Financial Disclosure Statement – Form 2
PART III. GENERAL INFORMATION AND NOTICES.
The Ethics Ordinance requires the collection of this information, which will be used primarily for public
disclosure and to determine compliance with the Ethics Ordinance. The information may be presented for
review or for copying, at the requestor’s expense, upon request by any person, including officials of state, local,
or federal government, who, upon presenting proof of identification, registers their name and address, along
with the name of the person whose statement is being reviewed. The subject has the right to review, correct, and
amend the record, and the right to know who has reviewed their disclosure statement, and principal home
addresses of candidates, officers, and employees will be redacted.
Standards of Conduct
The Ethics Ordinance includes definitions and standards of conduct applicable to all financial disclosure filers
including employees and elected and appointed officials. The standards address disqualification from
participation, prohibited secondary employment, prohibited ownership interests, misuse of position, prohibited
solicitation and acceptance of gifts, misuse of confidential information, post-employment limitations, prohibited
dealings with the County, procurement specifications assistance restrictions, and other matters. The law provides
for exceptions and exemptions under certain circumstances. If you have any questions about the Ethics
Ordinance, please contact the Carroll County Ethics Commission, c/o the Office of Administrative Hearings, or
see it on the website at https://ccgovernment.carr.org/ccg/attorney/code/ .
Failure to file or report information required by the Ethics Ordinance by the due date could subject a filer to
administrative penalties of $2.00 per day up to a maximum of $250.00 and other disciplinary action, including
a civil fine of up to $5,000.00 per day by the Circuit Court for Carroll County, or any other court having
proper jurisdiction for the purpose of enforcing compliance.
PART IV. SCHEDULES A THROUGH D.
ALL FILERS MUST CHECK EITHER “YES” OR “NO” TO THE INITIALQUESTIONS IN
SCHEDULES A, B, AND C.
IF “YES” PROVIDE FURTHER DETAIL USING ADDITIONAL
SHEETS IF NECESSARY. PLEASE PRINT LEGIBLY.
INCOMPLETE OR UNSIGNED FORMS WILL BE RETURNED TO YOU
Schedule A – Ownership or interest in, or liabilities to, corporations, partnerships, limited liability
companies, limited liability partnerships, sole proprietorships, or other business entities.
To your knowledge, during the reporting period, did you or a qualified relative as defined in the Ethics Ordinance
interest of greater than 3% in, or annual
income of more than $1,000.00* from, or a financial obligation** to, a business
entity (corporation, partnership, limited
liability company (LLC), limited liability partnership (LLP), sole
proprietorship, other) that:
Was regulated, licensed by, or doing business with, your department, board, or commission; OR
Had, or was negotiating, a contract of at least $5,000.00 with Carroll County or with your department, board, or
*in the current year, three prior years, or entitled to in a future year
**excluding consumer credit accounts, e.g. “credit cards”
______ Yes _____ No (go to Schedule B)
If Yes, answer each question below. If No, go to Schedule B on page 4.