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2014 SESSION

14100091D
HOUSE BILL NO. 15
Offered January 8, 2014
Prefiled November 19, 2013
A BILL to amend and reenact §§ 2.2-3117 and 30-111 of the Code of Virginia and to amend the Code of Virginia by adding a section numbered 30-110.1, relating to the State and Local Government Conflict of Interests Act and the General Assembly Conflicts of Interests Act; gifts; disclosures.
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Patron-- Marshall, R.G.
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Referred to Committee on Rules
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Be it enacted by the General Assembly of Virginia:

1. That §§ 2.2-3117 and 30-111 of the Code of Virginia are amended and reenacted and that the Code of Virginia is amended by adding a section numbered 30-110.1 as follows:

§ 2.2-3117. Disclosure form.

The disclosure form to be used for filings required by subsections A and D of § 2.2-3114 and subsections A and E of § 2.2-3115 shall be substantially as follows:


                         STATEMENT OF ECONOMIC INTERESTS.
  Name ...............................................................
  Office or position held or sought ..................................
  Address ............................................................
  Names of members of immediate family ...............................

DEFINITIONS AND EXPLANATORY MATERIAL.

"Business" means a corporation, partnership, sole proprietorship, firm, enterprise, franchise, association, trust or foundation, or any other individual or entity carrying on a business or profession, whether or not for profit.

"Close financial association" means an association in which the person filing shares significant financial involvement with an individual and the filer would reasonably be expected to be aware of the individual's business activities and would have access to the necessary records either directly or through the individual. "Close financial association" does not mean an association based on (i) the receipt of retirement benefits or deferred compensation from a business by which the person filing this statement is no longer employed, or (ii) the receipt of compensation for work performed by the person filing as an independent contractor of a business that represents an entity before any state governmental agency when the person filing has had no communications with the state governmental agency.

"Contingent liability" means a liability that is not presently fixed or determined, but may become fixed or determined in the future with the occurrence of some certain event.

"Dependent" means any person, whether or not related by blood or marriage, who receives from the officer or employee, or provides to the officer or employee, more than one-half of his financial support.

"Gift" means any gratuity, favor, discount, entertainment, hospitality, loan, forbearance, or other item having monetary value. It includes services as well as gifts of transportation, local travel, lodgings and meals, whether provided in-kind, by purchase of a ticket, payment in advance or reimbursement after the expense has been incurred. "Gift" shall not include any offer of a ticket or other admission or pass unless the ticket, admission, or pass is used. "Gift" shall not include honorary degrees and presents from relatives. "Relative" means the donee's spouse, child, uncle, aunt, niece, or nephew; a person to whom the donee is engaged to be married; the donee's or his spouse's parent, grandparent, grandchild, brother, or sister; or the donee's brother's or sister's spouse.

"Immediate family" means (i) a spouse and (ii) any other person residing in the same household as the officer or employee, who is a dependent of the officer or employee or of whom the officer or employee is a dependent. For purposes of reporting gifts pursuant to Item 5 and Schedule E, "immediate family" also includes (a) the officer's or employee's or his spouse's parent, grandparent, child, grandchild, brother, and sister and (b) any person with whom the officer or employee has been habitually cohabiting in a relationship analogous to a marriage.

TRUST. If you or your immediate family, separately or together, are the only beneficiaries of a trust, treat the trust's assets as if you own them directly. If you or your immediate family has a proportional interest in a trust, treat that proportion of the trust's assets as if you own them directly. For example, if you and your immediate family have a one-third interest in a trust, complete your Statement as if you own one-third of each of the trust's assets. If you or a member of your immediate family created a trust and can revoke it without the beneficiaries' consent, treat its assets as if you own them directly.

REPORT TO THE BEST OF INFORMATION AND BELIEF. Information required on this Statement must be provided on the basis of the best knowledge, information and belief of the individual filing the Statement as of the date of this report unless otherwise stated.

COMPLETE ITEMS 1 THROUGH 10. REFER TO SCHEDULES ONLY IF DIRECTED.

You may attach additional explanatory information.

1. Offices and Directorships.

Are you or a member of your immediate family a paid officer or paid director of a business?

EITHER check NO /  / OR check YES /  / and complete Schedule A.

2. Personal Liabilities.

Do you or a member of your immediate family or does a business in which you or a member of your immediate family holds an ownership interest owe more than $10,000 to any one creditor including contingent liabilities? (Exclude debts to any government and loans secured by recorded liens on property at least equal in value to the loan.) This requirement to disclose business liabilities does not apply to an ownership interest in a business unless the ownership interest exceeds three percent of the total equity of the business.

EITHER check NO /  / OR check YES /  / and complete Schedule B.

3. Securities.

Do you or a member of your immediate family, directly or indirectly, separately or together, own securities valued in excess of $10,000 invested in one business? Account for mutual funds, limited partnerships and trusts.

EITHER check NO /  / OR check YES /  / and complete Schedule C.

4. Payments for Talks, Meetings, and Publications.

During the past 12 months did you receive lodging, transportation, money, or anything else of value with a combined value exceeding $200 for a single talk, meeting, or published work in your capacity as an officer or employee of your agency?

EITHER check NO /  / OR check YES /  / and complete Schedule D.

