Board of Trustees Application

Name and contact information

First name

Middle name

Last name

Suffix

Spouse's name

Primary phone number

Secondary phone number

Email

Residential address

Street number

Street name

Apartment/Suite number (Only enter the numbers and/or letters for your apt, suite, trailer, lot, unit, etc.)

City You have to reside in Bexar County

State

Zip code

Employer name

Employer

Current job title

Employer address

Street number

Street name

Apartment/Suite number (Only enter the numbers and/or letters for your apt, suite, trailer, lot, unit, etc.)

City

State

Zip code

How did you hear about this opportunity?

Quadrant of residence

In which city council district do you reside? (Look up your district at sanantonio.gov)

This section is required

Are you a U.S. citizen?

Yes No

Are you a permanent resident of
Bexar County?

Yes No

Are you a customer of CPS Energy?

Yes No

List three professional references (optional)

1. Name

Phone

Relationship

2. Name

Phone

Relationship

3. Name

Phone

Relationship

Click to upload a resume

Upload a Word or PDF

Click to upload
letter of recommendation 1

Upload a Word or PDF

Click to upload
letter of recommendation 2

Upload a Word or PDF

Click to upload
letter of recommendation 3

Upload a Word or PDF

Click to upload
letter of recommendation 4

Upload a Word or PDF

Click to upload
letter of recommendation 5

Upload a Word or PDF

You may also email your resume and letter(s) of recommendation at a later time to: boardrelations@cpsenergy.com

Social media information

Facebook

Yes No

Username :

Instagram

Yes No

Username :

YouTube

Yes No

Username :

X.com (formerly Twitter)

Yes No

Username :

Yes No

Username :

Snapchat

Yes No

Username :

Other

Yes No

Details :

Background information questions

1. Do you or your spouse have a financial interest in any contract with the City of San Antonio (City), CPS Energy or the San Antonio Water System (SAWS), or in the sale to the City, CPS Energy or SAWS of any land, interests, supplies or service? [1]

Yes No

If yes, please provide details, e.g., name of organization, your relationship to it and details of contract or sale:

[1] As defined by the Code of Ethics of the City of San Antonio, a "financial interest" exists if any of the following individuals or entities is a party to such contract or sale:

The Applicant, the Applicant's parent, child or spouse or any other family member within the first degree of consanguinity or affinity;
A business entity in which the Applicant or the Applicant's parent, child or spouse directly or indirectly owns: A) 10% or more of the voting stock or shares, or B) 10% or more of the fair market value of the business; or
A business entity of which the Applicant, the Applicant's parent, child, or spouse or any other family member within the first degree of consanguinity or affinity or a business entity described in (2)(A) or (B) is a subcontractor on a City, CPS Energy, or SAWS contract or is a partner or parent or subsidiary business entity to an organization who is party to such contract or sale.

2. Do you or your spouse have any interest in, or are either of you employed by, any company or organization that does business with, or that receives funds from, the City, CPS Energy or SAWS?

Yes No

If yes, please provide name of organization, your relationship to it and details of business and/or funding:

3. Are you related to any CPS Energy employee, to any CPS Energy Board Member or to any member of the San Antonio City Council? A relative is a legally-recognized spouse, child/stepchild, parent/stepparent, sibling/stepsibling, grandparent, grandchild, aunt, uncle, niece, nephew, parents-in-law, or any family member residing in the applicant's residence.

Yes No

If answer is yes, please explain:

4a. Do you serve on any local, state, or federal government board, commission, or committee, or in any elected office?

Yes No

If yes, please list:

4b. If yes, are you paid for your services or reimbursed for your expenses?

Yes No

If yes, please provide details:

5. Are you, or is any company in which you have a 10% or greater interest, or of which you have been an officer or principal, delinquent in any local, state, or federal taxes? "Delinquent" means that payment of any taxes owed is past due.

Yes No

If yes, please provide details:

6. Have you, or has any company in which you have a 10% or greater interest, or of which you have been an officer or principal, been reprimanded, fined, or suspended from doing business with any public entity within the last five years?

Yes No

If yes, please describe:

7. Have you filed federal income tax returns for the past five years?

Yes No

If no, please provide details:

8. Have you ever defaulted on a personal, business, or student loan?

Yes No

If yes, please provide details:

9. Have you, your spouse, or any company in which you have a 10% or greater interest, or of which you have been an officer or principal, been involved in any bankruptcy proceeding?

Yes No

If yes, please provide details:

10. Have you, your spouse, or any company in which you have a 10% or greater interest, or of which you have been an officer or principal, been party to litigation?

Yes No

If yes, please provide details:

The position of Trustee is one of public trust with responsibility for making and overseeing the rules and regulations governing the furnishing of electric and gas service, including customer payment requirements. Thus, it is important that Trustees maintain a current (paid) CPS Energy account status.

11a. Are you current on all CPS Energy gas and/or electric accounts that are in your name, or for which you have any financial responsibility? "Current" means that there is not a past due balance on your CPS Energy bill. Please note that you are financially responsible for any account that is under your name, or that serves the premise in which you reside.

Yes No

If no, please provide details:

11b. Do you have any history of delinquent payment on the accounts referred to in Question 11a? "Delinquent" means that the account balance was/is 31 days or greater past due.

Yes No

If yes, please provide details:

12. In less than 2,000 characters, please describe in your own words why you would like to serve as a CPS Energy Trustee:

Acknowledgment & notice

The position of CPS Energy Board member is one of public trust. By submitting this online application, I give CPS Energy full authority to conduct background investigations on me, including a detailed, 7-year public records background check to be conducted by third-party provider. I agree to provide the information necessary to perform the background check by completing and submitting a separate form provided by CPS Energy.

Information resulting from such background check will be shared with the CPS Energy Board of Trustees and CPS Energy officials and employees assisting with the Trustee search.

The information may also be subject to disclosure under the Texas Public Information Act.

Name

Date

This section is required

By submitting this application online, I hereby certify and acknowledge that:*

I exercised due diligence and care when responding to each question on this application;

The statements contained in the foregoing application are true, accurate and complete; and
I understand that any misrepresentation or omission of facts in the application may result in my disqualification from further consideration or a disqualification from appointment.

Why you are not eligible.

Thank you for your interest in serving on the CPS Energy Board of Trustees. Unfortunately, the address you entered is not in Quadrant 2, which is a requirement for this position.

Our records indicate that this address is in Quadrant . The current board representative for that area is , whose term expires on .

Please check back in the future when openings become available in your quadrant.

If you believe this is incorrect or have any other questions, please email us at boardrelations@cpsenergy.com.

Thank you for your interest.

Why you are not eligible

Unfortunately, to apply for the CPS Energy Board of Trustees, you must be a U.S citizen and a permanent resident of Bexar Country.

Based on your response, you are not eligible to proceed with the application.

If you believe this is an error or have questions, please contact us at boardrelations@cpsenergy.com