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
4Ninetieth General Assembly.
   5BE IT RESOLVED BY THE SENATE, That the Senate Code
6of Ethics for the Eighty-ninth Ninetieth 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 BY SENATORS. Each senator
15shall file with the secretary of the senate within ten
16days after the adoption of the code of ethics by the
17senate, and within ten days after the convening of the
18second session of the general assembly, a financial
19statement under section 68B.35 on forms provided by
20the secretary of the senate setting forth the following
21information:
   22The nature of each business in which the senator
23is engaged and the nature of the business of each
24company in which the senator has a financial interest.
25A senator shall not be required to file a financial
26statement or be assumed to have a financial interest
27if the annual income derived from the investment
28in stocks, bonds, bills, notes, mortgages, or other
29securities offered for sale through recognized
30financial brokers is less than one thousand dollars.
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   1Disclosures required under this rule shall be as
2of the date filed unless provided to the contrary,
3and shall be amended to include interests and changes
4encompassed by this rule that occur while the general
5assembly is in session. All filings under this rule
6shall be open to public inspection in the office of the
7secretary of the senate at all reasonable times.
   8The secretary of the senate shall inform the ethics
9committee of the financial statements which are filed
10and shall report to the ethics committee the names
11of any senators who appear not to have filed complete
12financial statements. The chairperson of the ethics
13committee shall request in writing that a senator
14who has failed to complete the financial statement or
15appears to have filed an incomplete financial statement
16do so within five days, and, upon the failure of the
17senator to comply, the ethics committee shall require
18the senator to appear before the committee.
   1911A. DISCLOSURE REQUIRED BY CANDIDATES FOR SENATE.
20 Each candidate for senate shall file with the secretary
21of the senate within fourteen days after the deadline
22for the filing of nomination papers or fourteen days
23after the nominating convention, as applicable, a
24financial statement under section 68B.35 on forms
25provided by the secretary of the senate setting forth
26the following information:
   27The nature of each business in which the candidate
28for senate is engaged and the nature of the business
29of each company in which the candidate for senate has a
30financial interest. A candidate for senate shall not
-6-1be required to file a financial statement or be assumed
2to have a financial interest if the annual income
3derived from the investment in stocks, bonds, bills,
4notes, mortgages, or other securities offered for sale
5through recognized financial brokers is less than one
6thousand dollars.
   7Disclosures required under this rule shall be for
8the year preceding the year in which the election is to
9be held. All filings under this rule shall be open to
10public inspection in the office of the secretary of the
11senate at all reasonable times.
   12The secretary of the senate shall provide
13information to persons interested in becoming
14candidates for senate of the duty to file financial
15statements under this rule and the applicable
16deadlines.
   17The secretary of the senate shall inform the ethics
18committee of the financial statements that are filed
19and shall report to the ethics committee the names
20of any candidates for senate who appear not to have
21filed complete financial statements. The secretary of
22the senate shall request that a candidate for senate
23who has failed to complete the financial statement
24or appears to have filed an incomplete financial
25report to do so within five days. If a candidate for
26senate does not file a complete financial statement
27within five days, the candidate shall be fined fifty
28dollars, payable to the Iowa senate for deposit in the
29general fund, and the ethics committee may require the
30candidate to appear before the committee.
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   112. STATUTORY VIOLATIONS. Members of the general
2assembly are urged to familiarize themselves with
3chapters 68B, 721, and 722.
   412A. HARASSMENT — RETALIATION. Senators,
5lobbyists, and clients of lobbyists shall not engage
6in conduct that constitutes harassment or retaliation
7as provided in the personnel guidelines for the Iowa
8Senate.
   912B. DISCRIMINATION — HARASSMENT — ABUSE. As
10provided and defined in the personnel guidelines of the
11Iowa Senate, a senator shall not engage in any act of
12discrimination, harassment, or abuse of any person.
   1313. CHARGE ACCOUNTS. Senators shall not charge any
14amount or item to any charge account to be paid for by
15any lobbyist or any client the lobbyist represents.
