This government document is issued by State Ethics Commission for use in Maryland
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https://www.google.com/url?client=internal-element-cse&cx=007821330218074952993:soh-ofbnzfm&q=https://ethics.maryland.gov/wp-content/uploads/filebase/local-gov/local-gov-forms/PGNO1.pdf&sa=U&ved=2ahUKEwiNu9fukOKGAxX49bsIHbZ3AdMQFnoECAIQAQ&usg=AOvVaw2uV-4spBsuHQrO3C34fIGE&arm=e&fexp=72519171,72519168