Senate Resolution 1 - Introduced


An Act 1relating to the Senate Code of Ethics
2governing the conduct of members of the Senate in
3relation to their senatorial duties during the
4Eighty-ninth General Assembly.
   5BE IT RESOLVED BY THE SENATE, That the Senate Code
6of Ethics for the Eighty-eighth Eighty-ninth General
7Assembly shall be amended to read as follows:

8SENATE CODE OF ETHICS
   9PREAMBLE. Every legislator owes a duty to uphold
10the integrity and honor of the general assembly, to
11encourage respect for the law and for the general
12assembly and the members thereof, and to observe the
13legislative code of ethics.
   14In doing so, members of the senate have a duty to
15conduct themselves so as to reflect credit on the
16general assembly, and to inspire the confidence,
17respect, and trust of the public, and to strive to
18avoid both unethical and illegal conduct and the
19appearance of unethical and illegal conduct.
   20Recognizing that service in the Iowa general
21assembly is a part-time endeavor and that members of
22the general assembly are honorable individuals who
23are active in the affairs of their localities and
24elsewhere and that it is necessary that they maintain
25a livelihood and source of income apart from their
26legislative compensation, the following rules are
27adopted pursuant to section 68B.31, to assist the
-1-1members in the conduct of their legislative affairs.
   21. ECONOMIC INTEREST OF SENATOR. Taking into
3account that legislative service is part-time, a
4senator shall not accept economic or investment
5opportunity, under circumstances where the senator
6knows, or should know, that there is a reasonable
7possibility that the opportunity is being afforded the
8senator with intent to influence the senator’s conduct
9in the performance of official duties.
   102. DIVESTITURE. Where a senator learns that
11an economic or investment opportunity previously
12accepted was offered with the intent of influencing
13the senator’s conduct in the performance of official
14duties, the senator shall take steps to divest that
15senator of that investment or economic opportunity, and
16shall report the facts of the situation to the senate
17ethics committee.
   183. CHARGES FOR SERVICES. A senator shall not
19charge to or accept from a person, corporation,
20partnership, or association known to have a legislative
21interest a price, fee, compensation, or other
22consideration for the sale or lease of any property or
23the furnishing of services which is in excess of that
24which the senator would charge another.
   254. USE OF CONFIDENTIAL INFORMATION. A senator in
26order to further the senator’s own economic or other
27interests, or those of any other person, shall not
28disclose or use confidential information acquired in
29the course of official duties.
   305. HONORARIA. A senator shall not accept an
-2-1honorarium from a restricted donor for a speech,
2writing for publication, or other similar activity,
3except as otherwise provided in section 68B.23.
   46. EMPLOYMENT. A senator shall not accept
5employment, either directly or indirectly, from a
6political action committee or from an organization
7exempt from taxation under section 501(c)(4),
8501(c)(6), or 527 of the Internal Revenue Code that
9engages in activities related to the nomination,
10election, or defeat of a candidate for public office.
11A senator may accept employment from a political
12party, but shall disclose the employment relationship
13in writing to the secretary of the senate within ten
14days after the beginning of each legislative session.
15If a senator accepts employment from a political
16party during a legislative session, the senator shall
17disclose the employment relationship within ten days
18after acceptance of the employment.
   19For the purpose of this rule, a political action
20committee means a committee, but not a candidate’s
21committee, which accepts contributions, makes
22expenditures, or incurs indebtedness in the aggregate
23of more than one thousand dollars in any one calendar
24year to expressly advocate the nomination, election, or
25defeat of a candidate for public office or to expressly
26advocate the passage or defeat of a ballot issue or
27influencing legislative action, or an association,
28lodge, society, cooperative, union, fraternity,
29sorority, educational institution, civic organization,
30labor organization, religious organization, or
-3-1professional organization which makes contributions in
2the aggregate of more than one thousand dollars in any
3one calendar year to expressly advocate the nomination,
4election, or defeat of a candidate for public office or
5ballot issue or influencing legislative action.
