BOARD OF ETHICS COMPLAINT

The Board of Ethics has jurisdiction over the Section 22A of HB597. The Ethics Office is required to send written notice to the subject of any ethics complaint. The Ethics Office shall dismiss complaints over which it has no jurisdiction.

PART ONE: PERSON VIOLATING THE CODE OF ETHICS.

State the name, address, telephone number, and email address of the person who you believe has violated the Code of Ethics.

Name *

County position or title

Department or agency

Work Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Email Address *

Phone Number

PART TWO: SPECIFIC LAW VIOLATED

State the specific section or sections of the Code of Ethics that you believe was violated. *

PART THREE: STATEMENT OF FACTS

Describe the facts on which this complaint is based, including relevant dates, places, and actions. *

PART FOUR: WITNESS INFORMATION.

State the names, addresses, telephone numbers, and email addresses of persons with firsthand knowledge of the facts alleged or other information that could help. *

PART FIVE: SUPPORTING DOCUMENTS

List any records or documents that would assist the Board of Ethics in its investigation. Please mail or deliver to the Ethics Office any documentary evidence that supports the facts. *

PART SIX: PERSON MAKING THE COMPLAINT

Name

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Email *

Phone Number

I agree to receive service of any notice via the email address set forth above

I declare under penalty of perjury and false swearing that I have reviewed the information given in this complaint and, to the best of my knowledge, it is a true, accurate, and complete statement.

Signature

Date

Received by

Date

Completion of this form by a Complainant is not proof of any allegation made. The Board will determine whether a violation of the DeKalb Ethics Code exists upon investigation and full hearing of the complaint.
Complaints should be mailed to:
Ethics Officer
DeKalb County Board of Ethics
178 Sams Street
Decatur, Georgia 30030

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DeKalb Ethics

BOARD OF ETHICS COMPLAINT