Mansfield, PA · Tioga County
2025 Act 44 Disclosure Form for Pension System Professional Services
This annual disclosure form is for contractors providing professional services to Mansfield Borough’s pension system and receiving payment from its pension fund.
What this form is
Mansfield Borough’s form collects annual disclosures from contractors providing professional services to one or more of its pension funds. It asks contractors to identify the pension plan and relevant personnel, answer questions about matters such as contributions and conflicts of interest, and provide details for affirmative answers. The form also includes a verification for an authorized contractor representative to sign and date.
Who needs it
Contractors paid by a Mansfield Borough pension fund for professional services must complete the disclosure form.
How to submit it
Return the completed form to Mansfield Borough, Attn: Casandra Cowles, Borough Manager, 14 South Main Street, Mansfield, PA 16933, or email [email protected]. The form states a December 1, 2025 submission date.
About notarization
This document is signed without a notary; the verification refers to unsworn falsification, and the authorized signer just signs and dates it.
How to submit this form
- 1
Download The Form
Download the 2025 Act 44 disclosure form for Mansfield Borough’s pension system.
- 2
Complete The Disclosure
Identify applicable pension plans, answer the questions, and provide requested details for each affirmative response.
- 3
Gather Required Attachments
Attach separate sheets with detailed answers where requested; the form also requires a municipal acknowledgment letter for a disclosed financial, commercial, or business relationship.
- 4
Sign And Submit
Have an authorized contractor representative sign and date the verification, then return the form to Mansfield Borough by the method listed on it.
Frequently asked questions
- Who must complete the Mansfield Act 44 disclosure form?
- Contractors providing professional services under contract to a Mansfield Borough pension fund and receiving payment from that fund must complete the disclosure.
- What information does the disclosure form request?
- It asks for the pension plan and service-provider information, answers to disclosure questions, details for affirmative answers, and a signed verification.
- Do I need a notary for the Mansfield Act 44 disclosure form?
- No. The document is signed without a notary; its verification refers to unsworn falsification, and the authorized signer just signs and dates it.
- How do I submit the Mansfield Act 44 disclosure form?
- The form says to return it to Mansfield Borough, Attn: Casandra Cowles, Borough Manager, at 14 South Main Street, Mansfield, PA 16933, or email [email protected].