   67. ECONOMIC INTERESTS OF LOBBYIST. With the
7exception of exercising unfettered discretion in
8supporting or refusing to support proposed legislation,
9a senator shall not take action intended to affect the
10economic interests of a lobbyist or citizen supporting
11or opposing proposed legislation.
   128. APPEARANCE BEFORE GOVERNMENTAL AGENCY. A
13senator may appear before a governmental agency or
14board in any representation case, except that the
15senator shall not act as a lobbyist. Whenever a
16senator appears before a governmental agency or board,
17the senator shall carefully avoid all conduct which
18might in any way lead members of the general public
19to conclude that the senator is using the senator’s
20official position to further the senator’s professional
21success or personal financial interest.
   229. CONFLICTS OF INTERESTS. In order to permit the
23general assembly to function effectively, a senator
24will sometimes be required to vote on bills and
25participate in committee work which will affect the
26senator’s employment and other monetary interests. In
27making a decision relative to the senator’s activity on
28given bills or committee work which are subject to the
29code, the following factors shall be considered:
   30a. Whether a substantial threat to the senator’s
-4-1independence of judgment has been created by the
2conflict situation.
   3b. The effect of the senator’s participation on
4public confidence in the integrity of the legislature.
   5c. The need for the senator’s particular
6contribution, such as special knowledge of the
7subject matter, to the effective functioning of the
8legislature.
   910. GIFTS. Except as otherwise provided in section
1068B.22, a senator, or that person’s immediate family
11member, shall not, directly or indirectly, accept or
12receive any gift or series of gifts from a restricted
13donor.
   1411. DISCLOSURE REQUIRED. Each senator shall file
15with the secretary of the senate within ten days after
16the adoption of the code of ethics by the senate, and
17within ten days after the convening of the second
18session of the general assembly, a statement under
19section 68B.35 on forms provided by the secretary of
20the senate setting forth the following information:
   21The nature of each business in which the senator
22is engaged and the nature of the business of each
23company in which the senator has a financial interest.
24A senator shall not be required to file a report or
25be assumed to have a financial interest if the annual
26income derived from the investment in stocks, bonds,
27bills, notes, mortgages, or other securities offered
28for sale through recognized financial brokers is less
29than one thousand dollars.
   30Disclosures required under this rule shall be as
-5-1of the date filed unless provided to the contrary,
2and shall be amended to include interests and changes
3encompassed by this rule that occur while the general
4assembly is in session. All filings under this rule
5shall be open to public inspection in the office of the
6secretary of the senate at all reasonable times.
   7The secretary of the senate shall inform the
8ethics committee of the statements which are filed
9and shall report to the ethics committee the names of
10any senators who appear not to have filed complete
11statements. The chairperson of the ethics committee
12shall request in writing that a senator who has failed
13to complete the report or appears to have filed an
14incomplete report do so within five days, and, upon
15the failure of the senator to comply, the ethics
16committee shall require the senator to appear before
17the committee.
   1812. STATUTORY VIOLATIONS. Members of the general
19assembly are urged to familiarize themselves with
20chapters 68B, 721, and 722.
   2112A. HARASSMENT — RETALIATION. Senators,
22lobbyists, and clients of lobbyists shall not engage
23in conduct that constitutes harassment or retaliation
24as provided in the personnel guidelines for the Iowa
25Senate.
   2612B. DISCRIMINATION — HARASSMENT — ABUSE. As
27provided and defined in the personnel guidelines of the
28Iowa Senate, a senator shall not engage in any act of
29discrimination, harassment, or abuse of any person.
   3013. CHARGE ACCOUNTS. Senators shall not charge any
-6-1amount or item to any charge account to be paid for by
2any lobbyist or any client the lobbyist represents.
   314. TRAVEL EXPENSES. A senator shall not charge
4to the state of Iowa amounts for travel and expenses
5unless the senator actually has incurred those mileage
6and expense costs. Senators shall not file the
7vouchers for weekly mileage reimbursement required
8by section 2.10, subsection 1, unless the travel
9was actually incurred at commensurate expense to the
10senator.