5. Gifts.

During the past 12 months did a business, government, or individual other than a relative or personal friend (i) furnish you with any gift or entertainment at a single event, and the value received by you exceeded $50 in value or (ii) furnish you with gifts or entertainment in any combination and the total value received by you exceeded $100 in total value; or during the past 12 months did a business, government, or individual furnish a member of your immediate family with gifts or entertainment in any combination and the total value received exceeded $100 where such business, government, or individual transacted or is transacting business with the Commonwealth or its agencies, departments, or political subdivisions within 12 months from the date of the gift; and for which you or the member of your immediate family neither paid nor rendered services in exchange? Account for entertainment events only if the average value per person attending the event exceeded $50 in value. Account for all business entertainment (except if related to your or your immediate family member's private profession or occupation) even if unrelated to your official duties.

EITHER check NO /  / OR check YES /  / and complete Schedule E.

6. Salary and Wages.

List each employer that pays you or a member of your immediate family salary or wages in excess of $10,000 annually. (Exclude state or local government or advisory agencies.)

If no reportable salary or wages, check here /  /.

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

7. Business Interests.

Do you or a member of your immediate family, separately or together, operate your own business, or own or control an interest in excess of $10,000 in a business?

EITHER check NO /  / OR check YES /  / and complete Schedule F.

8. Payments for Representation and Other Services.

8A. Did you represent, excluding activity defined as lobbying in § 2.2-419, any businesses before any state governmental agencies, excluding courts or judges, for which you received total compensation during the past 12 months in excess of $1,000, excluding compensation for other services to such businesses and representation consisting solely of the filing of mandatory papers and subsequent representation regarding the mandatory papers? (Officers and employees of local governmental and advisory agencies do NOT need to answer this question or complete Schedule G-1.)

EITHER check NO /  / OR check YES /  / and complete Schedule G-1.

8B. Subject to the same exceptions as in 8A, did persons with whom you have a close financial association (partners, associates or others) represent, excluding activity defined as lobbying in § 2.2-419, any businesses before any state governmental agency for which total compensation was received during the past 12 months in excess of $1,000? (Officers and employees of local governmental and advisory agencies do NOT need to answer this question or complete Schedule G-2.)

EITHER check NO /  / OR check YES /  / and complete Schedule G-2.

8C. Did you or persons with whom you have a close financial association furnish services to businesses operating in Virginia pursuant to an agreement between you and such businesses, or between persons with whom you have a close financial association and such businesses for which total compensation in excess of $1,000 was received during the past 12 months?

EITHER check NO /  / OR check YES /  / and complete Schedule G-3.

9. Real Estate.

9A. State Officers and Employees.

Do you or a member of your immediate family hold an interest, including a partnership interest, valued at $10,000 or more in real property (other than your principal residence) for which you have not already listed the full address on Schedule F? Account for real estate held in trust.

EITHER check NO /  / OR check YES /  / and complete Schedule H-1.

9B. Local Officers and Employees.

Do you or a member of your immediate family hold an interest, including a partnership interest, or option, easement, or land contract, valued at $10,000 or more in real property (other than your principal residence) for which you have not already listed the full address on Schedule F? Account for real estate held in trust.

EITHER check NO /  / OR check YES /  / and complete Schedule H-2.

10. Real Estate Contracts with Governmental Agencies.

Do you or a member of your immediate family hold an interest valued at more than $10,000 in real estate, including a corporate, partnership, or trust interest, option, easement, or land contract, which real estate is the subject of a contract, whether pending or completed within the past 12 months, with a governmental agency? If the real estate contract provides for the leasing of the property to a governmental agency, do you or a member of your immediate family hold an interest in the real estate valued at more than $1,000? Account for all such contracts whether or not your interest is reported in Schedule F, H-1, or H-2. This requirement to disclose an interest in a lease does not apply to an interest derived through an ownership interest in a business unless the ownership interest exceeds three percent of the total equity of the business.

EITHER check NO /  / OR check YES /  / and complete Schedule I.

Statements of Economic Interests are open for public inspection.

AFFIRMATION BY ALL FILERS.

I swear or affirm that the foregoing information is full, true and correct to the best of my knowledge.

Signature ......................................................

(Return only if needed to complete Statement.)


                                      SCHEDULES
                                          to
                            STATEMENT OF ECONOMIC INTERESTS.

NAME ......................................................

SCHEDULE A - OFFICES AND DIRECTORSHIPS.

Identify each business of which you or a member of your immediate family is a paid officer or paid director.

___________________________________________________________________
 
  Name of Business        Address of Business      Position Held
  _____________________   ______________________   __________________
  _____________________   ______________________   __________________
  _____________________   ______________________   __________________
  _____________________   ______________________   __________________
  ___________________________________________________________________
                                                     RETURN TO ITEM 2

SCHEDULE B - PERSONAL LIABILITIES.

Report personal liability by checking each category. Report only debts in excess of $10,000. Do not report debts to any government. Do not report loans secured by recorded liens on property at least equal in value to the loan.

Report contingent liabilities below and indicate which debts are contingent.

