FOR OFFICE USE ONLY
File No. ________________________________
DISCLOSURE STATEMENT OF CONDITIONAL GIFTS
FROM FOREIGN PERSONS
(Tex. Education Code, ยงยง 51.571 to 51.575)
A subject institution that receives a gift from or enters into a contract with
a foreign source, the value of which is $250,000 or more, considered alone
or in combination with all other gifts from or contracts with that foreign
source within a calendar year, shall file a disclosure statement with the U.S.
Secretary of Education and the Texas Secretary of State on January 31 or
July 31, whichever is sooner.
See the attached Information Sheet for definitions. Attach additional pages
as necessary.
Address: ________________________________________________________________________________________________
Name of Institution: _____________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Complete (1) or (2) as applicable:
(1) For gifts received from or contracts entered into with a foreign source other than a foreign government,
provide the following:
The aggregate dollar amount of such gifts/contracts - __________________________________
The country to which such gifts/contracts is attributable - _____________________________
Additionally, if there are restrictions or conditions to the gift/contract, provide the following:
The date of such gifts/contracts - ______________________________________________________
A description of any conditions or restrictions -
(2) For gifts received from or contracts entered into with a foreign government, provide:
The aggregate dollar amount of such gifts and contracts - __________________________________
The foreign government making such gifts/contracts - _____________________________________
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