House Journal: Page 287: Tuesday, February 6, 2001
14 percentage of ownership of an asset is less than 100
15 percent, multiply your percentage of ownership by the
16 total revenue produced to determine if you have
17 reached the $1,000 threshold.
18 Do not report income received by your spouse or
19 other family members.
20 In completing this form, if insufficient space is
21 provided for your answer, you may attach additional
22 information/answers on full-size sheets of paper.
23 Division I. Business, Occupation, Profession.
24 List each business, occupation, or profession in
25 which you are engaged, the nature of the business if
26 not evident, and your position or job title. No
27 income threshold or time requirement applies.
28 Examples:
29 If you are employed by an individual, state the
30 name of the individual employer, the nature of the
Page 18
1 business, and your position.
2 If you are self-employed and are not incorporated
3 or are not doing business under a particular business
4 name, state that you are self-employed, the nature of
5 the business, and your position.
6 If you own your own corporation, are employed by a
7 corporation, or are doing business under a particular
8 business name, state the name and nature of the
9 business or corporation and your position.
10 1_____________________________________________________
11 2_____________________________________________________
12 3_____________________________________________________
13 4_____________________________________________________
14 5_____________________________________________________
15 6_____________________________________________________
16 Division II. Commissions from Sales of Goods or
17 Services to Political Subdivisions.
18 This part is to be completed only by Legislators.
19 If you received income in the form of a commission
20 from the sale of goods or services to a political
21 subdivision, state the name of the purchasing
22 political subdivision. The amount of commission
23 earned is not required to be listed.
24 1_____________________________________________________
25 2_____________________________________________________
26 3_____________________________________________________
27 4_____________________________________________________
28 5_____________________________________________________
29 6_____________________________________________________
30 Division III. Sources of Gross Income.
© 2001 Cornell College and
League of Women Voters of Iowa
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