Form 1_2014- Financial Interests**** BOTH PARTS OF THIS SECTION MUST BE COMPLETED ****
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR
YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING
EITHER (must check one):
DECEMBER 31, 2014 OR 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:
COMPARATIVE (PERCENTAGE) THRESHOLDS OR DOLLAR VALUE THRESHOLDS
FORM 1
PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions]
(If you have nothing to report, write "none" or "n/a")
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
PART B -- SECONDARY SOURCES OF INCOME
[Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions]
(If you have nothing to report, write "none" or "n/a")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2.
INSTRUCTIONS on who must file this form and how to fill it out begin on page 3.
FOR OFFICE USE ONLY:
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions]
(If you have nothing to report, write "none" or "n/a")
CE FORM 1 - Effective: January 1, 2015 (Continued on reverse side) PAGE 1Adopted by reference in Rule 34-8.202(1), F.A.C.
NAME OF OFFICE OR POSITION HELD OR SOUGHT :
NAME OF AGENCY :
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF CANDIDATE OR NEW EMPLOYEE OR APPOINTEE
MAILING ADDRESS :
LAST NAME -- FIRST NAME -- MIDDLE NAME :
Please print or type your name, mailing
address, agency name, and position below:
CITY : ZIP : COUNTY :
STATEMENT OF
FINANCIAL INTERESTS
2014
FILING INSTRUCTIONS:
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE
PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions]
(If you have nothing to report, write "none" or "n/a") \
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
PART E — LIABILITIES [Major debts - See instructions]
(If you have nothing to report, write "none" or "n/a")
NAME OF CREDITOR ADDRESS OF CREDITOR
PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions]
(If you have nothing to report, write "none" or "n/a") BUSINESS ENTITY # 1 BUSINESS ENTITY # 2
NAME OF BUSINESS ENTITY
ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5% INTEREST IN THE BUSINESS
NATURE OF MY OWNERSHIP INTEREST
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:
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. A
candidate who files a Form 1 with a qualifying
officer is not required to file with the Commission
or Supervisor of Elections.
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; physical
address: 325 John Knox Road, Building E, Suite
200, Tallahassee, FL 32303.
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.
Facsimiles will not be accepted.
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 1F) within 60 days of leaving office or
employment. However, filing a CE Form 1F (Final
Statement of Financial Interests) does not relieve
the filer of filing a CE Form 1 if he or she was in
their position on December 31, 2014.
CE FORM 1 - Effective: January 1, 2015. PAGE 2Adopted by reference in Rule 34-8.202(1), F.A.C.
SIGNATURE OF FILER:
Signature:
____________________________________________
Date Signed:
____________________________________________
CPA or ATTORNEY SIGNATURE ONLY
If a certified public accountant licensed under Chapter 473, or
attorney in good standing with the Florida Bar prepared this
form for you, he or she must complete the following statement:
I, _______________________________________, prepared
the CE Form 1 in accordance with Section 112.3145, Florida
Statutes, and the instructions to the form. Upon my reasonable
knowledge and belief, the disclosure herein is true and correct.
CPA/Attorney Signature: ______________________________
Date Signed: _______________________________________
If your interests and gross income exceeded these thresholds, then for that business entity you must list every source of income to the business entity
which exceeded 10% of the business entity’s gross income (computed on
the basis of the business entity’s most recently completed fiscal year), the
source’s address, and the source’s principal business activity.
Examples:
— You are the sole proprietor of a dry cleaning business, from which
you received more than 10% of your gross income—an amount
that was more than $1,500. If only one customer, a uniform rental
company, provided more than 10% of your dry cleaning business, you
must list the name of the uniform rental company, its address, and its
principal business activity (uniform rentals).
— You are a 20% partner in a partnership that owns a shopping mall
and your partnership income exceeded the thresholds listed above.
You should list each tenant of the mall that provided more than 10%
of the partnership’s gross income, the tenant’s address and principal
business activity.
PART C — REAL PROPERTY
[Required by s. 112.3145(3)(a)3 or (b)3, F.S.]
In this part, list the location or description of all real property
in Florida in which you owned directly or indirectly at any time
during the previous tax year in excess of 5% of the property’s
value. You are not required to list your residences and vacation
homes.
Indirect ownership includes situations where you are a
beneficiary of a trust that owns the property, as well as situations
where you are more than a 5% partner in a partnership or
stockholder in a corporation that owns the property. The value of the property may be determined by the most recently assessed
value for tax purposes, in the absence of a more current
appraisal.
The location or description of the property should be sufficient
to enable anyone who looks at the form to identify the property. A street address should be used, if one exists.
PART D — INTANGIBLE PERSONAL PROPERTY
[Required by s. 112.3145(3)(a)3 or (b)3, F.S.]
Describe any intangible personal property that, at any time
during the disclosure period, was worth more than 10% of your
total assets, and state the business entity to which the property related. Intangible personal property includes things such as
cash on hand, stocks, bonds, certificates of deposit, vehicle
leases, interests in businesses, beneficial interests in trusts,
money owed you, Deferred Retirement Option Program (DROP)
accounts, the Florida Prepaid College Plan, and bank accounts. Intangible personal property also includes investment products
held in IRAs, brokerage accounts, and the Florida College
Investment Plan. Note that the product contained in a brokerage
account, IRA, or the Florida College Investment Plan is your
asset—not the account or plan itself. Things like automobiles and houses you own, jewelry, and paintings are not intangible
property. Intangibles relating to the same business entity may
be aggregated; for example, CD’s and savings accounts with the
same bank.
Calculations: In order to decide whether the intangible
property exceeds 10% of your total assets, you will need to total
the fair market value of all of your assets (including real property, intangible property, and tangible personal property such as jewelry,
furniture, etc.). When making this calculation, do not subtract any
liabilities (debts) that may relate to the property. Multiply the total
figure by 10% to arrive at the disclosure threshold. List only the
intangibles that exceed this threshold amount. The value of a leased vehicle is the vehicle’s present value minus the lease
residual (a number which can be found on the lease document).
Property that is only jointly owned property should be valued
according to the percentage of your joint ownership. Property
owned as tenants by the entirety or as joint tenants with right of survivorship should be valued at 100%. None of your calculations
or the value of the property have to be disclosed on the form.
Example:
You own 50% of the stock of a small corporation that is
worth $100,000, the estimated fair market value of your home
and other property (bank accounts, automobile, furniture, etc.) is $200,000. As your total assets are worth $250,000, you must
disclose intangibles worth over $25,000. Since the value of the
stock exceeds this threshold, you should list “stock” and the name
of the corporation. If your accounts with a particular bank exceed
$25,000, you should list “bank accounts” and bank’s name.