   1614. TRAVEL EXPENSES. A senator shall not charge
17to the state of Iowa amounts for travel and expenses
18unless the senator actually has incurred those mileage
19and expense costs. Senators shall not file the
20vouchers for weekly mileage reimbursement required
21by section 2.10, subsection 1, unless the travel
22was actually incurred at commensurate expense to the
23senator.
   2415. COMPLAINTS. Complaints or charges against any
25senator, candidate for senate, lobbyist, or client of
26a lobbyist shall be in writing, made under penalty of
27perjury, and filed with the secretary of the senate.
28When filed with the secretary of the senate, the
29secretary shall immediately advise the chairperson of
30the ethics committee of the receipt of the complaint.
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   1Complaint forms shall be available from the
2secretary of the senate, or the chairperson of the
3ethics committee, but a complaint shall not be rejected
4for failure to use an approved form if the complaint
5substantially complies with senate requirements.
   6A complainant may submit exhibits and affidavits
7attached to the complaint.
   816. FILING OF COMPLAINTS.
   9a. Persons entitled. Complaints may be filed by
10any person believing that a senator, candidate for
11senate, lobbyist, or client of a lobbyist has violated
12the senate ethics code, the joint rules governing
13lobbyists, or chapter 68B, as applicable. A violation
14of the criminal law may be considered to be a violation
15of this code of ethics if the violation constitutes a
16serious misdemeanor or greater, or a repetitive and
17flagrant violation of the law.
   18b. Committee complaint. The ethics committee
19may, upon its own motion, initiate a complaint,
20investigation, or disciplinary action.
   2117. PERMANENT RECORD. The secretary of the senate
22shall maintain a permanent record of all complaints
23filed, evidence received by the committee, and any
24transcripts or other recordings made of committee
25proceedings, including a separate file containing
26the date filed, name and address of the complainant,
27name and address of the respondent, a brief statement
28of the charges made, and ultimate disposition of
29the complaint. The secretary shall keep each such
30complaint confidential until public disclosure is made
-9-1by the ethics committee.
   218. PREHEARING PROCEDURE.
   3a. Defective complaint. Upon receipt of a
4complaint, the chairperson and ranking member of the
5ethics committee shall determine whether the complaint
6substantially complies with the requirements of this
7code of ethics and section 68B.31, subsection 6. If
8the complaint does not substantially comply with
9the requirements for formal sufficiency under the
10code of ethics, the complaint may be returned to the
11complainant with a statement that the complaint is not
12in compliance with the code and a copy of the code. If
13the complainant fails to amend the complaint to comply
14with the code within a reasonable time, the chairperson
15and ranking member may dismiss the complaint with
16prejudice for failure to prosecute.
   17b. Service of complaint on respondent. Upon
18receipt of any complaint substantially complying
19with the requirements of this code of ethics, the
20chairperson of the ethics committee shall cause a copy
21of the complaint and any supporting information to be
22delivered promptly to the respondent, requesting a
23written response to be filed within ten days. At the
24time delivery is made to the respondent, delivery of
25copies of the complaint and any supporting information
26shall be made to legislative staff assigned to the
27ethics committee. The response may do any of the
28following:
   29(1) Admit or deny the allegation or allegations.
   30(2) Object that the allegation fails to allege a
-10-1violation of chapter 68B, the joint rules governing
2lobbyists, or the code of ethics.
   3(3) Object to the jurisdiction of the committee.
   4(4) Request a more specific statement of the
5allegation or allegations.
   6c. Objection to member. In addition to the
7items which may be included in a response pursuant
8to paragraph “b”, the response may also include an
9objection to the participation of any member of the
10committee in the consideration of the allegation or
11allegations on the grounds that the member cannot
12render an impartial and unbiased decision.
   13d. Extension of time. At the request of the
14respondent and upon a showing of good cause, the
15committee, or the chairperson and ranking member,
16may extend the time for response, not to exceed ten
17additional days.
   18e. Confidentiality. If a complaint is not
19otherwise made public by the complainant, the members
20of the committee and legislative staff assigned to
21the ethics committee shall treat the complaint and
22all supporting information as confidential until the
23written response is received from the respondent.