   1115. COMPLAINTS. Complaints or charges against
12any senator or any lobbyist shall be in writing, made
13under penalty of perjury, and filed with the secretary
14of the senate. When filed with the secretary of the
15senate, the secretary shall immediately advise the
16chairperson of the ethics committee of the receipt of
17the complaint.
   18Complaint forms shall be available from the
19secretary of the senate, or the chairperson of the
20ethics committee, but a complaint shall not be rejected
21for failure to use an approved form if the complaint
22substantially complies with senate requirements.
   23A complainant may submit exhibits and affidavits
24attached to the complaint.
   2516. FILING OF COMPLAINTS.
   26a. Persons entitled. Complaints may be filed by any
27person believing that a senator, lobbyist, or client
28of a lobbyist has violated the senate ethics code,
29the joint rules governing lobbyists, or chapter 68B.
30A violation of the criminal law may be considered to
-7-1be a violation of this code of ethics if the violation
2constitutes a serious misdemeanor or greater, or a
3repetitive and flagrant violation of the law.
   4b. Committee complaint. The ethics committee
5may, upon its own motion, initiate a complaint,
6investigation, or disciplinary action.
   717. PERMANENT RECORD. The secretary of the senate
8shall maintain a permanent record of all complaints
9filed, evidence received by the committee, and any
10transcripts or other recordings made of committee
11proceedings, including a separate file containing
12the date filed, name and address of the complainant,
13name and address of the respondent, a brief statement
14of the charges made, and ultimate disposition of
15the complaint. The secretary shall keep each such
16complaint confidential until public disclosure is made
17by the ethics committee.
   1818. PREHEARING PROCEDURE.
   19a. Defective complaint. Upon receipt of a
20complaint, the chairperson and ranking member of the
21ethics committee shall determine whether the complaint
22substantially complies with the requirements of this
23code of ethics and section 68B.31, subsection 6. If
24the complaint does not substantially comply with
25the requirements for formal sufficiency under the
26code of ethics, the complaint may be returned to the
27complainant with a statement that the complaint is not
28in compliance with the code and a copy of the code. If
29the complainant fails to amend the complaint to comply
30with the code within a reasonable time, the chairperson
-8-1and ranking member may dismiss the complaint with
2prejudice for failure to prosecute.
   3b. Service of complaint on respondent. Upon
4receipt of any complaint substantially complying
5with the requirements of this code of ethics, the
6chairperson of the ethics committee shall cause a copy
7of the complaint and any supporting information to be
8delivered promptly to the respondent, requesting a
9written response to be filed within ten days. At the
10time delivery is made to the respondent, delivery of
11copies of the complaint and any supporting information
12shall be made to legislative staff assigned to the
13ethics committee. The response may do any of the
14following:
   15(1) Admit or deny the allegation or allegations.
   16(2) Object that the allegation fails to allege a
17violation of chapter 68B, the joint rules governing
18lobbyists, or the code of ethics.
   19(3) Object to the jurisdiction of the committee.
   20(4) Request a more specific statement of the
21allegation or allegations.
   22c. Objection to member. In addition to the
23items which may be included in a response pursuant
24to paragraph “b”, the response may also include an
25objection to the participation of any member of the
26committee in the consideration of the allegation or
27allegations on the grounds that the member cannot
28render an impartial and unbiased decision.
   29d. Extension of time. At the request of the
30respondent and upon a showing of good cause, the
-9-1committee, or the chairperson and ranking member,
2may extend the time for response, not to exceed ten
3additional days.
   4e. Confidentiality. If a complaint is not
5otherwise made public by the complainant, the members
6of the committee and legislative staff assigned to
7the ethics committee shall treat the complaint and
8all supporting information as confidential until the
9written response is received from the respondent.
   10f. Communications with ethics committee. After a
11complaint has been filed or an investigation has been
12initiated, a party to the complaint or investigation
13shall not communicate, or cause another to communicate,
14as to the merits of the complaint or investigation with
15a member of the committee, except under the following
16circumstances:
   17(1) During the course of any meetings or other
18official proceedings of the committee regarding the
19complaint or investigation.
   20(2) In writing, if a copy of the writing is
21delivered to the adverse party or the designated
22representative for the adverse party.