PART E — LIABILITIES
[Required by s. 112.3145(3)(a)4 or (b)4, F.S.]
List the name and address of each creditor to whom you owed any
amount that, at any time during the disclosure period, exceeded your
net worth. You are not required to list the amount of any debt or your
net worth. You do not have to disclose: credit card and retail installment
accounts, taxes owed (unless reduced to a judgment), indebtedness on
a life insurance policy owed to the company of issuance, or contingent
liabilities. A “contingent liability” is one that will become an actual liability
only when one or more future events occur or fail to occur, such as where
you are liable only as a guarantor, surety, or endorser on a promissory
note. If you are a “co-maker” and have signed as being jointly liable or
jointly and severally liable, then this is not a contingent liability.
Calculations: In order to decide whether the debt exceeds your net worth, you will need to total all of your liabilities (including promissory
notes, mortgages, credit card debts, judgments against you, etc.). The
amount of the liability of a vehicle lease is the sum of any past-due
payments and all unpaid prospective lease payments. Subtract the sum
total of your liabilities from the value of all your assets as calculated above for Part D. This is your “net worth.” You must list on the form each
creditor to whom your debt exceeded this amount unless it is one of the
types of indebtedness listed in the paragraph above (credit card and retail
installment accounts, etc.). Joint liabilities with others for which you are
“jointly and severally liable,” meaning that you may be liable for either your part or the whole of the obligation, should be included in your calculations
at 100% of the amount owed.
Examples:
— You owe $15,000 to a bank for student loans, $5,000 for credit card debts, and $60,000 (with spouse) to a savings and loan for
a home mortgage. Your home (owned by you and your spouse) is
worth $80,000 and your other property is worth $20,000. Since your
net worth is $20,000 ($100,000 minus $80,000), you must report only
the name and address of the savings and loan.
PART F — INTERESTS IN SPECIFIED BUSINESSES
[Required by s. 112.3145(5), F.S.]
The types of businesses covered in this disclosure include: state and
federally chartered banks; state and federal savings and loan associations;
cemetery companies; insurance companies; mortgage companies; credit
unions; small loan companies; alcoholic beverage licensees; pari-mutuel
wagering companies, utility companies, entities controlled by the Public
Service Commission; and entities granted a franchise to operate by either
a city or a county government.
You are required to disclose in this part of the form the fact that
you owned during the disclosure period an interest in, or held any of
certain positions with, particular types of businesses listed above. You
are required to make this disclosure if you own or owned (either directly
or indirectly in the form of an equitable or beneficial interest) at any time
during the disclosure period more than 5% of the total assets or capital
stock of one of the types of business entities listed above. You also must
complete this part of the form for each of these types of businesses
for which you are, or were at any time during the disclosure period, an
officer, director, partner, proprietor, or agent (other than a resident agent
solely for service of process).
If you have or held such a position or ownership interest in one
of these types of businesses, list the name of the business, its address
and principal business activity, and the position held with the business (if
any). If you own(ed) more than a 5% interest in the business, you must
indicate that fact and describe the nature of your interest.
(End of Percentage Thresholds Instructions.)
NOTICE
Annual Statements of Financial Interests are due July 1. If the annual form is not filed or postmarked by September 1, an
automatic fine of $25 for each day late will be imposed, up to a maximum penalty of $1,500. [s. 112.3145, F.S. - applicable to non-
judicial officials] Failure to file also can result in removal from public office or employment. [Ch. 2014-183, Laws of Florida]
In addition, failure to make any required disclosure constitutes grounds for and may be punished by one or more of the following:
disqualification from being on the ballot, impeachment, removal, or suspension from office or employment, demotion, reduction
in salary, reprimand, or a civil penalty not exceeding $10,000. [s. 112.317, F.S.]
1) Elected public officials not serving in a political subdivision of the
state and any person appointed to fill a vacancy in such office, unless
required to file full disclosure on Form 6.
2) Appointed members of each board, commission, authority, or
council having statewide jurisdiction, excluding members of solely advisory
bodies, but including judicial nominating commission members; Directors
of Enterprise Florida, Scripps Florida Funding Corporation, and Workforce
Florida; and members of the Council on the Social Status of Black Men
and Boys; the Executive Director, Governors, and senior managers of
Citizens Property Insurance Corporation; Governors and senior managers
of Florida Workers' Compensation Joint Underwriting Association; board
members of the Northeast Fla. Regional Transportation Commission;
members of the board of Triumph Gulf Coast, Inc; members of the board
of Florida Is For Veterans, Inc.; and members of the Technology Advisory
Council within the Agency for State Technology.
3) The Commissioner of Education, members of the State Board of
Education, the Board of Governors, and the local Boards of Trustees and
Presidents of state universities.
4) Persons elected to office in any political subdivision (such as
municipalities, counties, and special districts) and any person appointed
to fill a vacancy in such office, unless required to file Form 6.
5) Appointed members of the following boards, councils,
commissions, authorities, or other bodies of county, municipality, school
district, independent special district, or other political subdivision: the
governing body of the subdivision; community college or junior college
district boards of trustees; boards having the power to enforce local code
provisions; boards of adjustment; planning or zoning boards having the
power to recommend, create, or modify land planning or zoning within
a political subdivision, except for citizen advisory committees, technical
coordinating committees, and similar groups who only have the power
to make recommendations to planning or zoning boards; pension or
retirement boards empowered to invest pension or retirement funds
or determine entitlement to or amount of pensions or other retirement
benefits.
6) Any appointed member of a local government board who is
required to file a statement of financial interests by the appointing authority
or the enabling legislation, ordinance, or resolution creating the board.
7) Persons holding any of these positions in local government:
mayor; county or city manager; chief administrative employee or finance
director of a county, municipality, or other political subdivision; county or
municipal attorney; chief county or municipal building inspector; county
or municipal water resources coordinator; county or municipal pollution
control director; county or municipal environmental control director; county
or municipal administrator with power to grant or deny a land development
permit; chief of police; fire chief; municipal clerk; appointed district school
superintendent; community college president; district medical examiner;
purchasing agent (regardless of title) having the authority to make any
purchase exceeding $20,000 for the local governmental unit.
8) Officers and employees of entities serving as chief administrative
officer of a political subdivision.
9) Members of governing boards of charter schools operated by a
city or other public entity.
10) Employees in the office of the Governor or of a Cabinet member
who are exempt from the Career Service System, excluding secretarial,
clerical, and similar positions.