   24f. Communications with ethics committee. After a
25complaint has been filed or an investigation has been
26initiated, a party to the complaint or investigation
27shall not communicate, or cause another to communicate,
28as to the merits of the complaint or investigation with
29a member of the committee, except under the following
30circumstances:
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   1(1) During the course of any meetings or other
2official proceedings of the committee regarding the
3complaint or investigation.
   4(2) In writing, if a copy of the writing is
5delivered to the adverse party or the designated
6representative for the adverse party.
   7(3) Orally, if adequate prior notice of the
8communication is given to the adverse party or the
9designated representative for the adverse party.
   10(4) As otherwise authorized by statute, the senate
11code of ethics, the joint rules governing lobbyists, or
12vote of the committee.
   13g. Scheduling hearing. Upon receipt of the
14response, the committee shall schedule a public meeting
15to review the complaint and available information, and
16shall do one of the following:
   17(1) Notify the complainant that no further
18action will be taken, unless further substantiating
19information is produced.
   20(2) Dismiss the complaint for failure to meet the
21statutory and code of ethics requirements for valid
22complaints.
   23(3) Take action on the complaint without requesting
24the appointment of an independent special counsel
25if the committee determines the complaint is valid
26and determines no dispute exists between the parties
27regarding the material facts that establish a
28violation. The committee may do any of the following:
   29(a) Issue an admonishment to advise against the
30conduct that formed the basis for the complaint and to
-12-1exercise care in the future.
   2(b) Issue an order to cease and desist the conduct
3that formed the basis for the complaint.
   4(c) Make a recommendation to the senate that
5the person subject to the complaint be censured or
6reprimanded.
   7(4) Request that the chief justice of the supreme
8court appoint an independent special counsel to conduct
9an investigation of the complaint and supporting
10information, to make a determination of probable cause,
11and to report the findings to the committee, which
12shall be received within a reasonable time.
   13h. Public hearing. If independent special counsel
14is appointed, upon receipt of the report of independent
15special counsel’s findings, the committee shall
16schedule a public meeting to review the report and
17shall do either of the following:
   18(1) Cause the complaint to be scheduled for a
19public hearing.
   20(2) Dismiss the complaint based upon a
21determination by independent special counsel and the
22committee that insufficient evidence exists to support
23a finding of probable cause.
   2419. HEARING PROCEDURE.
   25a. Notice of hearing. If the committee causes a
26complaint to be scheduled for a public hearing, notice
27of the hearing date and time shall be given to the
28complainant and respondent in writing, and of the
29respondent’s right to appear in person, be represented
30by legal counsel, present statements and evidence, and
-13-1examine and cross-examine witnesses. The committee
2shall not be bound by formal rules of evidence, but
3shall receive relevant evidence, subject to limitations
4on repetitiveness. Any evidence taken shall be under
5oath.
   6b. Subpoena power. The committee may require, by
7subpoena or otherwise, the attendance and testimony of
8witnesses and the production of such books, records,
9correspondence, memoranda, papers, documents, and any
10other things it deems necessary to the conduct of the
11inquiry.
   12c. Ex post facto. An investigation shall not be
13undertaken by the committee of a violation of a law,
14rule, or standard of conduct that is not in effect at
15the time of violation.
   16d. Disqualification of member. Members of the
17committee may disqualify themselves from participating
18in any investigation of the conduct of another person
19upon submission of a written statement that the member
20cannot render an impartial and unbiased decision
21in a case. A member may also be disqualified by a
22unanimous vote of the remaining eligible members of the
23committee.
   24A member of the committee is ineligible to
25participate in committee meetings, as a member of the
26committee, in any proceeding relating to the member’s
27own official conduct.
   28If a member of the committee is disqualified or
29ineligible to act, the majority or minority leader who
30appointed the member shall appoint a replacement member
-14-1to serve as a member of the committee during the period
2of disqualification or ineligibility.
   3e. Hearing. At the hearing, the chairperson shall
4open the hearing by stating the charges, the purpose of
5the hearing, and its scope. The burden of proof rests
6upon the complainant to establish the facts as alleged,
7by clear and convincing evidence. However, questioning
8of witnesses shall be conducted by the members of the
9committee, by independent special counsel, or by a
10senator. The chairperson shall also permit questioning
11by legal counsel representing the complainant or
12respondent.
