public class CIMTextSymbol : CIMSymbol, System.ComponentModel.INotifyPropertyChanged, System.Xml.Serialization.IXmlSerializable  

{
  //Create a simple point text element and assign basic symbology and text settings.

  //Note: Must be on QueuedTask.Run
  //Build 2D point geometry
  Coordinate2D coord2D = new Coordinate2D(3.5, 10);

  //Set symbology, create and add element to layout
  CIMTextSymbol sym = SymbolFactory.Instance.ConstructTextSymbol(
                ColorFactory.Instance.RedRGB, 32, "Arial", "Regular");
  string textString = "Point text";

  //use ElementInfo to set placement properties during create
  var elemInfo = new ElementInfo()
  {
    Anchor = Anchor.CenterPoint,
    Rotation = 45
  };
  var ptTxtElm = ElementFactory.Instance.CreateTextGraphicElement(
    layout, TextType.PointText, coord2D.ToMapPoint(), sym, textString,
                       "New Point Text", true, elemInfo);

  //Change additional text properties
  ptTxtElm.SetX(4.5);
  ptTxtElm.SetY(9.5);
}

{
  //Note: Must be on QueuedTask.Run
  //Create rectangle text with background and border symbology.  
  //Build 2D polygon geometry
  List<Coordinate2D> plyCoords = new List<Coordinate2D>();
  plyCoords.Add(new Coordinate2D(3.5, 7));
  plyCoords.Add(new Coordinate2D(4.5, 7));
  plyCoords.Add(new Coordinate2D(4.5, 6.7));
  plyCoords.Add(new Coordinate2D(5.5, 6.7));
  plyCoords.Add(new Coordinate2D(5.5, 6.1));
  plyCoords.Add(new Coordinate2D(3.5, 6.1));
  Polygon poly = PolygonBuilderEx.CreatePolygon(plyCoords);

  //Set symbology, create and add element to layout
  //Also notice how formatting tags are using within the text string.
  CIMTextSymbol sym = SymbolFactory.Instance.ConstructTextSymbol(
                    ColorFactory.Instance.GreyRGB, 10, "Arial", "Regular");
  string text = "Some Text String that is really long and is " +
                "<BOL>forced to wrap to other lines</BOL> so that " +
                "we can see the effects." as String;

  GraphicElement polyTxtElm = ElementFactory.Instance.CreateTextGraphicElement(
    layout, TextType.RectangleParagraph, poly, sym, text, "Polygon Paragraph");

  //(Optionally) Modify paragraph border 
  CIMGraphic polyTxtGra = polyTxtElm.GetGraphic();
  CIMParagraphTextGraphic cimPolyTxtGra = polyTxtGra as CIMParagraphTextGraphic;
  cimPolyTxtGra.Frame.BorderSymbol = new CIMSymbolReference();
  cimPolyTxtGra.Frame.BorderSymbol.Symbol =
               SymbolFactory.Instance.ConstructLineSymbol(
                          ColorFactory.Instance.GreyRGB, 1.0, SimpleLineStyle.Solid);
  polyTxtElm.SetGraphic(polyTxtGra);
}

{
  //Note: Must be on QueuedTask
  //create a picture element
  var imgPath = @"https://www.esri.com/content/dam/esrisites/en-us/home/" +
   "homepage-tile-podcast-business-resilience-climate-change.jpg";

  //Build a geometry to place the picture
  Coordinate2D ll = new Coordinate2D(3.5, 1);
  Coordinate2D ur = new Coordinate2D(6, 5);
  Envelope env = EnvelopeBuilderEx.CreateEnvelope(ll, ur);
  //create a picture element on the page
  var gElement = PresentationElementFactory.Instance.CreatePictureGraphicElement(page, env, imgPath);

  //create a text element
  //Set symbology, create and add element to a presentation page
  CIMTextSymbol sym = SymbolFactory.Instance.ConstructTextSymbol(
                ColorFactory.Instance.RedRGB, 15, "Arial", "Regular");
  //use ElementInfo to set placement properties
  var elemInfo = new ElementInfo()
  {
    Anchor = Anchor.CenterPoint,
    Rotation = 45
  };
  string textString = "My text";
  var textPos = new Coordinate2D(5, 3).ToMapPoint();
  var tElement = PresentationElementFactory.Instance.CreateTextGraphicElement(page,
    TextType.PointText, textPos, sym, textString, "telement", false, elemInfo);

  //create a group element with elements created above
  var elmList = new List<Element> { gElement, tElement };
  GroupElement grp1 = PresentationElementFactory.Instance.CreateGroupElement(page, elmList, "My Group");
}