Ethics Complaint Form

Complainant Information

Your Full Name

Your Email Address

Your Phone Number

Are you an ICMA Member?

YES

Tenet 3

Do you wish to be identified to the member as the complainant or remain anonymous; or are you self-reporting an ethics matter involving yourself?

Select one:

Remain Anonymous

If you wish to remain anonymous, please make sure all of your identifying information is redacted from the documentation you submit to substantiate your allegation.

Be Named as Complainant

Self Reporting

Complaint

Full name of the member whose conduct is the subject of this complaint

Member’s Position Title

Name of the member’s community

(city/county name, state/territory, and country)

Confirm this person is an ICMA Member.

YES

Confirm this person is an ICMA Member by verifying their membership status of the individual through the Who’s Who database. There will be a banner indicating “ICMA Member” for those current members. Please note many individuals have created a profile in Who’s Who but this does not necessarily mean the individual is an ICMA member.

Description: How do you specifically think this member’s conduct may have may have violated the Code?

When did this conduct occur?

Please indicate start and end dates as applicable to the situation.

Start Date

End Date

Attachments

Please provide documentation that substantiates the allegation(s) from your perspective, e.g., email threads, published articles, documents, etc. You may submit up to 3 separate documents. If you wish to remain anonymous, please make sure all of your identifying information is redacted from the documentation you submit to substantiate your allegation.

Attachment #1

One file only.
50 MB limit.
Allowed types: pdf, doc, docx, ppt, pptx.

Attachment #2

One file only.
50 MB limit.
Allowed types: pdf, doc, docx, ppt, pptx.

Attachment #3

One file only.
50 MB limit.
Allowed types: pdf, doc, docx, ppt, pptx.

Review Complaint

Please verify all the information you entered is correct before clicking “Submit.” You will not be able to edit the information after submission. You will receive a confirmation of your submission to the email address you provided on the form.