   13The chairperson or other member of the committee
14presiding at a hearing shall rule upon procedural
15questions or any question of admissibility of evidence
16presented to the committee. Rulings may be reversed by
17a majority vote of the committee members present.
   18The committee may continue the hearing to a future
19date if necessary for appropriate reasons or purposes.
   20f. Committee action. Upon receipt of all relevant
21evidence and arguments, the committee shall consider
22the same and recommend to the senate any of the
23following:
   24(1) That the complaint be dismissed.
   25(2) That the senator, candidate for senate,
26lobbyist, or client of a lobbyist be censured or
27reprimanded, and recommend the appropriate form of
28censure or reprimand.
   29(3) Any other appropriate sanction, including
30suspension or expulsion from membership in the senate,
-15-1or suspension of lobbying privileges.
   2g. Disposition resolution. By appropriate
3resolution, the senate may amend, adopt, or reject
4the report of the ethics committee, including the
5committee’s recommendations regarding disciplinary
6action.
   720. COMMITTEE AUTHORIZED TO MEET. The senate
8ethics committee is authorized to meet at the
9discretion of the chairperson to conduct hearings and
10other business that properly may come before it. If
11the committee submits a report seeking senate action
12against a senator, candidate for senate, lobbyist, or
13client of a lobbyist after the second regular session
14of a general assembly has adjourned sine die, the
15report shall be submitted to and considered by the
16subsequent general assembly. However, the report
17may be submitted to and considered during any special
18session which may take place after the second regular
19session of a general assembly has adjourned sine die,
20but before the convening of the next general assembly.
   2121. ADVISORY OPINIONS.
   22a. Requests for formal opinions. A request for a
23formal advisory opinion may be filed by any person who
24is subject to the authority of the ethics committee.
25The ethics committee may also issue a formal advisory
26opinion on its own motion, without having previously
27received a formal request for an opinion, on any issue
28that is within the jurisdiction of the committee.
29Requests shall be filed with either the secretary of
30the senate or the chairperson of the ethics committee.
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   1b. Form and contents of requests. A request for
2a formal advisory opinion shall be in writing and
3may pertain to any subject matter that is related
4to the application of the senate code of ethics, the
5joint rules governing lobbyists, or chapter 68B to
6any person who is subject to the authority of the
7ethics committee. Requests shall contain one or
8more specific questions and shall relate either to
9future conduct or be stated in the hypothetical. A
10request for an advisory opinion shall not specifically
11name any individual or contain any other specific
12identifying information, unless the request relates
13to the requester’s own conduct. However, any request
14may contain information which identifies the kind
15of individual who may be affected by the subject
16matter of the request. Examples of this latter kind
17of identifying information may include references
18to conduct of a category of individuals, such as but
19not limited to conduct of legislators, legislative
20staff, candidates for senate, lobbyists, or clients of
21lobbyists.
   22c. Confidentiality of formal requests and opinions.
23Requests for formal opinions are not confidential and
24any deliberations of the committee regarding a request
25for a formal opinion shall be public. Opinions issued
26in response to requests for formal opinions are not
27confidential, shall be in writing, and shall be placed
28on file in the office of the secretary of the senate.
29Persons requesting formal opinions shall personally
30receive a copy of the written formal opinion that is
-17-1issued in response to the request.
   222. CALCULATION OF TIME — DAYS. For purposes of
3these rules, unless the context otherwise requires,
4the word “day” or “days” shall mean a calendar day
5except that if the day is the last day of a specific
6time period and falls upon a Saturday, Sunday, or legal
7holiday, the time prescribed shall be extended so as to
8include the whole of the next day in which the offices
9of the senate and the general assembly are open for
10official business.
   1123. COMPLAINT FILING FORM. The following form
12shall be used to file a complaint under these rules:
13THE SENATE
14Ethics Complaint Form
15Re: ______________________________ (Senator/Candidate
16for Senate/Lobbyist/Client of Lobbyist), of
17_____________________, Iowa.