   23(3) Orally, if adequate prior notice of the
24communication is given to the adverse party or the
25designated representative for the adverse party.
   26(4) As otherwise authorized by statute, the senate
27code of ethics, the joint rules governing lobbyists, or
28vote of the committee.
   29g. Scheduling hearing. Upon receipt of the
30response, the committee shall schedule a public meeting
-10-1to review the complaint and available information, and
2shall do one of the following:
   3(1) Notify the complainant that no further
4action will be taken, unless further substantiating
5information is produced.
   6(2) Dismiss the complaint for failure to meet the
7statutory and code of ethics requirements for valid
8complaints.
   9(3) Take action on the complaint without requesting
10the appointment of an independent special counsel
11if the committee determines the complaint is valid
12and determines no dispute exists between the parties
13regarding the material facts that establish a
14violation. The committee may do any of the following:
   15(a) Issue an admonishment to advise against the
16conduct that formed the basis for the complaint and to
17exercise care in the future.
   18(b) Issue an order to cease and desist the conduct
19that formed the basis for the complaint.
   20(c) Make a recommendation to the senate that
21the person subject to the complaint be censured or
22reprimanded.
   23(4) Request that the chief justice of the supreme
24court appoint an independent special counsel to conduct
25an investigation of the complaint and supporting
26information, to make a determination of probable cause,
27and to report the findings to the committee, which
28shall be received within a reasonable time.
   29h. Public hearing. If independent special counsel
30is appointed, upon receipt of the report of independent
-11-1special counsel’s findings, the committee shall
2schedule a public meeting to review the report and
3shall do either of the following:
   4(1) Cause the complaint to be scheduled for a
5public hearing.
   6(2) Dismiss the complaint based upon a
7determination by independent special counsel and the
8committee that insufficient evidence exists to support
9a finding of probable cause.
   1019. HEARING PROCEDURE.
   11a. Notice of hearing. If the committee causes a
12complaint to be scheduled for a public hearing, notice
13of the hearing date and time shall be given to the
14complainant and respondent in writing, and of the
15respondent’s right to appear in person, be represented
16by legal counsel, present statements and evidence, and
17examine and cross-examine witnesses. The committee
18shall not be bound by formal rules of evidence, but
19shall receive relevant evidence, subject to limitations
20on repetitiveness. Any evidence taken shall be under
21oath.
   22b. Subpoena power. The committee may require, by
23subpoena or otherwise, the attendance and testimony of
24witnesses and the production of such books, records,
25correspondence, memoranda, papers, documents, and any
26other things it deems necessary to the conduct of the
27inquiry.
   28c. Ex post facto. An investigation shall not be
29undertaken by the committee of a violation of a law,
30rule, or standard of conduct that is not in effect at
-12-1the time of violation.
   2d. Disqualification of member. Members of the
3committee may disqualify themselves from participating
4in any investigation of the conduct of another person
5upon submission of a written statement that the member
6cannot render an impartial and unbiased decision
7in a case. A member may also be disqualified by a
8unanimous vote of the remaining eligible members of the
9committee.
   10A member of the committee is ineligible to
11participate in committee meetings, as a member of the
12committee, in any proceeding relating to the member’s
13own official conduct.
   14If a member of the committee is disqualified or
15ineligible to act, the majority or minority leader who
16appointed the member shall appoint a replacement member
17to serve as a member of the committee during the period
18of disqualification or ineligibility.
   19e. Hearing. At the hearing, the chairperson shall
20open the hearing by stating the charges, the purpose of
21the hearing, and its scope. The burden of proof rests
22upon the complainant to establish the facts as alleged,
23by clear and convincing evidence. However, questioning
24of witnesses shall be conducted by the members of the
25committee, by independent special counsel, or by a
26senator. The chairperson shall also permit questioning
27by legal counsel representing the complainant or
28respondent.
   29The chairperson or other member of the committee
30presiding at a hearing shall rule upon procedural
-13-1questions or any question of admissibility of evidence
2presented to the committee. Rulings may be reversed by
3a majority vote of the committee members present.