11) The following positions in each state department, commission,
board, or council: Secretary, Assistant or Deputy Secretary, Executive
Director, Assistant or Deputy Executive Director, and anyone having the
power normally conferred upon such persons, regardless of title.
12) The following positions in each state department or division:
Director, Assistant or Deputy Director, Bureau Chief, Assistant Bureau
Chief, and any person having the power normally conferred upon such
persons, regardless of title.
13) Assistant State Attorneys, Assistant Public Defenders, criminal
conflict and civil regional counsel, and assistant criminal conflict and civil
regional counsel, Public Counsel, full-time state employees serving as
counsel or assistant counsel to a state agency, administrative law judges,
and hearing officers.
14) The Superintendent or Director of a state mental health institute
established for training and research in the mental health field, or any
major state institution or facility established for corrections, training,
treatment, or rehabilitation.
15) State agency Business Managers, Finance and Accounting
Directors, Personnel Officers, Grant Coordinators, and purchasing agents
(regardless of title) with power to make a purchase exceeding $20,000.
16) The following positions in legislative branch agencies: each
employee (other than those employed in maintenance, clerical,
secretarial, or similar positions and legislative assistants exempted
by the presiding officer of their house); and each employee of the
Commission on Ethics.
INSTRUCTIONS FOR COMPLETING FORM 1:
INTRODUCTORY INFORMATION (At Top of Form):
If your name, mailing address, public agency, and position are already printed on the form, you do not need to provide this information unless it should be changed. To change any of this information, write the correct information on the form, and contact your agency's financial disclosure coordinator. Your coordinator is identified in the financial disclosure portal on the Commission on Ethics website: www.ethics.
state.fl.us.
NAME OF AGENCY: This should be the name of the governmental unit which you serve or served, by which you are or were employed,
or for which you are a candidate.
OFFICE OR POSITION HELD OR SOUGHT: Use the title of the office or position you hold, are seeking, or held during the disclosure period even if you have since left that position. If you are a candidate for office or are a new employee or appointee, check the appropriate box.
PUBLIC RECORD: The disclosure form and everything attached to it
is a public record. Your Social Security Number is not required and you
should redact it from any documents you file. If you are an active or
former officer or employee listed in Section 119.071(4)(d), F.S., whose
home address is exempt from disclosure, the Commission is required to
maintain the confidentiality of your home address if you submit a written
request for confidentiality. Persons listed in Section 119.071(4)(d), F.S.,
are encouraged to provide an address other than their home address.
DISCLOSURE PERIOD: The tax year for most individuals is the
calendar year (January 1 through December 31). If that is the case
for you, then your financial interests should be reported for the
calendar year 2014; just check the box and you do not need to add
any information in this part of the form. However, if you file your IRS
tax return based on a tax year that is not the calendar year, you
should specify the dates of your tax year in this portion of the form
and check the appropriate box. This is the time frame or "disclosure
period" for your report.
WHO MUST FILE FORM 1:
CE FORM 1 - Effective: January 1, 2015. Adopted by reference in Rule 34-8.202(1), F.A.C. PAGE 6 CE FORM 1 - Effective: January 1, 2015. Adopted by reference in Rule 34-8.202(1), F.A.C. PAGE 3
PART A — PRIMARY SOURCES OF INCOME
[Required by s. 112.3145(3)(a)1 or (b)1, F.S.]
Part A is intended to require the disclosure of your principal sources
of income during the disclosure period. You do not have to disclose the
amount of income received, and you need not list your public salary from
serving in the position(s) which requires you to file this form. The income
of your spouse need not be disclosed; however, if there is joint income
to you and your spouse from property you own jointly (such as interest
or dividends from a bank account or stocks), you should disclose the
source of that income if it exceeded the threshold.
Please list in this part of the form the name, address, and principal
business activity of each source of your income which exceeded $2,500
of gross income received by you in your own name or by any other
person for your use or benefit.
"Gross income" means the same as it does for income tax
purposes, even if the income is not actually taxable, such as interest
on tax-free bonds. Examples include: compensation for services,
income from business, gains from property dealings, interest, rents,
dividends, pensions, IRA distributions, social security, distributive share of partnership gross income, and alimony, but not child support.
Examples:
— If you were employed by a company that manufactures
computers and received more than $2,500, then you should list the
name of the company, its address, and its principal business activity
(computer manufacturing).
— If you were a partner in a law firm and your distributive share
of partnership gross income exceeded $2,500, then you should list
the name of the firm, its address, and its principal business activity
(practice of law).
— If you were the sole proprietor of a retail gift business and your
gross income from the business exceeded $2,500, then you should
list the name of the business, its address, and its principal business
activity (retail gift sales).
— If you received income from investments in stocks and bonds,
you are required to list only each individual company from which
you derived more than $2,500, rather than aggregating all of your
investment income.
— If more than $2,500 of your gross income was gain from the
sale of property (not just the selling price), then you should list as
a source of income the name of the purchaser, the purchaser’s
address, and the purchaser’s principal business activity. If the
purchaser’s identity is unknown, such as where securities listed
on an exchange are sold through a brokerage firm, the source
of income should be listed simply as "sale of (name of company)
stock," for example.
— If more than $2,500 of your gross income was in the form of
interest from one particular financial institution (aggregating interest
from all CD’s, accounts, etc., at that institution), list the name of the
institution, its address, and its principal business activity.
PART B — SECONDARY SOURCES OF INCOME
[Required by s. 112.3145(3)(a)2 or (b)2, F.S.]
This part is intended to require the disclosure of major customers, clients,
and other sources of income to businesses in which you own an interest. It
is not for reporting income from second jobs. That kind of income should be
reported as "Primary Sources of Income," if it meets the reporting threshold.
You will not have anything to report unless, during the disclosure period:
(1) You owned (either directly or indirectly in the form of an equitable or
beneficial interest) during the disclosure period more than 5% of the total
assets or capital stock of a business entity (a corporation, partnership,
LLC, limited partnership, proprietorship, joint venture, trust, firm, etc.,
doing business in Florida); and
(2) You received more than $5,000 of your gross income during the
disclosure period from that business entity.
If your interests and gross income exceeded these thresholds, then for that
business entity you must list every source of income to the business entity
which exceeded 10% of the business entity’s gross income (computed on
the basis of the business entity's most recently completed fiscal year), the source’s address, and the source's principal business activity.
Examples:
— You are the sole proprietor of a dry cleaning business, from which
you received more than $5,000. If only one customer, a uniform rental
company, provided more than 10% of your dry cleaning business, you
must list the name of the uniform rental company, its address, and its
principal business activity (uniform rentals).
