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In accordance with the Charter Township of Clinton Ethics Policy, Public Officials must complete this form in full and file it with the Human Resources Department within 30 days of taking office.
Questions should be directed to the Human Resources Department, 40700 Romeo Plank Rd., Clinton Township, MI 48038, Telephone 586-286-9341.
FORM MUST BE FILED WITH THE HUMAN RESOURCES DEPARTMENT WITHIN 30 DAYS OF TAKING OFFICE
List the name and address of each full and part-time employer(s) with which the filer currenly holds a position. Include all public and private sector employment other than your employment with Clinton Township. For the purpose of this section, an employer is one who provides you with a W-2 or 1099NEC.
List the name and address of any entity on which the filer serves as an officer, director, member, or partner, and receives compensation.
List the name and a general description of each source of income generated by the filer. The Internal Revenue Service definition of “income” for the filing of Federal tax returns is the definition of “income under this Policy. General description can include: stocks, mutual funds, bank accounts, etc.
List each business in which the filer holds a direct ownership interest worth at least 5% or $50,000.
List all real property owned by the filer located within Clinton Township and/or contiguous to the Township.
I hereby acknowledge that the information contained herein is to the best of my knowledge true, correct and complete. I further certify that I have not and will not transfer any asset or interest for the purpose of concealing it from disclosure while retaining an equitable interest therein.
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