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2. Acknowledgement of Receipt of Corporate Compliance Plan and Policies*

   
   

   Click here to review Plan:
   https://www.madisoncounty.ny.gov/DocumentCenter/View/1254/Madison-County-Corporate-Compliance-Plan

   Click here to review Policies: 
   https://www.madisoncounty.ny.gov/1554/Policies

   I, the undersigned, by checking the "I agree" box below, acknowledge that I have received copies of the Corporate Compliance Plan and related policies. I further acknowledge that I have reviewed and understand the Corporate Compliance Plan that was provided to me by Madison County. I understand it is my responsibility to comply with the plan, policies, code of conduct and all applicable federal and state laws. I also understand that I must promptly report any issues concerns or possible violations of our compliance plan, policies, or code of conduct to my supervisor or the Corporate Compliance Officer.

   1. I agree.
4. Electronic Signature*
5. Date*
   Date
7. Print Name*
8. Department*
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10. 1. Receive an email copy of this form.
11. Email address

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