— You are a 20% partner in a partnership that owns a shopping mall
and your partnership income exceeded the thresholds listed above. You
should list each tenant of the mall that provided more than 10% of the
partnership's gross income, the tenant's address and principal business
activity.
PART C — REAL PROPERTY
[Required by s. 112.3145(3)(a)3 or (b)3, F.S.]
In this part, list the location or description of all real property in Florida
in which you owned directly or indirectly at any time during the previous tax
year in excess of 5% of the property’s value. You are not required to list your
residences and vacation homes.
Indirect ownership includes situations where you are a beneficiary of a
trust that owns the property, as well as situations where you are more than
a 5% partner in a partnership or stockholder in a corporation that owns the property. The value of the property may be determined by the most recently
assessed value for tax purposes, in the absence of a more current appraisal.
The location or description of the property should be sufficient to enable
anyone who looks at the form to identify the property. A street address should
be used, if one exists.
PART D — INTANGIBLE PERSONAL PROPERTY
[Required by s. 112.3145(3)(a)3 or (b)3, F.S.]
Describe any intangible personal property that, at any time during the
disclosure period, was worth more than $10,000 and state the business
entity to which the property related. Intangible personal property includes
things such as cash on hand, stocks, bonds, certificates of deposit, vehicle
leases, interests in businesses, beneficial interests in trusts, money owed
you, Deferred Retirement Option Program (DROP) accounts, the Florida
Prepaid College Plan, and bank accounts. Intangible personal property
also includes investment products held in IRAs, brokerage accounts, and
the Florida College Investment Plan. Note that the product contained in
a brokerage account, IRA, or the Florida College Investment Plan is your
asset—not the account or plan itself. Things like automobiles and houses
you own, jewelry, and paintings are not intangible property. Intangibles
relating to the same business entity may be aggregated; for example, CDs
and savings accounts with the same bank. Property owned as tenants by
the entirety or as joint tenants with right of survivorship should be valued at
100%. The value of a leased vehicle is the vehicle’s present value minus the
lease residual (a number found on the lease document).
PART E — LIABILITIES
[Required by s. 112.3145(3)(a)4 or (b)4, F.S.]
List the name and address of each creditor to whom you owed
more than $10,000 at any time during the disclosure period. The
amount of the liability of a vehicle lease is the sum of any past-
due payments and all unpaid prospective lease payments. You
are not required to list the amount of any debt. You do not have
to disclose credit card and retail installment accounts, taxes owed
(unless reduced to a judgment), indebtedness on a life insurance
policy owed to the company of issuance, or contingent liabilities.
A “contingent liability” is one that will become an actual liability
only when one or more future events occur or fail to occur, such
as where you are liable only as a guarantor, surety, or endorser
on a promissory note. If you are a “co-maker” and have signed as
being jointly liable or jointly and severally liable, then this is not a
contingent liability.
PART F — INTERESTS IN SPECIFIED BUSINESSES
[Required by s. 112.3145(5), F.S.]
The types of businesses covered in this disclosure include: state
and federally chartered banks; state and federal savings and loan
associations; cemetery companies; insurance companies; mortgage
companies; credit unions; small loan companies; alcoholic beverage
licensees; pari-mutuel wagering companies, utility companies,
entities controlled by the Public Service Commission; and entities
granted a franchise to operate by either a city or a county
government.
You are required to disclose in this part of the form the fact that
you owned during the disclosure period an interest in, or held any
of certain positions with, particular types of businesses listed above.
You are required to make this disclosure if you own or owned (either
directly or indirectly in the form of an equitable or beneficial interest)
at any time during the disclosure period more than 5% of the total
assets or capital stock of one of the types of business entities listed
above. You also must complete this part of the form for each of these
types of businesses for which you are, or were at any time during
the disclosure period, an officer, director, partner, proprietor, or agent
(other than a resident agent solely for service of process).
If you have or held such a position or ownership interest in
one of these types of businesses, list the name of the business, its
address and principal business activity, and the position held with
the business (if any). If you own(ed) more than a 5% interest in the
business, you must indicate that fact and describe the nature of your
interest.
(End of Dollar Value Thresholds Instructions.)
PART A — PRIMARY SOURCES OF INCOME
[Required by s. 112.3145(3)(a)1 or (b)1, F.S.]
Part A is intended to require the disclosure of your principal
sources of income during the disclosure period. You do not have
to disclose the amount of income received, and you need not list
your public salary received from serving in the position(s) which
requires you to file this form, but this amount should be included
when calculating your gross income for the disclosure period. The
income of your spouse need not be disclosed; however, if there is
joint income to you and your spouse from property you own jointly (such as interest or dividends from a bank account or stocks), you should include all of that income when calculating your gross income and disclose the source of that income if it exceeded the threshold.
Please list in this part of the form the name, address, and principal business activity of each source of your income which
exceeded 5% of the gross income received by you in your own
name or by any other person for your benefit or use during the
disclosure period.
"Gross income" means the same as it does for income tax
purposes, even if the income is not actually taxable, such as interest
on tax-free bonds. Examples include: compensation for services,
income from business, gains from property dealings, interest, rents, dividends, pensions, IRA distributions, social security, distributive share of partnership gross income, and alimony, but not child support.
Examples:
— If you were employed by a company that manufactures
computers and received more than 5% of your gross income
(salary, commissions, etc.) from the company, you should list
the name of the company, its address, and its principal business
activity (computer manufacturing).
— If you were a partner in a law firm and your distributive
share of partnership gross income exceeded 5% of your gross
income, then you should list the name of the firm, its address, and its principal business activity (practice of law).
— If you were the sole proprietor of a retail gift business and your gross income from the business exceeded 5% of
your total gross income, then you should list the name of the business, its address, and its principal business activity (retail gift sales).
— If you received income from investments in stocks and
bonds, you are required to list only each individual company
from which you derived more than 5% of your gross income,
rather than aggregating all of your investment income.
— If more than 5% of your gross income was gain from the sale
of property (not just the selling price), then you should list as a
source of income the name of the purchaser, the purchaser’s
address, and the purchaser's principal business activity. If the purchaser's identity is unknown, such as where securities listed on an exchange are sold through a brokerage firm, the source of income should be listed as "sale of (name of company) stock," for example.
— If more than 5% of your gross income (or, alternatively,
$2,500) was in the form of interest from one particular financial
institution (aggregating interest from all CD’s, accounts, etc., at
that institution), list the name of the institution, its address, and
its principal business activity.
PART B — SECONDARY SOURCES OF INCOME
[Required by s. 112.3145(3)(a)2 or (b)2, F.S.]
