Reeves- Form 1- 6-20-17FORM 1 STATEMENT OF 2016
Flims pd,a or type your man, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY:
.,.' agency name, and position n an
LAST NAME — FIRST NAME — MIDDLE NAME
Reeves Mitchell E.
MAILING ADDRESS
1663 Sea Oats Drive
Received
CITY: ZIP: COUNTY:
Atlantic Beach, Florida 32233 Duval
2 2011
JUN 0
NAME OF AGENCY'
City of Atlantic Beach
NAME OF OFFICE OR POSITION HELD OR SOUGHT:
Mayor, Seat #1 office of City clerk
You are not limited to Me spam on Me Imes on Mle form. Aaaclradditional asap, N naceeaery.
CHECK ONLY IF 5i CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE
a•.. BOTH PARTS OF THIS SECTION MUST BE COMPLETED ....
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON ACALENDAR
YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING
EITHER (must check one):
d DECEMBER 31, 2016 QR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR
MANNER OF CALCULATING REPORTABLE INTERESTS:
FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER
CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions
for further details). CHECK THE ONE YOU ARE USING (must cheek one):
iif COMPARATIVE (PERCENTAGE) THRESHOLDS QE ❑ DOLLAR VALUE THRESHOLDS
PART A — PRIMARY SOURCES OF INCOME [Major sources of iM'onle to the reporting person - See instructions)
(If you have nothing to report write "none" cr "Na")
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
G. T. Distributors
2545 Brockton Dr, Ste. 100, Austin, TX 78758
Distributor Of Polios Equipment
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
Mayor, Government Agency
Social Security Administration
P.O. Box 17775, Baltimore, Maryland, 21235
Social Security Benefits
Surfside Transportation
126 Cedar St, Neptune Beach, FL 32266
Private Car/Shuttle Service
PART B — SECONDARY SOURCES OF INCOME
[Moo customers, clients, and other sources of income to businesses owned by the reporting person - See imtnwtions]
(N you have nothing ts report, write mouse" or'n/e")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS INCOME OF SOURCE ACTIVITY OF SOURCE
None
N/A
WA
WA
None
N/A
N/A
N/A
None
N/A
WA
N/A
PART C — REAL PROPERTY [Lang buildings owned by the reporting person - See instructions)
(N you have nothing Is report, writs "none" or "Ma")
FILING INSTRUCTIONS for when
and where to file this form are
located at the bottom of page 2.
1663 Sea Oats Drive, Atlantic Beach, Florida 32233 (HOME)
INSTRUCTIONS on who must file
N/A
this form and how to fill it out
begin on page 3.
WA
CE Fon.,- Eamlm January irun n0mg Mon,mrr Wq PAGEI
Irc sun 4 reM1ryn[9. PUN u 3,", FP C.
PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructional
(N you have nothing to report, writ "none" or "Na")
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
None N/A
None N/A
PARTE — LIABILITIES [Major debts- See instructions)
(If you have nothing to mount, writ "noM' or "Ma")
NAME OF CREDITOR iADDRESS OF CREDITOR
tat Federal Bank of FI. (Home Mortgage) P.O. Box 1807, Lake City, FL 32058-1807
None I N/A
PART F— INTERESTS IN SPECIFIED BUSINESSES [Ownership or poahiom in certain types of businesses -Sea Instructions]
(N you have nothing to report, write "none" or "Na")
BUSINESS ENTITY# 1 BUSINESS ENTITY#2
NAME OF BUSINESS ENTITY Nolle Nolle
ADDRESS OF BUSINESS ENTITY WA WA
PRINCIPAL BUSINESS ACTIVITY WA WA
POSITION HELD WITH ENTITY WA WA
IOWN MORE THAN A 5% INTEREST IN THE BUSINESS WA N/A
NATURE OF MY OWNERSHIP INTEREST WA N/A
PARTG—TRAINING
For elected municipal officers required to complete annual ethics training pursuant to section 112.3102, F.S.
JJ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING.
IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑
SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY
If a certified public accountant licensed under Chapter 473, or attorney
Signature: in good standing with the Florida Bar prepared this form for you, he or
she must complete the fidlovnng statement
I. prepared the CE
Form 1 in accordance with Section 112.3145, Florida Statutes, and Uw
instructions to the term. Upon my reasonable knowledge and belief, the
disclosure herein is true and caned.
Date Signed:
CPArAbomey Sign one
SAN C-Qd Q 7
Date Signed
FILING INSTRUCTIONS:
WHAT TO FILE: WHERE TO FILE: WHEN TO FILE:
After completing all pans of this form, Including If you were mailed the form by the Commission Initially, each kcal oficedemployee, stale officer,
sionnand dating N. send back only the that on Ethics a a County Supervisor of Elections for and specified stat employee must file witldn
sheet (pages 1 and 2) for filing. your annual disclosure filing, return the forth to 30 days of the date of his or her appointment
that location. or of the beginning of employment. Appointees
If you have nothing to report in a Particular Local olecarsrempIoy", file ooh the who must tie confimled by the Senate must file
section, write "none" or "We" in that section(s). Supervisorof Elections ofthe county in which they poor to confirmation, even if that is lass than
permanaMy reside. (If you do not pamlanenly 30 days tom doe date of their appointment.
NOTE: reside in Florida, file with the Supervisor of the Candidates must file st the same time they file
MULTIPLE FILING UNNECESSARY: county where your agency has its headquarters) their qualifying papers.
ACandi snot reo file to file with withConmissing Same olReers or spechkid stat employees �rT^tlB°�B'• fik by July 1 tlkrwing each calendar
officer file ooh the Commission on Ethics, P.O. Orawer #hay hold chair positions.
or Supervisor of Elections. 15709, Tallahassee, FL 323175709; physical Riwaly, file a final cadmium form (Form IF)
address: 325 John Knox Road, Building E, Suite worst 60 days of leaving office or employment.
Facsimiles will not be arceDted. 200, Tallahassee, FL 32303. Filing a CE Form 1F(Final Statement of Financial
Candidates file this tom together with their Interesk) doss apt relieve the filer of filing a CE
Form 1 if the filer eyes in his or her position on
qualifying papers. Decanter 31, 2016.
To determine what category you position falls
under, see page 3 of instructions.
CE FORM b 1-Effbli January 1, 2017. pM3E2
NW,pa,MJ by,envY Inn a.=h), FAC