Reeves, Mitchell-Statement of Financial Initerests- 2012 Form 1FORM 1
STATEMENT OF
FINANCIAL INTERESTS
2012
Please print or type your name, mailing
address, agency name, and position below:
JUN
FOR OFFICE USE ONLY:
LAST NAME -- FIRST NAME -- MIDDLE NAME :
Reeves, Mitchell E.
Received
1
1 7 2013
Office of City Clerk
MAILING ADDRESS :
1663 Sea Oats Drive
N/A
CITY : ZIP : COUNTY :
Atlantic Beach 32233 Duval
NAME OF AGENCY :
City of Atlantic Beach
NAME OF OFFICE OR POSITION HELD OR SOUGHT :
Mayor, Seat #1
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF m CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE
**** BOTH PARTS OF THIS SECTION MUST BE COMPLETED
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER
YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING
EITHER (must check one):
m DECEMBER 31, 2012 OR U SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR
MANNER OF CALCULATING REPORTABLE INTERESTS:
THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE
REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED
(see instructions for further details). CHECK THE ONE YOU ARE USING:
WI COMPARATIVE (PERCENTAGE) THRESHOLDS OR U DOLLAR VALUE THRESHOLDS
****
BASED ON A CALENDAR
TAX YEAR ENDING
YEAR:
DOLLAR VALUES, WHICH
ON PERCENTAGE VALUES
PART A -- PRIMARY SOURCES OF INCOME
(If you have nothing to report, you
NAME OF SOURCE
OF INCOME
[Major sources of income to the reporting person - See instructions]
must write "none" or "n/a")
SOURCE'S
ADDRESS
DESCRIPTION OF THE SOURCE'S
PRINCIPAL BUSINESS ACTIVITY
Code 3, Inc.
10986 N. Warson Road, St. Louis, MO 63114
Current Employer
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
PART B -- SECONDARY SOURCES
[Major customers, clients,
(If you have nothing to report,
NAME OF
BUSINESS ENTITY
OF INCOME
and other sources of income to businesses
write "none" or "n/a")
NAME OF MAJOR SOURCES
OF BUSINESS' INCOME
owned by the reporting person - See
ADDRESS
OF SOURCE
instructions]
PRINCIPAL BUSINESS
ACTIVITY OF SOURCE
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions]
(If you have nothing to report, you must write "none" or "n/a")
FILING
when
INSTRUCTIONS for
and where to file this
are located at the bottom
page 2.
on who must
this form and how to fill it
begin on page 3.
1663 Sea Oats Drive, Atlantic Beach, FL 32233 (Home)
form
N/A
of
N/A
INSTRUCTIONS
file
N/A
_. out
CE FORM 1 - Effective: January 1, 2013. Refer to Rule 34-8.202(1), F.A.C. (Continued on reverse side)
PAGE 1
6/.,/,3
PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions]
(If you have nothing to report, you must write "none" or "n/a")
TYPE OF INTANGIBLE
BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
401 Account
Charles Schwab Bank Custodian; Public Safety Equipment Inc.
N/A
N/A
N/A
N/A
PART E — LIABILITIES [Major debts - See instructions]
(If you have nothing to report, you must write "none" or "n/a")
NAME OF CREDITOR
ADDRESS OF CREDITOR
First Federal Bank of Florida (Home Mortgage)
P.O. Box 1807, Lake City, Florida 32056-1807
N/A
N/A
N/A
N/A
PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions]
(If you have nothing to report, you must write "none" or "n/a")
BUSINESS ENTITY # 1 BUSINESS ENTITY # 2
BUSINESS ENTITY # 3
NAME OF BUSINESS ENTITY
N/A
N/A
N/A
ADDRESS OF BUSINESS ENTITY
N/A
N/A
N/A
PRINCIPAL BUSINESS ACTIVITY
N/A
N/A
N/A
POSITION HELD WITH ENTITY
N/A
N/A
N/A
I OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
N/A
N/A
N/A
NATURE OF MY
OWNERSHIP INTEREST
N/A
N/A
N/A
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑
SIGNATURE (reauir d :
DATE SIGNED (required):
June 17, 2013
FILING INSTRUCTIONS:
WHERE TO FILE:
If you were mailed the form by the Commission
on Ethics or a County Supervisor of Elections
for your annual disclosure filing, return the
form to that location.
Local officers/employees file with the
Supervisor of Elections of the county in
which they permanently reside. (If you do not
permanently reside in Florida, file with the
Supervisor of the county where your agency
has its headquarters.)
State officers or specified state employees
file with the Commission on Ethics, P.O.
Drawer 15709, Tallahassee, FL 32317-5709.
Candidates file this form together with their
qualifying papers.
To determine what category your position falls
under, see the "Who Must File" Instructions on
page 3.
WHAT TO FILE:
After completing all parts of this form,
including signing and dating it, send back
only the first sheet (pages 1 and 2) for filing.
If you have nothing to report in a particular
section, you must write "none" or "n/a" in that
section(s).
NOTE:
MULTIPLE FILING UNNECESSARY:
Generally, a person who has filed Form 1
for a calendar or fiscal year is not required
to file a second Form 1 for the same year.
However, a candidate who previously filed
Form 1 because of another public position
must at least file a copy of his or her original
Form 1 when qualifying.
Facsimiles will not be accented.
WHEN TO FILE:
Initially, each local officer/employee,
state officer, and specified state employee
must file within 30 days of the date of
his or her appointment or of the beginning
of employment. Appointees who must be
confirmed by the Senate must file prior to
confirmation, even if that is less than 30
days from the date of their appointment.
Candidates for publicly -elected local office
must file at the same time they file their
qualifying papers.
Thereafter, local officers/employees, state
officers, and specified state employees
are required to file by July 1st following
each calendar year in which they hold their
positions.
Finally, at the end of office or employment,
each local officer/employee, state officer, and
specified state employee is required to file a
final disclosure form (Form 1 F) within 60 days
of leaving office or employment. However,
filing a CE Form 1F (Final Statement of
Financial Interests) does nit relieve the filer
of filing a CE Form 1 if he or she was in their
position on December 31, 2012.
CE FORM 1 - Effective: January 1, 2013. Refer to Rule 34-8.202 (1), F.A.C.
PAGE 2