Montgomery, PA · Lycoming County
Act 44 Disclosure Form for Entities Providing Professional Services to Montgomery Borough’s Pension System
Professional services contractors complete this form to disclose information about their work for Montgomery Borough’s pension system.
What this form is
Montgomery Borough requires entities with professional services contracts for its pension system to complete this annual disclosure. The form asks about contractors, related personnel, lobbying, contributions, gifts, business relationships, and potential conflicts of interest. It also includes a verification for a participating contractor representative to sign and date.
Who needs it
Entities providing professional services to Montgomery Borough’s pension system and receiving payment from its pension fund must complete this disclosure.
How to submit it
Return the completed form to Montgomery Borough, Attn: Angelia Adams, 35 South Main Street, Montgomery, PA 17752, or email [email protected].
About notarization
This disclosure is signed and dated without a notary; its verification is an unsworn statement, and no notarized attachment is identified.
How to submit this form
- 1
Download The Form
Download the Act 44 disclosure PDF for Montgomery Borough’s pension-system professional services contractors.
- 2
Complete The Disclosure
Answer the form’s questions about the contractor, related personnel, contributions, relationships, gifts, and conflicts of interest.
- 3
Gather Any Attachments
If needed, answer items on a separate sheet and attach it; the form also calls for a municipal acknowledgment letter for a disclosed business relationship.
- 4
Sign And Return
Have a participating contractor representative sign and date the verification, then return the form to the Borough by the listed address or email.
Frequently asked questions
- Who completes the Act 44 disclosure form?
- Entities providing professional services under a contract with Montgomery Borough’s pension system and receiving payment from its pension fund complete the disclosure.
- How do I submit the Act 44 disclosure form?
- Return it to Montgomery Borough, Attn: Angelia Adams, at 35 South Main Street, Montgomery, PA 17752, or email it to [email protected].
- Do I need a notary for the Act 44 disclosure form?
- No. The form has a verification for the contractor representative to sign and date, but no notary block or notarized attachment is identified.