This part is intended to require the disclosure of major customers, clients, and other sources of income to businesses in which you own an interest. It is not for reporting income from second jobs. That kind
of income should be reported as a "Primary Source of Income," if it
meets the reporting threshold. You will not have anything to report
unless during the disclosure period:
(1) You owned (either directly or indirectly in the form of an equitable or beneficial interest) more than 5% of the total assets or capital stock of a business entity (a corporation, partnership,
LLC, limited partnership, proprietorship, joint venture, trust, firm,
etc., doing business in Florida); and
(2) You received more than 10% of your gross income from that business entity; and
(3) You received more than $1,500 in gross income from that
business entity.
As noted on the form, filers have the option of reporting based on either thresholds that are comparative (usually, based on percentage
values) or thresholds that are based on absolute dollar values. The instructions on the following pages specifically describe the
different thresholds. Check the box that reflects the choice you have made. You must use the type of threshold you have chosen for
each part of the form. In other words, if you choose to report based on absolute dollar value thresholds, you cannot use a percentage
threshold on any part of the form.
MANNER OF CALCULATING REPORTABLE INTEREST
IF YOU HAVE CHOSEN DOLLAR VALUE THRESHOLDS
THE FOLLOWING INSTRUCTIONS APPLY
IF YOU HAVE CHOSEN COMPARATIVE (PERCENTAGE) THRESHOLDS
THE FOLLOWING INSTRUCTIONS APPLY
CE FORM 1 - Effective: January 1, 2015. Adopted by reference in Rule 34-8.202(1), F.A.C. PAGE 5CE FORM 1 - Effective: January 1, 2015. Adopted by reference in Rule 34-8.202(1), F.A.C.. PAGE 4
PART A — PRIMARY SOURCES OF INCOME
[Required by s. 112.3145(3)(a)1 or (b)1, F.S.]
Part A is intended to require the disclosure of your principal sources
of income during the disclosure period. You do not have to disclose the
amount of income received, and you need not list your public salary from
serving in the position(s) which requires you to file this form. The income
of your spouse need not be disclosed; however, if there is joint income
to you and your spouse from property you own jointly (such as interest
or dividends from a bank account or stocks), you should disclose the
source of that income if it exceeded the threshold.
Please list in this part of the form the name, address, and principal
business activity of each source of your income which exceeded $2,500
of gross income received by you in your own name or by any other
person for your use or benefit.
"Gross income" means the same as it does for income tax
purposes, even if the income is not actually taxable, such as interest
on tax-free bonds. Examples include: compensation for services,
income from business, gains from property dealings, interest, rents,
dividends, pensions, IRA distributions, social security, distributive share of partnership gross income, and alimony, but not child support.
Examples:
— If you were employed by a company that manufactures
computers and received more than $2,500, then you should list the
name of the company, its address, and its principal business activity
(computer manufacturing).
— If you were a partner in a law firm and your distributive share
of partnership gross income exceeded $2,500, then you should list
the name of the firm, its address, and its principal business activity
(practice of law).
— If you were the sole proprietor of a retail gift business and your
gross income from the business exceeded $2,500, then you should
list the name of the business, its address, and its principal business
activity (retail gift sales).
— If you received income from investments in stocks and bonds,
you are required to list only each individual company from which
you derived more than $2,500, rather than aggregating all of your
investment income.
— If more than $2,500 of your gross income was gain from the
sale of property (not just the selling price), then you should list as
a source of income the name of the purchaser, the purchaser’s
address, and the purchaser’s principal business activity. If the
purchaser’s identity is unknown, such as where securities listed
on an exchange are sold through a brokerage firm, the source
of income should be listed simply as "sale of (name of company)
stock," for example.
— If more than $2,500 of your gross income was in the form of
interest from one particular financial institution (aggregating interest
from all CD’s, accounts, etc., at that institution), list the name of the
institution, its address, and its principal business activity.
PART B — SECONDARY SOURCES OF INCOME
[Required by s. 112.3145(3)(a)2 or (b)2, F.S.]
This part is intended to require the disclosure of major customers, clients,
and other sources of income to businesses in which you own an interest. It
is not for reporting income from second jobs. That kind of income should be
reported as "Primary Sources of Income," if it meets the reporting threshold.
You will not have anything to report unless, during the disclosure period:
(1) You owned (either directly or indirectly in the form of an equitable or
beneficial interest) during the disclosure period more than 5% of the total
assets or capital stock of a business entity (a corporation, partnership,
LLC, limited partnership, proprietorship, joint venture, trust, firm, etc.,
doing business in Florida); and
(2) You received more than $5,000 of your gross income during the
disclosure period from that business entity.
If your interests and gross income exceeded these thresholds, then for that
business entity you must list every source of income to the business entity
which exceeded 10% of the business entity’s gross income (computed on
the basis of the business entity's most recently completed fiscal year), the source’s address, and the source's principal business activity.
Examples:
— You are the sole proprietor of a dry cleaning business, from which
you received more than $5,000. If only one customer, a uniform rental
company, provided more than 10% of your dry cleaning business, you
must list the name of the uniform rental company, its address, and its
principal business activity (uniform rentals).
— You are a 20% partner in a partnership that owns a shopping mall
and your partnership income exceeded the thresholds listed above. You
should list each tenant of the mall that provided more than 10% of the
partnership's gross income, the tenant's address and principal business
activity.
PART C — REAL PROPERTY
[Required by s. 112.3145(3)(a)3 or (b)3, F.S.]
In this part, list the location or description of all real property in Florida
in which you owned directly or indirectly at any time during the previous tax
year in excess of 5% of the property’s value. You are not required to list your
residences and vacation homes.
Indirect ownership includes situations where you are a beneficiary of a
trust that owns the property, as well as situations where you are more than
a 5% partner in a partnership or stockholder in a corporation that owns the property. The value of the property may be determined by the most recently
assessed value for tax purposes, in the absence of a more current appraisal.
The location or description of the property should be sufficient to enable
anyone who looks at the form to identify the property. A street address should
be used, if one exists.
PART D — INTANGIBLE PERSONAL PROPERTY
[Required by s. 112.3145(3)(a)3 or (b)3, F.S.]
Describe any intangible personal property that, at any time during the
disclosure period, was worth more than $10,000 and state the business
entity to which the property related. Intangible personal property includes
things such as cash on hand, stocks, bonds, certificates of deposit, vehicle
leases, interests in businesses, beneficial interests in trusts, money owed
you, Deferred Retirement Option Program (DROP) accounts, the Florida
Prepaid College Plan, and bank accounts. Intangible personal property
also includes investment products held in IRAs, brokerage accounts, and
the Florida College Investment Plan. Note that the product contained in
a brokerage account, IRA, or the Florida College Investment Plan is your
asset—not the account or plan itself. Things like automobiles and houses
you own, jewelry, and paintings are not intangible property. Intangibles
relating to the same business entity may be aggregated; for example, CDs
and savings accounts with the same bank. Property owned as tenants by
the entirety or as joint tenants with right of survivorship should be valued at
100%. The value of a leased vehicle is the vehicle’s present value minus the
lease residual (a number found on the lease document).
