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the municipal secretary desktop reference manual - Southwestern ...

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FINANCIAL INTEREST STATEMENT CHECKLIST FOR THE YEAR______<br />

The following positions are required to file a Financial Interest (Ethics) Statement. Record <strong>the</strong> date<br />

on <strong>the</strong> line on <strong>the</strong> left when you’ve mailed or handed out a statement for <strong>the</strong> prior year. Check <strong>the</strong><br />

line on <strong>the</strong> right when completed forms are received. Stamp <strong>the</strong> form with a “received” stamp and<br />

record <strong>the</strong> date received. On May 1 close <strong>the</strong> file and attach this form. File with prior year’s<br />

records.<br />

SENT NAME RECEIVED<br />

Secretary/Treasurer<br />

Supervisor (Councilman)<br />

Supervisor (Councilman)<br />

Supervisor (Councilman)<br />

Supervisor (Councilman)<br />

Supervisor (Councilman)<br />

(Councilman)<br />

(Councilman)<br />

Auditor<br />

Auditor<br />

Auditor<br />

Real Estate Tax Collector<br />

Solicitor<br />

Engineer<br />

Zoning Officer<br />

Sewage Officer<br />

Alt. Sewage Officer<br />

Public Works Director<br />

Zoning Hearing Board<br />

Zoning Hearing Board<br />

Zoning Hearing Board<br />

Zoning Hearing Board<br />

Zoning Hearing Board<br />

Z.H.B. Solicitor<br />

Emerg. Mgmt.Co-ordinator<br />

Vacancy Board Chairman<br />

Constable<br />

Chief of Police<br />

Administrative Assistant<br />

Assistant Treasurer<br />

Completed by:<br />

Name and Title<br />

V-43<br />

Revised July 2003

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