1. My personal debts are as follows:

_______________________________________________________________________
 
         Check                                            Check one
      appropriate                                  $10,001 to   More than
       categories                                    $50,000     $50,000
  Banks                                            __________   _________
  Savings institutions                             __________   _________
  Other loan or finance companies                  __________   _________
  Insurance companies                              __________   _________
  Stock, commodity, or other brokerage companies   __________   _________
  Other businesses:
  (State principal business activity for each
  creditor.)                                       __________   _________
                                                   __________   _________
                                                   __________   _________
  Individual creditors:
  (State principal business or
  occupation of each creditor.)                    __________   _________
                                                   __________   _________
                                                   __________   _________
  _______________________________________________________________________

2. The personal debts of the members of my immediate family are as follows:

_______________________________________________________________________
 
         Check                                            Check one
      appropriate                                  $10,001 to   More than
       categories                                    $50,000     $50,000
  Banks                                            __________   _________
  Savings institutions                             __________   _________
  Other loan or finance companies                  __________   _________
  Insurance companies                              __________   _________
  Stock, commodity, or other brokerage companies   __________   _________
  Other businesses:
  (State principal business activity for each
  creditor.)                                       __________   _________
                                                   __________   _________
                                                   __________   _________
  Individual creditors:
  (State principal business or
  occupation of each creditor.)                    __________   _________
                                                   __________   _________
                                                   __________   _________
  _______________________________________________________________________

3. The debts of my or my immediate family's business interests are as follows:

_______________________________________________________________________
 

         Check                                            Check one
      appropriate                                  $10,001 to   More than
       categories                                    $50,000     $50,000
  Banks                                            __________   _________
  Savings institutions                             __________   _________
  Other loan or finance companies                  __________   _________
  Insurance companies                              __________   _________
  Stock, commodity, or other brokerage companies   __________   _________
  Other businesses:
  (State principal business activity for each
  creditor.)                                       __________   _________
                                                   __________   _________
                                                   __________   _________
  Individual creditors:
  (State principal business or
  occupation of each creditor.)                    __________   _________
                                                   __________   _________
                                                   __________   _________
  _______________________________________________________________________

                                                         RETURN TO ITEM 3

SCHEDULE C - SECURITIES.


  "Securities" INCLUDES stocks, bonds,   "Securities" EXCLUDES
   mutual funds, limited partnerships,    certificates of deposit,
   and commodity futures contracts.       money market funds, annuity
   contracts, and insurance policies.

Identify each business or Virginia governmental entity in which you or a member of your immediate family, directly or indirectly, separately or together, own securities valued in excess of $10,000. Name each entity and type of security individually.

Do not list U.S. Bonds or other government securities not issued by the Commonwealth of Virginia or its authorities, agencies, or local governments. Do not list organizations that do not do business in this Commonwealth, but most major businesses conduct business in Virginia. Account for securities held in trust.

If no reportable securities, check here /  /.

____________________________________________________________________________
 
                                                            Check one
                               Type of Security     $10,001  $50,001    More
                   Type of  (stocks, bonds, mutual     to       to      than
  Name of Issuer   Entity        funds, etc.)       $50,000  $250,000 $250,000
  ______________   _______  _______________________ _______  _______  ________
  ______________   _______  _______________________ _______  _______  ________
  ______________   _______  _______________________ _______  _______  ________
  ______________   _______  _______________________ _______  _______  ________
  ____________________________________________________________________________
                                                              RETURN TO ITEM 4

SCHEDULE D - PAYMENTS FOR TALKS, MEETINGS, AND PUBLICATIONS.

List each source from which you received during the past 12 months lodging, transportation, money, or any other thing of value (excluding meals or drinks coincident with a meeting) with combined value exceeding $200 for your presentation of a single talk, participation in one meeting, or publication of a work in your capacity as an officer or employee of your agency.

List payments or reimbursements by an advisory or governmental agency only for meetings or travel outside the Commonwealth.

List a payment even if you donated it to charity.

Do not list information about a payment if you returned it within 60 days or if you received it from an employer already listed under Item 6 or from a source of income listed on Schedule F.

If no payment must be listed, check here / /.

__________________________________________________________________________
 
                                                           Type of payment
                                                           (e.g. honoraria,
                                                           travel reimburse-
  Payer        Approximate Value       Circumstances       ment, etc.)
  __________   _____________________   ________________    _________________
  __________   _____________________   ________________    _________________
  __________   _____________________   ________________    _________________
  __________   _____________________   ________________    _________________
  __________________________________________________________________________
                                                            RETURN TO ITEM 5

SCHEDULE E - GIFTS.

List each business, governmental entity, or individual that, during the past 12 months, (i) furnished you with any gift or entertainment at a single event and the value received by you exceeded $50 in value, or (ii) furnished you with gifts or entertainment in any combination and the total value received by you exceeded $100 in total value; and each business, governmental entity, or individual that, during the past 12 months, furnished a member of your immediate family with gifts or entertainment in any combination and the total value received exceeded $100 where such business, governmental entity, or individual transacted or is transacting business with the Commonwealth or its agencies, departments, or political subdivisions within 12 months from the date of the gift; and for which you or the member of your immediate family neither paid nor rendered services in exchange. List each such gift or event and the name of the recipient of the gift.

Do not list entertainment events unless the average value per person attending the event exceeded $50 in value. Do not list business entertainment related to your or your immediate family member's private profession or occupation. Do not list gifts or other things of value given by a relative or personal friend for reasons clearly unrelated to your public position.

Do not list campaign contributions publicly reported as required by Chapter 9.3 (§ 24.2-945 et seq.) of Title 24.2 of the Code of Virginia.

__________________________________________________________________________
 
                 Name of Business,    City or
  Name of        Organization, or     County       Gift or       Approximate
  Recipient      Individual           and State    Event         Value
  ____________   __________________   __________   ___________   ___________
  ____________   __________________   __________   ___________   ___________
  ____________   __________________   __________   ___________   ___________
  ____________   __________________   __________   ___________   ___________
  __________________________________________________________________________
                                                            RETURN TO ITEM 6

SCHEDULE F - BUSINESS INTERESTS.

Complete this Schedule for each self-owned or family-owned business (including rental property, a farm, or consulting work), partnership, or corporation in which you or a member of your immediate family, separately or together, own an interest having a value in excess of $10,000.