PART E — LIABILITIES
[Required by s. 112.3145(3)(a)4 or (b)4, F.S.]
List the name and address of each creditor to whom you owed
more than $10,000 at any time during the disclosure period. The
amount of the liability of a vehicle lease is the sum of any past-
due payments and all unpaid prospective lease payments. You
are not required to list the amount of any debt. You do not have
to disclose credit card and retail installment accounts, taxes owed
(unless reduced to a judgment), indebtedness on a life insurance
policy owed to the company of issuance, or contingent liabilities.
A “contingent liability” is one that will become an actual liability
only when one or more future events occur or fail to occur, such
as where you are liable only as a guarantor, surety, or endorser
on a promissory note. If you are a “co-maker” and have signed as
being jointly liable or jointly and severally liable, then this is not a
contingent liability.
PART F — INTERESTS IN SPECIFIED BUSINESSES
[Required by s. 112.3145(5), F.S.]
The types of businesses covered in this disclosure include: state
and federally chartered banks; state and federal savings and loan
associations; cemetery companies; insurance companies; mortgage
companies; credit unions; small loan companies; alcoholic beverage
licensees; pari-mutuel wagering companies, utility companies,
entities controlled by the Public Service Commission; and entities
granted a franchise to operate by either a city or a county
government.
You are required to disclose in this part of the form the fact that
you owned during the disclosure period an interest in, or held any
of certain positions with, particular types of businesses listed above.
You are required to make this disclosure if you own or owned (either
directly or indirectly in the form of an equitable or beneficial interest)
at any time during the disclosure period more than 5% of the total
assets or capital stock of one of the types of business entities listed
above. You also must complete this part of the form for each of these
types of businesses for which you are, or were at any time during
the disclosure period, an officer, director, partner, proprietor, or agent
(other than a resident agent solely for service of process).
If you have or held such a position or ownership interest in
one of these types of businesses, list the name of the business, its
address and principal business activity, and the position held with
the business (if any). If you own(ed) more than a 5% interest in the
business, you must indicate that fact and describe the nature of your
interest.
(End of Dollar Value Thresholds Instructions.)
PART A — PRIMARY SOURCES OF INCOME
[Required by s. 112.3145(3)(a)1 or (b)1, F.S.]
Part A is intended to require the disclosure of your principal
sources of income during the disclosure period. You do not have
to disclose the amount of income received, and you need not list
your public salary received from serving in the position(s) which
requires you to file this form, but this amount should be included
when calculating your gross income for the disclosure period. The
income of your spouse need not be disclosed; however, if there is
joint income to you and your spouse from property you own jointly (such as interest or dividends from a bank account or stocks), you should include all of that income when calculating your gross income and disclose the source of that income if it exceeded the threshold.
Please list in this part of the form the name, address, and principal business activity of each source of your income which
exceeded 5% of the gross income received by you in your own
name or by any other person for your benefit or use during the
disclosure period.
"Gross income" means the same as it does for income tax
purposes, even if the income is not actually taxable, such as interest
on tax-free bonds. Examples include: compensation for services,
income from business, gains from property dealings, interest, rents, dividends, pensions, IRA distributions, social security, distributive share of partnership gross income, and alimony, but not child support.
Examples:
— If you were employed by a company that manufactures
computers and received more than 5% of your gross income
(salary, commissions, etc.) from the company, you should list
the name of the company, its address, and its principal business
activity (computer manufacturing).
— If you were a partner in a law firm and your distributive
share of partnership gross income exceeded 5% of your gross
income, then you should list the name of the firm, its address, and its principal business activity (practice of law).
— If you were the sole proprietor of a retail gift business and your gross income from the business exceeded 5% of
your total gross income, then you should list the name of the business, its address, and its principal business activity (retail gift sales).
— If you received income from investments in stocks and
bonds, you are required to list only each individual company
from which you derived more than 5% of your gross income,
rather than aggregating all of your investment income.
— If more than 5% of your gross income was gain from the sale
of property (not just the selling price), then you should list as a
source of income the name of the purchaser, the purchaser’s
address, and the purchaser's principal business activity. If the purchaser's identity is unknown, such as where securities listed on an exchange are sold through a brokerage firm, the source of income should be listed as "sale of (name of company) stock," for example.
— If more than 5% of your gross income (or, alternatively,
$2,500) was in the form of interest from one particular financial
institution (aggregating interest from all CD’s, accounts, etc., at
that institution), list the name of the institution, its address, and
its principal business activity.
PART B — SECONDARY SOURCES OF INCOME
[Required by s. 112.3145(3)(a)2 or (b)2, F.S.]
This part is intended to require the disclosure of major customers, clients, and other sources of income to businesses in which you own an interest. It is not for reporting income from second jobs. That kind
of income should be reported as a "Primary Source of Income," if it
meets the reporting threshold. You will not have anything to report
unless during the disclosure period:
(1) You owned (either directly or indirectly in the form of an equitable or beneficial interest) more than 5% of the total assets or capital stock of a business entity (a corporation, partnership,
LLC, limited partnership, proprietorship, joint venture, trust, firm,
etc., doing business in Florida); and
(2) You received more than 10% of your gross income from that business entity; and
(3) You received more than $1,500 in gross income from that
business entity.
As noted on the form, filers have the option of reporting based on either thresholds that are comparative (usually, based on percentage
values) or thresholds that are based on absolute dollar values. The instructions on the following pages specifically describe the
different thresholds. Check the box that reflects the choice you have made. You must use the type of threshold you have chosen for
each part of the form. In other words, if you choose to report based on absolute dollar value thresholds, you cannot use a percentage
threshold on any part of the form.
MANNER OF CALCULATING REPORTABLE INTEREST
IF YOU HAVE CHOSEN DOLLAR VALUE THRESHOLDS
THE FOLLOWING INSTRUCTIONS APPLY
IF YOU HAVE CHOSEN COMPARATIVE (PERCENTAGE) THRESHOLDS
THE FOLLOWING INSTRUCTIONS APPLY
CE FORM 1 - Effective: January 1, 2015. Adopted by reference in Rule 34-8.202(1), F.A.C. PAGE 5CE FORM 1 - Effective: January 1, 2015. Adopted by reference in Rule 34-8.202(1), F.A.C.. PAGE 4
If your interests and gross income exceeded these thresholds, then for that business entity you must list every source of income to the business entity
which exceeded 10% of the business entity’s gross income (computed on
the basis of the business entity’s most recently completed fiscal year), the
source’s address, and the source’s principal business activity.
Examples:
— You are the sole proprietor of a dry cleaning business, from which
you received more than 10% of your gross income—an amount
that was more than $1,500. If only one customer, a uniform rental
company, provided more than 10% of your dry cleaning business, you
must list the name of the uniform rental company, its address, and its
principal business activity (uniform rentals).
— You are a 20% partner in a partnership that owns a shopping mall
and your partnership income exceeded the thresholds listed above.
You should list each tenant of the mall that provided more than 10%
of the partnership’s gross income, the tenant’s address and principal
business activity.
PART C — REAL PROPERTY
[Required by s. 112.3145(3)(a)3 or (b)3, F.S.]
In this part, list the location or description of all real property
in Florida in which you owned directly or indirectly at any time
during the previous tax year in excess of 5% of the property’s
value. You are not required to list your residences and vacation
homes.
Indirect ownership includes situations where you are a
beneficiary of a trust that owns the property, as well as situations
where you are more than a 5% partner in a partnership or
stockholder in a corporation that owns the property. The value of the property may be determined by the most recently assessed
value for tax purposes, in the absence of a more current
appraisal.
The location or description of the property should be sufficient
to enable anyone who looks at the form to identify the property. A street address should be used, if one exists.
PART D — INTANGIBLE PERSONAL PROPERTY
[Required by s. 112.3145(3)(a)3 or (b)3, F.S.]
Describe any intangible personal property that, at any time
during the disclosure period, was worth more than 10% of your
total assets, and state the business entity to which the property related. Intangible personal property includes things such as
cash on hand, stocks, bonds, certificates of deposit, vehicle
leases, interests in businesses, beneficial interests in trusts,
money owed you, Deferred Retirement Option Program (DROP)
accounts, the Florida Prepaid College Plan, and bank accounts. Intangible personal property also includes investment products
held in IRAs, brokerage accounts, and the Florida College
Investment Plan. Note that the product contained in a brokerage
account, IRA, or the Florida College Investment Plan is your
asset—not the account or plan itself. Things like automobiles and houses you own, jewelry, and paintings are not intangible
property. Intangibles relating to the same business entity may
be aggregated; for example, CD’s and savings accounts with the
same bank.
Calculations: In order to decide whether the intangible
property exceeds 10% of your total assets, you will need to total
the fair market value of all of your assets (including real property, intangible property, and tangible personal property such as jewelry,
furniture, etc.). When making this calculation, do not subtract any
liabilities (debts) that may relate to the property. Multiply the total
figure by 10% to arrive at the disclosure threshold. List only the
intangibles that exceed this threshold amount. The value of a leased vehicle is the vehicle’s present value minus the lease
residual (a number which can be found on the lease document).
Property that is only jointly owned property should be valued
according to the percentage of your joint ownership. Property
owned as tenants by the entirety or as joint tenants with right of survivorship should be valued at 100%. None of your calculations
or the value of the property have to be disclosed on the form.
Example:
You own 50% of the stock of a small corporation that is
worth $100,000, the estimated fair market value of your home
and other property (bank accounts, automobile, furniture, etc.) is $200,000. As your total assets are worth $250,000, you must
disclose intangibles worth over $25,000. Since the value of the
stock exceeds this threshold, you should list “stock” and the name
of the corporation. If your accounts with a particular bank exceed
$25,000, you should list “bank accounts” and bank’s name.
PART E — LIABILITIES
[Required by s. 112.3145(3)(a)4 or (b)4, F.S.]
List the name and address of each creditor to whom you owed any
amount that, at any time during the disclosure period, exceeded your
net worth. You are not required to list the amount of any debt or your
net worth. You do not have to disclose: credit card and retail installment
accounts, taxes owed (unless reduced to a judgment), indebtedness on
a life insurance policy owed to the company of issuance, or contingent
liabilities. A “contingent liability” is one that will become an actual liability
only when one or more future events occur or fail to occur, such as where
you are liable only as a guarantor, surety, or endorser on a promissory
note. If you are a “co-maker” and have signed as being jointly liable or
jointly and severally liable, then this is not a contingent liability.
Calculations: In order to decide whether the debt exceeds your net worth, you will need to total all of your liabilities (including promissory
notes, mortgages, credit card debts, judgments against you, etc.). The
amount of the liability of a vehicle lease is the sum of any past-due
payments and all unpaid prospective lease payments. Subtract the sum
total of your liabilities from the value of all your assets as calculated above for Part D. This is your “net worth.” You must list on the form each
creditor to whom your debt exceeded this amount unless it is one of the
types of indebtedness listed in the paragraph above (credit card and retail
installment accounts, etc.). Joint liabilities with others for which you are
“jointly and severally liable,” meaning that you may be liable for either your part or the whole of the obligation, should be included in your calculations
at 100% of the amount owed.
Examples:
— You owe $15,000 to a bank for student loans, $5,000 for credit card debts, and $60,000 (with spouse) to a savings and loan for
a home mortgage. Your home (owned by you and your spouse) is
worth $80,000 and your other property is worth $20,000. Since your
net worth is $20,000 ($100,000 minus $80,000), you must report only
the name and address of the savings and loan.
PART F — INTERESTS IN SPECIFIED BUSINESSES
[Required by s. 112.3145(5), F.S.]
The types of businesses covered in this disclosure include: state and
federally chartered banks; state and federal savings and loan associations;
cemetery companies; insurance companies; mortgage companies; credit
unions; small loan companies; alcoholic beverage licensees; pari-mutuel
wagering companies, utility companies, entities controlled by the Public
Service Commission; and entities granted a franchise to operate by either
a city or a county government.
You are required to disclose in this part of the form the fact that
you owned during the disclosure period an interest in, or held any of
certain positions with, particular types of businesses listed above. You
are required to make this disclosure if you own or owned (either directly
or indirectly in the form of an equitable or beneficial interest) at any time
during the disclosure period more than 5% of the total assets or capital
stock of one of the types of business entities listed above. You also must
complete this part of the form for each of these types of businesses
for which you are, or were at any time during the disclosure period, an
officer, director, partner, proprietor, or agent (other than a resident agent
solely for service of process).
If you have or held such a position or ownership interest in one
of these types of businesses, list the name of the business, its address
and principal business activity, and the position held with the business (if
any). If you own(ed) more than a 5% interest in the business, you must
indicate that fact and describe the nature of your interest.
