Page 1 of 3 Public Disclosure Form Suffolk County Form 22 - suffolkcountyny 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Contractor’s/Vendor’s Name, Address, City and State, and Zip Code in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Next, fill in the Contracting Department’s Name and its Address. This helps clarify which department you are working with.
4. Provide your Payee Identification or Social Security Number in the appropriate field to ensure proper processing.
5. Indicate your Type of Business by selecting one of the options: Corporation, Partnership, Sole Proprietorship, or Other.
6. Answer questions 5.a and 5.b regarding contracts with Suffolk County by checking 'Yes' or 'No' as applicable.
7. Complete the Table of Organization section by listing all principals involved. If necessary, attach an additional sheet for more names.
8. List shareholders holding more than five percent interest in your business and identify any who are also Suffolk County employees.
9. Respond to question 8 about revenue sources and prepare to submit financial statements if required.
10. Finally, ensure that an authorized officer signs the verification section at the bottom of the form before submission.

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