If the enterprise is owned or operated under a trade, partnership, or corporate name, list that name; otherwise, merely explain the nature of the enterprise. If rental property is owned or operated under a trade, partnership, or corporate name, list the name only; otherwise, give the address of each property. Account for business interests held in trust.

___________________________________________________________________________
 
  Name of Business,                                        Gross Income
  Corporation,
  Partnership,     City or   Nature of Enterprise           $50,001    More
  Farm; Address of County    (farming, law, rental $50,000     to      than
  Rental Property  and State property, etc.)       or less  $250,000 $250,000
  ________________ _________ _____________________ ________ ________ ________
  ________________ _________ _____________________ ________ ________ ________
  ________________ _________ _____________________ ________ ________ ________
  ________________ _________ _____________________ ________ ________ ________
  ___________________________________________________________________________
                                                             RETURN TO ITEM 8

SCHEDULE G-1 - PAYMENTS FOR REPRESENTATION BY YOU.

List the businesses you represented, excluding activity defined as lobbying in § 2.2-419, before any state governmental agency, excluding any court or judge, for which you received total compensation during the past 12 months in excess of $1,000, excluding compensation for other services to such businesses and representation consisting solely of the filing of mandatory papers and subsequent representation regarding the mandatory papers filed by you.

Identify each business, the nature of the representation and the amount received by dollar category from each such business. You may state the type, rather than name, of the business if you are required by law not to reveal the name of the business represented by you.

Only STATE officers and employees should complete this Schedule.

_____________________________________________________________________
 
              Pur-                       Amount Received
              pose
  Name  Type  of     Name
  of    of    Repre- of     $1,001  $10,001 $50,001  $100,001  $250,001
  Busi- Busi- senta- Agen-     to      to      to        to      and
  ness  ness  tion   cy     $10,000 $50,000 $100,000 $250,000    over
  _____ _____ ______ ______ _______ _______ ________ _________ ________
  _____ _____ ______ ______ _______ _______ ________ _________ ________
  _____ _____ ______ ______ _______ _______ ________ _________ ________
  _____ _____ ______ ______ _______ _______ ________ _________ ________
  _____________________________________________________________________

If you have received $250,001 or more from a single business within the reporting period, indicate the amount received, rounded to the nearest $10,000.


                                                Amount Received:______.

SCHEDULE G-2 - PAYMENTS FOR REPRESENTATION BY ASSOCIATES.

List the businesses that have been represented, excluding activity defined as lobbying in § 2.2-419, before any state governmental agency, excluding any court or judge, by persons who are your partners, associates or others with whom you have a close financial association and who received total compensation in excess of $1,000 for such representation during the past 12 months, excluding representation consisting solely of the filing of mandatory papers and subsequent representation regarding the mandatory papers filed by your partners, associates or others with whom you have a close financial association.

Identify such businesses by type and also name the state governmental agencies before which such person appeared on behalf of such businesses.

Only STATE officers and employees should complete this Schedule.

______________________________________________________________
 
  Type of business        Name of state governmental agency
  ____________________    ______________________________________
  ____________________    ______________________________________
  ____________________    ______________________________________
  ____________________    ______________________________________
  ______________________________________________________________

SCHEDULE G-3 - PAYMENTS FOR SERVICES GENERALLY.

Indicate below types of businesses that operate in Virginia to which services were furnished by you or persons with whom you have a close financial association pursuant to an agreement between you and such businesses, or between persons with whom you have a close financial association and such businesses and for which total compensation in excess of $1,000 was received during the past 12 months.

Identify opposite each category of businesses listed below (i) the type of business, (ii) the type of service rendered and (iii) the value by dollar category of the compensation received for all businesses falling within each category.

___________________________________________________________________________
 
                       Check                  Value of Compensation
                       if    Type
                       ser-  of
                       vices ser-
                       were  vice  $1,001  $10,001 $50,001  $100,001 $250,001
                       ren-  ren-    to       to      to       to      and
                       dered dered $10,000 $50,000 $100,000 $250,000   over
  Electric utilities   _____ _____ _______ _______ ________ ________ ________
  Gas utilities        _____ _____ _______ _______ ________ ________ ________
  Telephone utilities  _____ _____ _______ _______ ________ ________ ________
  Water utilities      _____ _____ _______ _______ ________ ________ ________
  Cable television
    companies          _____ _____ _______ _______ ________ ________ ________
  Interstate
    transportation
    companies          _____ _____ _______ _______ ________ ________ ________
  Intrastate
    transportation
    companies          _____ _____ _______ _______ ________ ________ ________
  Oil or gas retail
    companies          _____ _____ _______ _______ ________ ________ ________
  Banks                _____ _____ _______ _______ ________ ________ ________
  Savings institutions _____ _____ _______ _______ ________ ________ ________
  Loan or finance
    companies          _____ _____ _______ _______ ________ ________ ________
  Manufacturing
    companies  (state
    type of product,
    e.g., textile,
    furniture, etc.)   _____ _____ _______ _______ ________ ________ ________
  Mining companies     _____ _____ _______ _______ ________ ________ ________
  Life insurance
    companies          _____ _____ _______ _______ ________ ________ ________
  Casualty insurance
    companies          _____ _____ _______ _______ ________ ________ ________
  Other insurance
    companies          _____ _____ _______ _______ ________ ________ ________
  Retail companies     _____ _____ _______ _______ ________ ________ ________
  Beer, wine or liquor
    companies or
    distributors       _____ _____ _______ _______ ________ ________ ________
  Trade associations   _____ _____ _______ _______ ________ ________ ________
  Professional
    associations       _____ _____ _______ _______ ________ ________ ________
  Associations of
    public employees
    or officials       _____ _____ _______ _______ ________ ________ ________
  Counties, cities
    or towns           _____ _____ _______ _______ ________ ________ ________
  Labor organizations  _____ _____ _______ _______ ________ ________ ________
  Other                _____ _____ _______ _______ ________ ________ ________
  ___________________________________________________________________________
                                                             RETURN TO ITEM 9

SCHEDULE H-1 - REAL ESTATE - STATE OFFICERS AND EMPLOYEES.