   18I, ________________________ (Complainant), residing
19at ____________________, in the City of ______________,
20State of ________________________, hereby complain
21that _____________________________ (Senator/Candidate
22for Senate/Lobbyist/Client of Lobbyist), whose address
23is ___________________________________________, has
24violated the Senate Code of Ethics, chapter 68B, or
25Joint Rules Governing Lobbyists in that:
   26(Explain the basis for the complaint here. Use
27additional pages, if necessary.)
   28Under penalty of perjury, I certify that the above
29complaint is true and correct as I verily believe.
              30___________________________
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              1Signature of Complainant
   2SUBSCRIBED AND AFFIRMED to before me this __________
3day of ________________________, _______.
            4________________________________
            5Notary Public in and for the
            6State of ______________________
   724. COMPLAINT NOTICE FORM. The following form
8shall be used for notice of a complaint under these
9rules:
10STATE OF IOWA
11THE SENATE
12COMMITTEE ON ETHICS)
13IOWA STATE SENATE)
14)
15On The Complaint Of)NOTICE OF COMPLAINT
16)
17___________________________)
18)
19And Involving)
20)
21___________________________)
22)
23TO ________________________________,
  24Senator or Candidate for Senate or Lobbyist or
25Client of Lobbyist named above:
   26You are hereby notified that there is now on file
27with the Secretary of the Senate, State Capitol, Des
28Moines, Iowa, a complaint which alleges that you have
29committed a violation of the Senate’s Code of Ethics,
30chapter 68B, or Joint Rules Governing Lobbyists.
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   1A copy of the complaint and the Senate rules for
2processing the same are attached hereto and made a part
3of this notice.
   4You are further notified and requested to file your
5written answer to the complaint within ten days of the
6date upon which the notice was caused to be delivered
7to you, (date) ________________________, ________.
8Your answer is to be filed with the Secretary of the
9Senate, State Capitol, Des Moines, Iowa.
   10Dated this ________ day of ________________, ______.
             11________________________________
             12Chairperson, Senate Ethics
             13Committee,
             14or Secretary of the Senate
   1525. HEARING NOTICE FORM. The following form shall
16be used for notice of a hearing under these rules:
17STATE OF IOWA
18THE SENATE
19COMMITTEE ON ETHICS)
20IOWA STATE SENATE)
21)
22On The Complaint Of)NOTICE OF HEARING
23)
24___________________________)
25)
26And Involving)
27)
28___________________________)
29)
30TO ________________________________,
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  1Senator or Candidate for Senate or Lobbyist or
2Client of Lobbyist named above:
   3You are hereby notified that there is now on file
4with the Secretary of the Senate, State Capitol, Des
5Moines, Iowa, a complaint which alleges that you have
6committed a violation of the Senate’s Code of Ethics,
7chapter 68B, or Joint Rules Governing Lobbyists.
   8A copy of the complaint and the Senate rules for
9processing the same are attached hereto and made a part
10of this notice.
   11You are further notified that, after preliminary
12review, the committee has caused a public hearing to be
13scheduled on (date)___________________, ________, at
14(hour) ___________ (a.m.) (p.m.), in Room ____, State
15Capitol, Des Moines, Iowa.
   16At the hearing, you will have the right to appear
17in person, be represented by legal counsel at your own
18expense, present statements and evidence, and examine
19and cross-examine witnesses. The committee shall
20not be bound by formal rules of evidence, but shall
21receive relevant evidence, subject to limitations on
22repetitiveness. Any evidence taken shall be under
23oath.
   24The committee may continue the hearing to a future
25date if necessary for appropriate reasons or purposes.
   26You are further notified that the committee will
27receive such evidence and take such action as warranted
28by the evidence.
   29Dated this _____ day of ________________, ______.
             30________________________________
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             1Chairperson, Senate Ethics
             2Committee,
             3or Secretary of the Senate
   426. PERSONAL FINANCIAL DISCLOSURE FORM. The
5following form shall be used for disclosure of economic
6interests under these rules and section 68B.35:
7STATEMENT OF ECONOMIC INTERESTS
8Name:________________________________________________
   9(Last)     (First)     (Middle Initial)
10Address:_____________________________________________
    11(Street Address, Apt.#/P.O. Box)
    12______________________________________________
    13(City) (State) (Zip)
14Phone:(Home) ____/____-_____(Business) ____/____-_____
15******************************************************
   16a. Please list each business, occupation, or
17profession in which you are engaged. In listing
18the business, occupation, or profession, it is
19not necessary that your employer or the name of
20the business be listed, although all businesses,
21occupations, or professions must be listed, regardless
22of the amount of income derived or time spent
23participating in the activity. (Examples of types
24of businesses, occupations, or professions that may
25be listed: teacher, lawyer, legislator, real estate
26agent, insurance adjuster, salesperson....)
