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Nepotism & Conflict of Interest Statement Form


* Required Field

 

Employee Information

Do you have any known relatives or business associates currently employed by Cuyahoga County?

Relative/Business Associate Employed by Cuyahoga County

* Have you participated in any decision specifically to appoint, hire, promote, discipline, or discharge this relative for any position of the County?
* Do you supervise this relative in the performance of his/her official powers and duties?
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* Have you participated in any decision specifically to appoint, hire, promote, discipline, or discharge this relative for any position of the County?
* Do you supervise this relative in the performance of his/her official powers and duties?
* Add more Relatives/Business Associates?
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*Do you have business interest(s) which are or have been involved with Cuyahoga County?
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Business Interest

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Pursuant to Cuyahoga County Code Section 403.05, as a County employee you may not participate in any decision specifically to appoint, hire, promote, discipline, or discharge a relative for any position of the County, nor may you supervise a relative in the performance of their official powers and duties.

Moreover, as a County employee you shall not secure any public contract in which you, a member of your family, or any of your business associates has an interest in violation of Ohio Revised Code Section 2921.42.  Additionally, pursuant to Cuyahoga County Code Section 403.03, as a County employee you may not knowingly use your official position or official powers and duties to secure a financial or material benefit, or promise of a financial or material benefit, for you, a relative, or any private organization in which you have an interest.

Finally, pursuant to Cuyahoga County Code Section 403.04, if a matter involving the exercise of discretion comes before you or your Department, and you know or have reason to know the disposition of the matter could result in a direct financial or material benefit to you, a relative, business associate, or any private organization in which you have an interest, you shall disclose the nature of the interest to the public in an open meeting or in writing to the Agency of Inspector General, and shall recuse yourself as required by paragraph (C) of that County Code Section and the Ohio Revised Code.  You are prohibited from taking any official action, including discussing the matter in an official capacity or voting on an item, that could provide a direct financial or material benefit to you or any of the aforementioned parties.

If any of the information you provided changes, you must submit a new disclosure.

I certify that the information contained in this form is true, complete and accurate to the best of my knowledge.