List real estate other than your principal residence in which you or a member of your immediate family holds an interest, including a partnership interest, option, easement, or land contract, valued at $10,000 or more. Each parcel shall be listed individually.

_________________________________________________________________________
 
                         Describe the type of real
  List each location     estate you own in each      If the real estate is
  (state, and county     location (business, recre-  owned or recorded in
  or city) where you     ational, apartment, com-    a name other than your
  own real estate.       mercial, open land, etc.).  own, list that name.
  _____________________  __________________________  ______________________
  _____________________  __________________________  ______________________
  _____________________  __________________________  ______________________
  _____________________  __________________________  ______________________
  _____________________  __________________________  ______________________
  _________________________________________________________________________

SCHEDULE H-2 - REAL ESTATE - LOCAL OFFICERS AND EMPLOYEES.

List real estate other than your principal residence in which you or a member of your immediate family holds an interest, including a partnership interest or option, easement, or land contract, valued at $10,000 or more. Each parcel shall be listed individually. Also list the names of any co-owners of such property, if applicable.

_________________________________________________________________________
 
                     Describe the type
                     of real estate
                     you own in
                     each location     If the real estate
  List each location (business,        is owned or rec-
  (state, and county recreational,     orded in a name
  or city) where     apartment, com-   other than your    List the names
  you own real       mercial, open     own, list that     of any co-owners,
  estate.            land, etc.).      name.              if applicable.
  __________________ _________________ __________________ _________________
  __________________ _________________ __________________ _________________
  __________________ _________________ __________________ _________________
  __________________ _________________ __________________ _________________
  __________________ _________________ __________________ _________________
  _________________________________________________________________________

SCHEDULE I - REAL ESTATE CONTRACTS WITH GOVERNMENTAL AGENCIES.

List all contracts, whether pending or completed within the past 12 months, with a governmental agency for the sale or exchange of real estate in which you or a member of your immediate family holds an interest, including a corporate, partnership or trust interest, option, easement, or land contract, valued at $10,000 or more. List all contracts with a governmental agency for the lease of real estate in which you or a member of your immediate family holds such an interest valued at $1,000 or more. This requirement to disclose an interest in a lease does not apply to an interest derived through an ownership interest in a business unless the ownership interest exceeds three percent of the total equity of the business.

State officers and employees report contracts with state agencies.

Local officers and employees report contracts with local agencies.

_______________________________________________________________________
 
  List your real estate
  interest and the
  person or entity,
  including the type
  of entity, which
  is party to
  the contract.                                       State the annual
  Describe any                                        income from the
  management role and      List each governmental     contract, and the
  the percentage           agency which is a          amount, if any, of
  ownership                party to the contract      income you or any
  interest you or your     and indicate the           immediate family
  immediate family         county or city where       member derives
  member has in the real   the real estate            annually from the
  estate or entity.        is located.                contract.
  ______________________   ________________________   ___________________
  ______________________   ________________________   ___________________
  ______________________   ________________________   ___________________
  ______________________   ________________________   ___________________
  ______________________   ________________________   ___________________
  _______________________________________________________________________

§ 30-110.1. Disclosure of gifts made during legislative sessions.

In addition to the disclosures required by § 30-110, every legislator shall disclose any gift with a value in excess of $100 from any single source other than a relative or personal friend that is accepted during a regular session of the General Assembly within five business days of the acceptance of such gift. Disclosures required by this section shall be made using the disclosure form set forth in § 30-111. Members of the Senate shall file their disclosure forms with the Clerk of the Senate, and members of the House of Delegates shall file their disclosure forms with the Clerk of the House of Delegates. The disclosure forms of the members of the General Assembly shall be maintained as public records for five years in the office of the clerk of the appropriate house. Any gift reported pursuant to this section shall also be reported on the report required to be filed by § 30-110.

§ 30-111. Disclosure form.

A. The disclosure form to be used for filings required by subsections A and B of § 30-110 shall be substantially as follows:


                         STATEMENT OF ECONOMIC INTERESTS.
  Name ....................................................................
  Office or position held or sought .......................................
  Home address ............................................................
  Names of members of immediate family ....................................

DEFINITIONS AND EXPLANATORY MATERIAL.

"Business" means a corporation, partnership, sole proprietorship, firm, enterprise, franchise, association, trust or foundation, or any other individual or entity carrying on a business or profession, whether or not for profit.

"Close financial association" means an association in which the filer shares significant financial involvement with an individual and the filer would reasonably be expected to be aware of the individual's business activities and would have access to the necessary records either directly or through the individual. "Close financial association" does not mean an association based on (i) the receipt of retirement benefits or deferred compensation from a business by which the legislator is no longer employed, or (ii) the receipt of compensation for work performed by the legislator as an independent contractor of a business that represents an entity before any state governmental agency when the legislator has had no communications with the state governmental agency.