   4The committee may continue the hearing to a future
5date if necessary for appropriate reasons or purposes.
   6f. Committee action. Upon receipt of all relevant
7evidence and arguments, the committee shall consider
8the same and recommend to the senate any of the
9following:
   10(1) That the complaint be dismissed.
   11(2) That the senator, lobbyist, or client of a
12lobbyist be censured or reprimanded, and recommend the
13appropriate form of censure or reprimand.
   14(3) Any other appropriate sanction, including
15suspension or expulsion from membership in the senate,
16or suspension of lobbying privileges.
   17g. Disposition resolution. By appropriate
18resolution, the senate may amend, adopt, or reject
19the report of the ethics committee, including the
20committee’s recommendations regarding disciplinary
21action.
   2220. COMMITTEE AUTHORIZED TO MEET. The senate
23ethics committee is authorized to meet at the
24discretion of the chairperson to conduct hearings and
25other business that properly may come before it. If
26the committee submits a report seeking senate action
27against a senator, lobbyist, or client of a lobbyist
28after the second regular session of a general assembly
29has adjourned sine die, the report shall be submitted
30to and considered by the subsequent general assembly.
-14-1However, the report may be submitted to and considered
2during any special session which may take place after
3the second regular session of a general assembly has
4adjourned sine die, but before the convening of the
5next general assembly.
   621. ADVISORY OPINIONS.
   7a. Requests for formal opinions. A request for a
8formal advisory opinion may be filed by any person who
9is subject to the authority of the ethics committee.
10The ethics committee may also issue a formal advisory
11opinion on its own motion, without having previously
12received a formal request for an opinion, on any issue
13that is within the jurisdiction of the committee.
14Requests shall be filed with either the secretary of
15the senate or the chairperson of the ethics committee.
   16b. Form and contents of requests. A request for
17a formal advisory opinion shall be in writing and
18may pertain to any subject matter that is related
19to the application of the senate code of ethics, the
20joint rules governing lobbyists, or chapter 68B to
21any person who is subject to the authority of the
22ethics committee. Requests shall contain one or
23more specific questions and shall relate either to
24future conduct or be stated in the hypothetical. A
25request for an advisory opinion shall not specifically
26name any individual or contain any other specific
27identifying information, unless the request relates
28to the requester’s own conduct. However, any request
29may contain information which identifies the kind
30of individual who may be affected by the subject
-15-1matter of the request. Examples of this latter kind
2of identifying information may include references to
3conduct of a category of individuals, such as but not
4limited to conduct of legislators, legislative staff,
5lobbyists, or clients of lobbyists.
   6c. Confidentiality of formal requests and opinions.
7Requests for formal opinions are not confidential and
8any deliberations of the committee regarding a request
9for a formal opinion shall be public. Opinions issued
10in response to requests for formal opinions are not
11confidential, shall be in writing, and shall be placed
12on file in the office of the secretary of the senate.
13Persons requesting formal opinions shall personally
14receive a copy of the written formal opinion that is
15issued in response to the request.
   1622. CALCULATION OF TIME — DAYS. For purposes of
17these rules, unless the context otherwise requires,
18the word “day” or “days” shall mean a calendar day
19except that if the day is the last day of a specific
20time period and falls upon a Saturday, Sunday, or legal
21holiday, the time prescribed shall be extended so as to
22include the whole of the next day in which the offices
23of the senate and the general assembly are open for
24official business.
   2523. COMPLAINT FILING FORM. The following form
26shall be used to file a complaint under these rules:
27THE SENATE
28Ethics Complaint Form
29Re: ______________________________
30(Senator/Lobbyist/Client of Lobbyist), of
-16-1_____________________, Iowa.
   2I, ________________________ (Complainant),
3residing at ____________________, in the City of
4______________, State of ________________________,
5hereby complain that _____________________________
6(Senator/Lobbyist/Client of Lobbyist), whose address
7is ___________________________________________, has
8violated the Senate Code of Ethics, chapter 68B, or
9Joint Rules Governing Lobbyists in that:
   10(Explain the basis for the complaint here. Use
11additional pages, if necessary.)
