Please print this form, complete,
and mail to the following address:
GARRETT COUNTY ETHICS
COMMISSION
203 South Fourth Street - Room 207
Oakland, Maryland 21550
Name of Party Filing Complaint:
Address:
Telephone Number: (H)
(W)
Date Complaint Form Completed:
Person who is Subject of Complaint:
Applicable Section of Garrett County
Ethics Ordinance; (if known)
Brief Description of Substance of
Complaint (Continue on back if necessary):
I HEREBY AFFIRM UNDER
THE PENALTY OF PERJURY THAT THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE, INFORMATION
AND BELIEF.
Signature
STATE OF MARYLAND, COUNTY OF
, TO WIT:
I HEREBY CERTIFY that on this
day of
, before me, the subscriber, a Notary Public in and for the State and County
aforesaid, personally appeared
sign the attached Complaint.
AS WITNESS my hand and
Notarial Seal.
Notary Public
My Commission expires: