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House Journal: Page 305: Tuesday, February 9, 1999

18  information/answers on full-size sheets of paper.

19  Division I.  Business, Occupation, Profession.
20     List each business, occupation, or profession in
21  which you are engaged, the nature of the business if
22  not evident, and your position or job title.  No
23  income threshold or time requirement applies.
24     Examples:
25     If you are employed by an individual, state the
26  name of the individual employer, the nature of the
27  business, and your position.
28     If you are self-employed and are not incorporated
29  or are not doing business under a particular business
30  name, state that you are self-employed, the nature of
Page 18
 1  the business, and your position.
 2     If you own your own corporation, are employed by a
 3  corporation, or are doing business under a particular
 4  business name, state the name and nature of the
 5  business or corporation and your position.
 6   1_____________________________________________________
 7   2_____________________________________________________
 8   3_____________________________________________________
 9   4_____________________________________________________
10  5_____________________________________________________
11  6_____________________________________________________
12  Division II.  Commissions from Sales of Goods or
13  Services to Political Subdivisions.
14     This part is to be completed only by Legislators.
15  If you received income in the form of a commission
16  from the sale of goods or services to a political
17  subdivision, state the name of the purchasing
18  political subdivision.  The amount of commission
19  earned is not required to be listed.
20  1_____________________________________________________
21  2_____________________________________________________
22  3_____________________________________________________
23  4_____________________________________________________
24  5_____________________________________________________
25  6_____________________________________________________
26  Division III.  Sources of Gross Income.
27     In each one of the following categories list each
28  source which produces more than $1,000 in annual gross
29  income, if the revenue produced by the source was
30  subject to federal or state income taxes last year.
Page 19
 1  List the nature or type of each company, business,
 2  financial institution, corporation, partnership, or
 3  other entity which produces more than $1,000 of annual

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