(End of Percentage Thresholds Instructions.)
NOTICE
Annual Statements of Financial Interests are due July 1. If the annual form is not filed or postmarked by September 1, an
automatic fine of $25 for each day late will be imposed, up to a maximum penalty of $1,500. [s. 112.3145, F.S. - applicable to non-
judicial officials] Failure to file also can result in removal from public office or employment. [Ch. 2014-183, Laws of Florida]
In addition, failure to make any required disclosure constitutes grounds for and may be punished by one or more of the following:
disqualification from being on the ballot, impeachment, removal, or suspension from office or employment, demotion, reduction
in salary, reprimand, or a civil penalty not exceeding $10,000. [s. 112.317, F.S.]
1) Elected public officials not serving in a political subdivision of the
state and any person appointed to fill a vacancy in such office, unless
required to file full disclosure on Form 6.
2) Appointed members of each board, commission, authority, or
council having statewide jurisdiction, excluding members of solely advisory
bodies, but including judicial nominating commission members; Directors
of Enterprise Florida, Scripps Florida Funding Corporation, and Workforce
Florida; and members of the Council on the Social Status of Black Men
and Boys; the Executive Director, Governors, and senior managers of
Citizens Property Insurance Corporation; Governors and senior managers
of Florida Workers' Compensation Joint Underwriting Association; board
members of the Northeast Fla. Regional Transportation Commission;
members of the board of Triumph Gulf Coast, Inc; members of the board
of Florida Is For Veterans, Inc.; and members of the Technology Advisory
Council within the Agency for State Technology.
3) The Commissioner of Education, members of the State Board of
Education, the Board of Governors, and the local Boards of Trustees and
Presidents of state universities.
4) Persons elected to office in any political subdivision (such as
municipalities, counties, and special districts) and any person appointed
to fill a vacancy in such office, unless required to file Form 6.
5) Appointed members of the following boards, councils,
commissions, authorities, or other bodies of county, municipality, school
district, independent special district, or other political subdivision: the
governing body of the subdivision; community college or junior college
district boards of trustees; boards having the power to enforce local code
provisions; boards of adjustment; planning or zoning boards having the
power to recommend, create, or modify land planning or zoning within
a political subdivision, except for citizen advisory committees, technical
coordinating committees, and similar groups who only have the power
to make recommendations to planning or zoning boards; pension or
retirement boards empowered to invest pension or retirement funds
or determine entitlement to or amount of pensions or other retirement
benefits.
6) Any appointed member of a local government board who is
required to file a statement of financial interests by the appointing authority
or the enabling legislation, ordinance, or resolution creating the board.
7) Persons holding any of these positions in local government:
mayor; county or city manager; chief administrative employee or finance
director of a county, municipality, or other political subdivision; county or
municipal attorney; chief county or municipal building inspector; county
or municipal water resources coordinator; county or municipal pollution
control director; county or municipal environmental control director; county
or municipal administrator with power to grant or deny a land development
permit; chief of police; fire chief; municipal clerk; appointed district school
superintendent; community college president; district medical examiner;
purchasing agent (regardless of title) having the authority to make any
purchase exceeding $20,000 for the local governmental unit.
8) Officers and employees of entities serving as chief administrative
officer of a political subdivision.
9) Members of governing boards of charter schools operated by a
city or other public entity.
10) Employees in the office of the Governor or of a Cabinet member
who are exempt from the Career Service System, excluding secretarial,
clerical, and similar positions.
11) The following positions in each state department, commission,
board, or council: Secretary, Assistant or Deputy Secretary, Executive
Director, Assistant or Deputy Executive Director, and anyone having the
power normally conferred upon such persons, regardless of title.
12) The following positions in each state department or division:
Director, Assistant or Deputy Director, Bureau Chief, Assistant Bureau
Chief, and any person having the power normally conferred upon such
persons, regardless of title.
13) Assistant State Attorneys, Assistant Public Defenders, criminal
conflict and civil regional counsel, and assistant criminal conflict and civil
regional counsel, Public Counsel, full-time state employees serving as
counsel or assistant counsel to a state agency, administrative law judges,
and hearing officers.
14) The Superintendent or Director of a state mental health institute
established for training and research in the mental health field, or any
major state institution or facility established for corrections, training,
treatment, or rehabilitation.
15) State agency Business Managers, Finance and Accounting
Directors, Personnel Officers, Grant Coordinators, and purchasing agents
(regardless of title) with power to make a purchase exceeding $20,000.
16) The following positions in legislative branch agencies: each
employee (other than those employed in maintenance, clerical,
secretarial, or similar positions and legislative assistants exempted
by the presiding officer of their house); and each employee of the
Commission on Ethics.
INSTRUCTIONS FOR COMPLETING FORM 1:
INTRODUCTORY INFORMATION (At Top of Form):
If your name, mailing address, public agency, and position are already printed on the form, you do not need to provide this information unless it should be changed. To change any of this information, write the correct information on the form, and contact your agency's financial disclosure coordinator. Your coordinator is identified in the financial disclosure portal on the Commission on Ethics website: www.ethics.
state.fl.us.
NAME OF AGENCY: This should be the name of the governmental unit which you serve or served, by which you are or were employed,
or for which you are a candidate.
OFFICE OR POSITION HELD OR SOUGHT: Use the title of the office or position you hold, are seeking, or held during the disclosure period even if you have since left that position. If you are a candidate for office or are a new employee or appointee, check the appropriate box.
PUBLIC RECORD: The disclosure form and everything attached to it
is a public record. Your Social Security Number is not required and you
should redact it from any documents you file. If you are an active or
former officer or employee listed in Section 119.071(4)(d), F.S., whose
home address is exempt from disclosure, the Commission is required to
maintain the confidentiality of your home address if you submit a written
request for confidentiality. Persons listed in Section 119.071(4)(d), F.S.,
are encouraged to provide an address other than their home address.
DISCLOSURE PERIOD: The tax year for most individuals is the
calendar year (January 1 through December 31). If that is the case
for you, then your financial interests should be reported for the
calendar year 2014; just check the box and you do not need to add
any information in this part of the form. However, if you file your IRS
tax return based on a tax year that is not the calendar year, you
should specify the dates of your tax year in this portion of the form
and check the appropriate box. This is the time frame or "disclosure
period" for your report.
WHO MUST FILE FORM 1:
CE FORM 1 - Effective: January 1, 2015. Adopted by reference in Rule 34-8.202(1), F.A.C. PAGE 6 CE FORM 1 - Effective: January 1, 2015. Adopted by reference in Rule 34-8.202(1), F.A.C. PAGE 3