"Contingent liability" means a liability that is not presently fixed or determined, but may become fixed or determined in the future with the occurrence of some certain event.

"Dependent" means any person, whether or not related by blood or marriage, who receives from the legislator, or provides to the legislator, more than one-half of his financial support.

"Gift" means any gratuity, favor, discount, entertainment, hospitality, loan, forbearance, or other item having monetary value. It includes services as well as gifts of transportation, local travel, lodgings and meals, whether provided in-kind, by purchase of a ticket, payment in advance or reimbursement after the expense has been incurred. "Gift" shall not include any offer of a ticket or other admission or pass unless the ticket, admission, or pass is used. "Gift" shall not include honorary degrees and presents from relatives. "Relative" means the donee's spouse, child, uncle, aunt, niece, or nephew; a person to whom the donee is engaged to be married; the donee's or his spouse's parent, grandparent, grandchild, brother, or sister; or the donee's brother's or sister's spouse.

"Immediate family" means (i) a spouse and (ii) any other person residing in the same household as the legislator, who is a dependent of the legislator or of whom the legislator is a dependent. For purposes of reporting gifts pursuant to Item 5 and Schedule E, "immediate family" also includes (a) the legislator's or his spouse's parent, grandparent, child, grandchild, brother, and sister and (b) any person with whom the legislator has been habitually cohabiting in a relationship analogous to a marriage.

"Lobbyist relationship" means (i) an engagement, agreement, or representation that relates to legal services, consulting services, or public relations services, whether gratuitous or for compensation, between a member or member-elect and any person who is, or has been within the prior calendar year, registered as a lobbyist with the Secretary of the Commonwealth, or (ii) a greater than three percent ownership interest by a member or member-elect in a business that employs, or engages as an independent contractor, any person who is, or has been within the prior calendar year, registered as a lobbyist with the Secretary of the Commonwealth. The disclosure of a lobbyist relationship shall not (i) constitute a waiver of any attorney-client or other privilege, (ii) require a waiver of any attorney-client or other privilege for a third party, or (iii) be required where a member or member-elect is employed or engaged by a person and such person also employs or engages a person in a lobbyist relationship so long as the member or member-elect has no financial interest in the lobbyist relationship.

TRUST. If you or your immediate family, separately or together, are the only beneficiaries of a trust, treat the trust's assets as if you own them directly. If you or your immediate family has a proportional interest in a trust, treat that proportion of the trust's assets as if you own them directly. For example, if you and your immediate family have a one-third interest in a trust, complete your Statement as if you own one-third of each of the trust's assets. If you or a member of your immediate family created a trust and can revoke it without the beneficiaries' consent, treat its assets as if you own them directly.

REPORT TO THE BEST OF INFORMATION AND BELIEF. Information required on this Statement must be provided on the basis of the best knowledge, information and belief of the individual filing the Statement as of the date of this report unless otherwise stated.

COMPLETE ITEMS 1 THROUGH 11. REFER TO SCHEDULES ONLY IF DIRECTED.

You may attach additional explanatory information.

1. Offices and Directorships.

Are you or a member of your immediate family a paid officer or paid director of a business?

EITHER check NO /  / OR check YES /  / and complete Schedule A.

2. Personal Liabilities.

Do you or a member of your immediate family or does a business in which you or a member of your immediate family holds an ownership interest owe more than $10,000 to any one creditor including contingent liabilities? (Exclude debts to any government and loans secured by recorded liens on property at least equal in value to the loan.) This requirement to disclose business liabilities does not apply to an ownership interest in a business unless the ownership interest exceeds three percent of the total equity of the business.

EITHER check NO /  / OR check YES /  / and complete Schedule B.

3. Securities.

Do you or a member of your immediate family, directly or indirectly, separately or together, own securities valued in excess of $10,000 invested in one business? Account for mutual funds, limited partnerships and trusts.

EITHER check NO /  / OR check YES /  / and complete Schedule C.

4. Payments for Talks, Meetings, and Publications.

During the past 12 months did you receive lodging, transportation, money, or anything else of value with a combined value exceeding $200 for a single talk, meeting, or published work in your capacity as a legislator? Do not include payments and reimbursements from the Commonwealth for meetings attended in your capacity as a legislator; see Question 11 and Schedule D2 to report such meetings.

EITHER check NO /  / OR check YES /  / and complete Schedule D.

5. Gifts.

During the past 12 months did a business, government, or individual other than a relative or personal friend (i) furnish you with any gift or entertainment at a single event, and the value received by you exceeded $50 in value or (ii) furnish you with gifts or entertainment in any combination and the total value received by you exceeded $100 in total value; or during the past 12 months did a business, government, or individual furnish a member of your immediate family with gifts or entertainment in any combination and the total value received exceeded $100 where such business, government, or individual transacted or is transacting business with the Commonwealth or its agencies, departments, or political subdivisions within 12 months from the date of the gift; and for which you or the member of your immediate family neither paid nor rendered services in exchange? Account for entertainment events only if the average value per person attending the event exceeded $50 in value. Account for all business entertainment (except if related to you or your immediate family member's private profession or occupation) even if unrelated to your official duties.

EITHER check NO /  / OR check YES /  / and complete Schedule E.

6. Salary and Wages.

List each employer that pays you or a member of your immediate family salary or wages in excess of $10,000 annually. (Exclude any salary received as a member of the General Assembly pursuant to § 30-19.11.)

If no reportable salary or wages, check here /  / .

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

7. Business Interests and Lobbyist Relationships.

7A. Do you or a member of your immediate family, separately or together, operate your own business, or own or control an interest in excess of $10,000 in a business?

