FILINGS – CONFLICT OF INTEREST

DISCLOSURE OF CONFLICT OF INTEREST

Pursuant to Section 22A(d) of the DeKalb County Code of Ethics, any official or employee who has an interest that he or she has reason to believe may be affected by his or her official acts or those official acts of another official or employee shall give a detailed disclosure of the nature and value of such interest. Every official or employee who has an interest in any contract to which DeKalb County is or is about to become a party shall give a detailed disclosure of the nature and value of such interest. The Board of Ethics shall provide advice on how to proceed to each official or employee who reports a potential conflict of interest. Valuations of an interest shall not be made public record, but the nature of the conflict shall be public record.

Name *

Work Phone *

Work Email *

Description of The Conflict of Interest *

Signature

Clear Signature

Note: Please write your signature on the line directly above with either your mouse on a PC, or finger on a tablet device.

By signing this form you indicate that you declare under penalty of perjury and false swearing that you have reviewed the information as given in this disclosure. To the best of your knowledge your information being submitted is true and a complete statement.

Affirmation *

I Affirm

I declare under penalty of perjury and false swearing that I have reviewed the information as given in this disclosure. To the best of my knowledge my information being submitted is true and a complete statement.

Please Enter the Correct Answer *

DeKalb Ethics

DISCLOSURE OF CONFLICT OF INTEREST

Staff

Contact Us