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MARSHALL COUNTY CODE OF ETHICS
CONFLICT OF INTEREST DISCLOSURE STATEMENT
Instructions: This form is for reporting personal interest required to
be disclosed under Section 3 of the Code of Ethics of this county.
Officials and employees are required to disclose personal interests in
matters that affect or would lead a reasonable person to infer that it
would affect the exercise of discretion of an official or employee.
1. Date of disclosure:__________________________________
2. Name of official or employee:__________________________
3. Office and position:__________________________________
4. Description of personal interest (describe below in detail):
___________________________
Signature of Official or Employee
___________________________
Witness Signature
___________________________
Printed name of witness
CONFLICT OF INTEREST DISCLOSURE STATEMENT
Instructions: This form is for reporting personal interest required to
be disclosed under Section 3 of the Code of Ethics of this county.
Officials and employees are required to disclose personal interests in
matters that affect or would lead a reasonable person to infer that it
would affect the exercise of discretion of an official or employee.
1. Date of disclosure:__________________________________
2. Name of official or employee:__________________________
3. Office and position:__________________________________
4. Description of personal interest (describe below in detail):
___________________________
Signature of Official or Employee
___________________________
Witness Signature
___________________________
Printed name of witness
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