EITHER check NO /  / OR check YES /  / and complete Schedule F-1.

7B. Do you have a lobbyist relationship as that term is defined above?

EITHER check NO /  / OR check YES /  / and complete Schedule F-2.

8. Payments for Representation and Other Services.

8A. Did you represent any businesses before any state governmental agencies, excluding courts or judges, for which you received total compensation during the past 12 months in excess of $1,000, excluding compensation for other services to such businesses and representation consisting solely of the filing of mandatory papers and subsequent representation regarding the mandatory papers?

EITHER check NO /  / OR check YES /  / and complete Schedule G-1.

8B. Subject to the same exceptions as in 8A, did persons with whom you have a close financial association (partners, associates or others) represent any businesses before any state governmental agency for which total compensation was received during the past 12 months in excess of $1,000?

EITHER check NO /  / OR check YES /  / and complete Schedule G-2.

8C. Did you or persons with whom you have a close financial association furnish services to businesses operating in Virginia, pursuant to an agreement between you and such businesses, or between persons with whom you have a close financial association and such businesses for which total compensation in excess of $1,000 was received during the past 12 months? Services reported under this provision shall not include services involving the representation of businesses that are reported under question 8A or 8B above.

EITHER check NO /  / OR check YES /  / and complete Schedule G-3.

9. Real Estate.

Do you or a member of your immediate family hold an interest, including a partnership interest, valued at $10,000 or more in real property (other than your principal residence) for which you have not already listed the full address on Schedule F? Account for real estate held in trust.

EITHER check NO /  / OR check YES /  / and complete Schedule H.

10. Real Estate Contracts with State Governmental Agencies.

Do you or a member of your immediate family hold an interest valued at more than $10,000 in real estate, including a corporate, partnership, or trust interest, option, easement, or land contract, which real estate is the subject of a contract, whether pending or completed within the past 12 months, with a state governmental agency?

If the real estate contract provides for the leasing of the property to a state governmental agency, do you or a member of your immediate family hold an interest in the real estate, including a corporate, partnership, or trust interest, option, easement, or land contract valued at more than $1,000? Account for all such contracts whether or not your interest is reported in Schedule F or H. This requirement to disclose an interest in a lease does not apply to an interest derived through an ownership interest in a business unless the ownership interest exceeds three percent of the total equity of the business.

EITHER check NO /  / OR check YES /  / and complete Schedule I.

11. Payments by the Commonwealth for Meetings.

During the past 12 months did you receive lodging, transportation, money, or anything else of value with a combined value exceeding $200 from the Commonwealth for a single meeting attended out-of-state in your capacity as a legislator? Do not include reimbursements from the Commonwealth for meetings attended in the Commonwealth.

EITHER check NO /  / OR check YES /  / and complete Schedule D-2.

Statements of Economic Interests are open for public inspection.

AFFIRMATION.

In accordance with the rules of the house in which I serve, if I receive a request that this disclosure statement be corrected, augmented, or revised in any respect, I hereby pledge that I shall respond promptly to the request. I understand that if a determination is made that the statement is insufficient, I will satisfy such request or be subjected to disciplinary action of my house.

I swear or affirm that the foregoing information is full, true and correct to the best of my knowledge.


  Signature ________________________________
  Commonwealth of Virginia
  ________ of ________ to wit:
  The foregoing disclosure form was acknowledged before me
  This ________ day of ____________, 20____, by ______________
                                                Notary Public
  My commission expires ________________________
  (Return only if needed to complete Statement.)
 
                                      SCHEDULES
                                          to
                            STATEMENT OF ECONOMIC INTERESTS.

NAME ________________________________

SCHEDULE A - OFFICES AND DIRECTORSHIPS.

Identify each business of which you or a member of your immediate family is a paid officer or paid director.

_________________________________________________________________________
 
  Name of Business        Address of Business       Position Held
  _____________________   _______________________   _______________________
  _____________________   _______________________   _______________________
  _____________________   _______________________   _______________________
  _____________________   _______________________   _______________________
  _________________________________________________________________________
                                                           RETURN TO ITEM 2

SCHEDULE B - PERSONAL LIABILITIES.

Report personal liability by checking each category. Report only debts in excess of $10,000. Do not report debts to any government. Do not report loans secured by recorded liens on property at least equal in value to the loan.

Report contingent liabilities below and indicate which debts are contingent.

1. My personal debts are as follows:

__________________________________________________________________________
 
         Check                                               Check one
      appropriate                                     $10,001 to   More than
       categories                                     $50,000      $50,000
  Banks                                               __________   _________
  Savings institutions                                __________   _________
  Other loan or finance companies                     __________   _________
  Insurance companies                                 __________   _________
  Stock, commodity, or other brokerage
     companies                                        __________   _________
  Other businesses:
  (State principal business activity for each
     creditor.)                                       __________   _________
  ____________________________________________        __________   _________
  ____________________________________________        __________   _________
  Individual creditors:
  (State principal business or occupation of
     each creditor.)                                  __________   _________
  ____________________________________________        __________   _________
  ____________________________________________        __________   _________
  __________________________________________________________________________

2. The personal debts of the members of my immediate family are as follows:

__________________________________________________________________________
 
         Check                                               Check one
      appropriate                                     $10,001 to   More than
       categories                                     $50,000      $50,000
  Banks                                               __________   _________
  Savings institutions                                __________   _________
  Other loan or finance companies                     __________   _________
  Insurance companies                                 __________   _________
  Stock, commodity, or other brokerage
     companies                                        __________   _________
  Other businesses:
  (State principal business activity for each
     creditor.)                                       __________   _________
  ____________________________________________        __________   _________
  ____________________________________________        __________   _________
  Individual creditors:
  (State principal business or occupation of
     each creditor.)                                  __________   _________
  ____________________________________________        __________   _________
  ____________________________________________        __________   _________
  __________________________________________________________________________