   12Under penalty of perjury, I certify that the above
13complaint is true and correct as I verily believe.
              14___________________________
              15Signature of Complainant
   16SUBSCRIBED AND AFFIRMED to before me this __________
17day of ________________________, _______.
            18________________________________
            19Notary Public in and for the
            20State of ______________________
   2124. COMPLAINT NOTICE FORM. The following form
22shall be used for notice of a complaint under these
23rules:
24STATE OF IOWA
25THE SENATE
26COMMITTEE ON ETHICS)
27IOWA STATE SENATE)
28)
29On The Complaint Of)NOTICE OF COMPLAINT
30)
-17-
1___________________________)
2)
3And Involving)
4)
5___________________________)
6)
7TO ________________________________,
  8Senator or Lobbyist or Client of Lobbyist named
9above:
   10You are hereby notified that there is now on file
11with the Secretary of the Senate, State Capitol, Des
12Moines, Iowa, a complaint which alleges that you have
13committed a violation of the Senate’s Code of Ethics,
14chapter 68B, or Joint Rules Governing Lobbyists.
   15A copy of the complaint and the Senate rules for
16processing the same are attached hereto and made a part
17of this notice.
   18You are further notified and requested to file your
19written answer to the complaint within ten days of the
20date upon which the notice was caused to be delivered
21to you, (date) ________________________, ________.
22Your answer is to be filed with the Secretary of the
23Senate, State Capitol, Des Moines, Iowa.
   24Dated this ________ day of ________________, ______.
             25________________________________
             26Chairperson, Senate Ethics
             27Committee,
             28or Secretary of the Senate
   2925. HEARING NOTICE FORM. The following form shall
30be used for notice of a hearing under these rules:
-18-
1STATE OF IOWA
2THE SENATE
3COMMITTEE ON ETHICS)
4IOWA STATE SENATE)
5)
6On The Complaint Of)NOTICE OF HEARING
7)
8___________________________)
9)
10And Involving)
11)
12___________________________)
13)
14TO ________________________________,
  15Senator or Lobbyist or Client of Lobbyist named
16above:
   17You are hereby notified that there is now on file
18with the Secretary of the Senate, State Capitol, Des
19Moines, Iowa, a complaint which alleges that you have
20committed a violation of the Senate’s Code of Ethics,
21chapter 68B, or Joint Rules Governing Lobbyists.
   22A copy of the complaint and the Senate rules for
23processing the same are attached hereto and made a part
24of this notice.
   25You are further notified that, after preliminary
26review, the committee has caused a public hearing to be
27scheduled on (date)___________________, ________, at
28(hour) ___________ (a.m.) (p.m.), in Room ____, State
29Capitol, Des Moines, Iowa.
   30At the hearing, you will have the right to appear
-19-1in person, be represented by legal counsel at your own
2expense, present statements and evidence, and examine
3and cross-examine witnesses. The committee shall
4not be bound by formal rules of evidence, but shall
5receive relevant evidence, subject to limitations on
6repetitiveness. Any evidence taken shall be under
7oath.
   8The committee may continue the hearing to a future
9date if necessary for appropriate reasons or purposes.
   10You are further notified that the committee will
11receive such evidence and take such action as warranted
12by the evidence.
   13Dated this _____ day of ________________, ______.
             14________________________________
             15Chairperson, Senate Ethics
             16Committee,
             17or Secretary of the Senate
   1826. PERSONAL FINANCIAL DISCLOSURE FORM. The
19following form shall be used for disclosure of economic
20interests under these rules and section 68B.35:
21STATEMENT OF ECONOMIC INTERESTS
22Name:________________________________________________
   23(Last)     (First)     (Middle Initial)
24Address:_____________________________________________
    25(Street Address, Apt.#/P.O. Box)
    26______________________________________________
    27(City) (State) (Zip)
28Phone:(Home) ____/____-_____(Business) ____/____-_____
29******************************************************
   30a. Please list each business, occupation, or
-20-1profession in which you are engaged. In listing
2the business, occupation, or profession, it is
3not necessary that your employer or the name of
4the business be listed, although all businesses,
5occupations, or professions must be listed, regardless
6of the amount of income derived or time spent
7participating in the activity. (Examples of types
8of businesses, occupations, or professions that may
9be listed: teacher, lawyer, legislator, real estate
10agent, insurance adjuster, salesperson....)
