Municipal Ethics Law Exemption Information Form
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2MARYLAND STATE ETHICS COMMISSION
rd
45 Calvert Street, 3
Floor
Annapolis, MD 21401
410-260-7770 / 1-877-669-6085
MUNICIPAL ETHICS LAW EXEMPTION INFORMATION FORM
(Form 14A)
Name of City _____________________________________________________________________
Most Recent Population (2010 Census - update) ____________________________________
Area in Square Miles ______________________________________________________________
FY Budget (Attach a copy) ________________________________________________________
Titles of all Town Elected Officials (Specify ie: Mayor, Clerk, Treasurer, etc. - if there is more than one official in a
particular title, specify the number)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Number of Authorized Full-Time Employees _____________
Number of Authorized Part-Time Employees _____________
List the general functions or services provided by the town and the name of the department or agency that provides
the function or service, if any:
1. __________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2. __________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
3._________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Ethics Commission Form 14A
October 1, 2014
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