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FORM TITLE: Statement of Financial Interests
OFFICIAL NUMBER: None
DUE DATE: Public Officials-May 1 st of each year a position is held and of the year after
leaving such position.
Nominees-10 days before official or body approves or rejects the nomination.
Candidates-On or before the last day for filing a petition to appear on the ballot
for election.
Write-ins- Within 30 days of official certification of having been nominated or
elected unless such person resigns.
WHERE TO SEND COMPLETED FORM: Follow guide on form for various requirements.
NUMBER OF COPIES REQUIRED: ONE
FOR ASSISTANCE: State Ethics Commission at 1-800-932-0936
FAILURE TO SUBMITE FORM RESULTS IN: Person required to file may be found guilty of a
misdemeanor and may be fined not more than $1,000.00 or imprisoned for not more than one
year, or both. Failure by a candidate to file shall be a fatal defect to petition to appear on the
ballot. Failure of a public official or employee who is required to file (or filing deficient
statement) may be penalized $25.00 per day for each day said statement is delinquent or
deficient up to $250.00.
PRIOR TO COMPLETING, ASSEMBLE THE FOLLOWING INFORMATION: List of all
current municipal officials and employees required to file (see pg. V-43).
HELPFUL HINTS: Refer to prior statements for county code reference number.
V-39
Revised July 2003