27(1) __________________________________________________
28(2) __________________________________________________
29(3) __________________________________________________
30(4) __________________________________________________
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1(5) __________________________________________________
   2b. Please list the nature of each of the
3businesses, occupations, or professions which you
4listed in paragraph “a”, above, unless the nature of
5the business, occupation, or profession is already
6apparent from the information indicated above. The
7descriptions in this paragraph should correspond by
8number to the numbers for each of the businesses,
9occupations, or professions listed in paragraph “a”.
10(Examples: If you indicated, for example, that you
11were a salesperson in subparagraph (1) of paragraph
12“a”, you should list in subparagraph (1) of this
13paragraph the types of goods or services sold in this
14item. If you indicated that you were a teacher in
15subparagraph (2) of paragraph “a”, you should indicate
16in subparagraph (2) of this paragraph the type of
17school or institution in which you provide instruction
18or whether the instruction is provided on a private
19basis. If you indicated that you were a lawyer in
20subparagraph (3) of paragraph “a”, you should indicate
21your areas of practice and whether you are in private,
22corporate, or government practice in subparagraph (3)
23of this paragraph. If you indicated in subparagraph
24(4) of paragraph “a” that you were a consultant, in
25subparagraph (4) of this paragraph you should indicate
26the kind of services provided and types of clients
27served.)
28(1) __________________________________________________
29(2) __________________________________________________
30(3) __________________________________________________
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1(4) __________________________________________________
2(5) __________________________________________________
   3c. Please list each source, by general description,
4from which you receive, or which generates, more than
5one thousand dollars in gross annual income in the
6categories listed below. For purposes of this item,
7a source produces gross annual income if the revenue
8produced by the source is subject to federal or state
9income taxes. In completing this item, it is not
10necessary to list the name of the company, business,
11financial institution, corporation, partnership, or
12other entity which constitutes the source of the income
13and the amount or value of the holding should not be
14listed.
   15(1) Securities (Here for example, you need not
16state that you own X number of shares of any specific
17company by brand or corporate name, or that the stock
18is of a certain value, but may instead state that you
19possess stock in a company and indicate the nature of
20the company’s business.):
21______________________________________________________
22______________________________________________________
23______________________________________________________
24______________________________________________________
25______________________________________________________
   26(2) Instruments of Financial Institutions (You
27need not indicate, for example, in which institutions
28you hold certificates of deposit that produce annual
29income over the one thousand dollar threshold, but
30simply listing the nature of the institution will
-24-1suffice, e.g., bank, credit union, or savings and loan
2association.):
3______________________________________________________
4______________________________________________________
5______________________________________________________
6______________________________________________________
7______________________________________________________
   8(3) Trusts (The name of the particular trust need
9not be listed. However, if the income is received
10from a charitable trust/foundation, such as the Pugh
11Charitable Trust, in the form of a grant, the fact that
12the trust is a charitable trust should be noted here.):
13______________________________________________________
14______________________________________________________
15______________________________________________________
16______________________________________________________
17______________________________________________________
   18(4) Real Estate (When listing real estate, it is
19not necessary to list the location of the property, but
20the general nature of the real estate interest should
21be indicated, e.g., residential leasehold interest or
22farm leasehold interest.):
23______________________________________________________
24______________________________________________________
25______________________________________________________
26______________________________________________________
27______________________________________________________
   28(5) Retirement Systems (When listing retirement
29benefits, it is not necessary to list the name of
30the particular pension system or company, but rather
-25-1the type of benefit should be listed, e.g., health
2benefits, life insurance benefits, private pension, or
3government pension.):
4______________________________________________________
5______________________________________________________
6______________________________________________________
7______________________________________________________
8______________________________________________________
9(Signature of filer)        (Date)
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