11(1) __________________________________________________
12(2) __________________________________________________
13(3) __________________________________________________
14(4) __________________________________________________
15(5) __________________________________________________
   16b. Please list the nature of each of the
17businesses, occupations, or professions which you
18listed in paragraph “a”, above, unless the nature of
19the business, occupation, or profession is already
20apparent from the information indicated above. The
21descriptions in this paragraph should correspond by
22number to the numbers for each of the businesses,
23occupations, or professions listed in paragraph “a”.
24(Examples: If you indicated, for example, that you
25were a salesperson in subparagraph (1) of paragraph
26“a”, you should list in subparagraph (1) of this
27paragraph the types of goods or services sold in this
28item. If you indicated that you were a teacher in
29subparagraph (2) of paragraph “a”, you should indicate
30in subparagraph (2) of this paragraph the type of
-21-1school or institution in which you provide instruction
2or whether the instruction is provided on a private
3basis. If you indicated that you were a lawyer in
4subparagraph (3) of paragraph “a”, you should indicate
5your areas of practice and whether you are in private,
6corporate, or government practice in subparagraph (3)
7of this paragraph. If you indicated in subparagraph
8(4) of paragraph “a” that you were a consultant, in
9subparagraph (4) of this paragraph you should indicate
10the kind of services provided and types of clients
11served.)
12(1) __________________________________________________
13(2) __________________________________________________
14(3) __________________________________________________
15(4) __________________________________________________
16(5) __________________________________________________
   17c. Please list each source, by general description,
18from which you receive, or which generates, more than
19one thousand dollars in gross annual income in the
20categories listed below. For purposes of this item,
21a source produces gross annual income if the revenue
22produced by the source is subject to federal or state
23income taxes. In completing this item, it is not
24necessary to list the name of the company, business,
25financial institution, corporation, partnership, or
26other entity which constitutes the source of the income
27and the amount or value of the holding should not be
28listed.
   29(1) Securities (Here for example, you need not
30state that you own X number of shares of any specific
-22-1company by brand or corporate name, or that the stock
2is of a certain value, but may instead state that you
3possess stock in a company and indicate the nature of
4the company’s business.):
5______________________________________________________
6______________________________________________________
7______________________________________________________
8______________________________________________________
9______________________________________________________
   10(2) Instruments of Financial Institutions (You
11need not indicate, for example, in which institutions
12you hold certificates of deposit that produce annual
13income over the one thousand dollar threshold, but
14simply listing the nature of the institution will
15suffice, e.g., bank, credit union, or savings and loan
16association.):
17______________________________________________________
18______________________________________________________
19______________________________________________________
20______________________________________________________
21______________________________________________________
   22(3) Trusts (The name of the particular trust need
23not be listed. However, if the income is received
24from a charitable trust/foundation, such as the Pugh
25Charitable Trust, in the form of a grant, the fact that
26the trust is a charitable trust should be noted here.):
27______________________________________________________
28______________________________________________________
29______________________________________________________
30______________________________________________________
-23-
1______________________________________________________
   2(4) Real Estate (When listing real estate, it is
3not necessary to list the location of the property, but
4the general nature of the real estate interest should
5be indicated, e.g., residential leasehold interest or
6farm leasehold interest.):
7______________________________________________________
8______________________________________________________
9______________________________________________________
10______________________________________________________
11______________________________________________________
   12(5) Retirement Systems (When listing retirement
13benefits, it is not necessary to list the name of
14the particular pension system or company, but rather
15the type of benefit should be listed, e.g., health
16benefits, life insurance benefits, private pension, or
17government pension.):
18______________________________________________________
19______________________________________________________
20______________________________________________________
21______________________________________________________
22______________________________________________________
23(Signature of filer)        (Date)
-24-
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