Acknowledgment of Receipt of the Summary Conflict of Interest Law

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* 1. What is your name?

First

Middle

Last

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* 2. What department / office / board / committee do you work for?

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* 3. In accordance with Massachusetts General Laws, Chapter 303 of the Acts of 1975, I have been furnished a copy of the Conflict of Interest Law.

Yes

No

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* 4. Date Received

Date

Date

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* 5. Email Address

Please submit your State Ethics Commission Online Training Receipt to the Town Clerk's Office. You can email it to townclerk@westfordma.gov