you became aware that the originally filed questionnaire was
incomplete or inaccurate.)
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3. |
Name of local government officer about whom the information in this
section is being disclosed. (If you have no disclosures, click "NONE" at the
bottom of the page.)
Name of the Officer:
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4. |
Describe each employment or other business
relationship with the local government officer, or a family member of the
officer, as described by Section 176.003(a)(2)(A).
Complete subparts A and B for each employment or business relationship
described above.
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A. |
Is the local government officer or a family member of the
officer receiving or likely to receive taxable income, other than
investment income, from the vendor?
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B. |
Is the vendor receiving or likely to receive taxable
income, other than investment income, from or at the direction of the
local government officer or a family member of the officer AND the taxable
income is not received from the local governmental entity?
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Describe any family relationship with the local government officer.
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5. |
Describe each employment or business relationship that the vendor named
in Question 1 maintains with a corporation or other business entity with respect
to which the local government officer serves as an officer or director, or holds
an ownership interest of one percent or more.
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6. |
Has the vendor given the local government officer or a family member of the
officer one or more gifts as described in Section 176.003(a)(2)(B), excluding
gifts described in Section 176.003(a-1)?
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7. |
Shay Freund
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7/13/2022
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Signature of vendor doing business with the government entity |
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Date |