3. The debts of my or my immediate family's business interests are as follows:

_______________________________________________________________________
 

         Check                                            Check one
      appropriate                                  $10,001 to   More than
       categories                                    $50,000     $50,000
  Banks                                            __________   _________
  Savings institutions                             __________   _________
  Other loan or finance companies                  __________   _________
  Insurance companies                              __________   _________
  Stock, commodity, or other brokerage companies   __________   _________
  Other businesses:
  (State principal business activity for each
  creditor.)                                       __________   _________
                                                   __________   _________
                                                   __________   _________
  Individual creditors:
  (State principal business or
  occupation of each creditor.)                    __________   _________
                                                   __________   _________
                                                   __________   _________
  _______________________________________________________________________

                                                         RETURN TO ITEM 3

SCHEDULE C - SECURITIES.


  "Securities" INCLUDES stocks, bonds,     "Securities" EXCLUDES
   mutual funds, limited partnerships,      certificates of deposit,
   and commodity futures contracts.         money market funds, annuity
                                            contracts, and insurance policies.

Identify each business or Virginia governmental entity in which you or a member of your immediate family, directly or indirectly, separately or together, own securities valued in excess of $10,000. Name each entity and type of security individually.

Do not list U.S. Bonds or other government securities not issued by the Commonwealth of Virginia or its authorities, agencies, or local governments. Do not list organizations that do not do business in this Commonwealth, but most major businesses conduct business in Virginia. Account for securities held in trust.

If no reportable securities, check here /  / .

__________________________________________________________________________
 
                                                         Check one
                            Type of Security    $10,001   $50,001     More
                  Type of   (stocks, bonds,       to        to        than
  Name of Issuer  Entity   mutual funds, etc.)  $50,000   $250,000  $250,000
  ______________  _______  ___________________  ________  ________  ________
  ______________  _______  ___________________  ________  ________  ________
  ______________  _______  ___________________  ________  ________  ________
  ______________  _______  ___________________  ________  ________  ________
  __________________________________________________________________________
                                                            RETURN TO ITEM 4

SCHEDULE D-1 - PAYMENTS FOR TALKS, MEETINGS, AND PUBLICATIONS.

List each source from which you received during the past 12 months lodging, transportation, money, or any other thing of value (excluding meals or drinks coincident with a meeting) with a combined value exceeding $200 for your presentation of a single talk, participation in one meeting, or publication of a work in your capacity as a legislator. Do not list payments or reimbursements by the Commonwealth. (See Schedule D-2 for such payments or reimbursements.) List a payment even if you donated it to charity. Do not list information about a payment if you returned it within 60 days or if you received it from an employer already listed under Item 6 or from a source of income listed on Schedule F.

If no payment must be listed, check here /  / .

__________________________________________________________________________
 
                                                           Type of Payment
                                                           (e.g., Honoraria,
                                                           Travel reimburse-
  Payer               Approximate Value   Circumstances    ment, etc.)
  __________________  __________________  _______________  _________________
  __________________  __________________  _______________  _________________
  __________________  __________________  _______________  _________________
  __________________  __________________  _______________  _________________
  __________________________________________________________________________
                                                            RETURN TO ITEM 5

SCHEDULE D-2 - PAYMENTS BY THE COMMONWEALTH FOR MEETINGS.

List each meeting for which the Commonwealth provided payments or reimbursements during the past 12 months to you for lodging, transportation, money, or any other thing of value (excluding meals or drinks coincident with a meeting) with a combined value exceeding $200 for your participation in your capacity as a legislator. Do not list payments or reimbursements by the Commonwealth for meetings or travel within the Commonwealth.

If no payment must be listed, check here /  / .

__________________________________________________________________________
 
                                                           Type of Payment
                                                           (e.g., Travel
                                                           reimbursement,
  Payer               Approximate Value   Circumstances    etc.)
  __________________  __________________  _______________  _________________
  __________________  __________________  _______________  _________________
  __________________  __________________  _______________  _________________
  __________________  __________________  _______________  _________________
  __________________________________________________________________________

SCHEDULE E - GIFTS.

List each business, governmental entity, or individual that, during the past 12 months, (i) furnished you with any gift or entertainment at a single event and the value received by you exceeded $50 in value, or (ii) furnished you with gifts or entertainment in any combination and the total value received by you exceeded $100 in total value; and each business, governmental entity, or individual that, during the past 12 months, furnished a member of your immediate family with gifts or entertainment in any combination and the total value received exceeded $100 where such business, governmental entity, or individual transacted or is transacting business with the Commonwealth or its agencies, departments, or political subdivisions within 12 months from the date of the gift; and for which you or the member of your immediate family neither paid nor rendered services in exchange. List each such gift or event and the name of the recipient of the gift.

Do not list entertainment events unless the average value per person attending the event exceeded $50 in value. Do not list business entertainment related to your or your immediate family member's private profession or occupation. Do not list gifts or other things of value given by a relative or personal friend for reasons clearly unrelated to your public position.

Do not list campaign contributions publicly reported as required by Chapter 9.3 (§ 24.2-945 et seq.) of Title 24.2 of the Code of Virginia.

__________________________________________________________________________
 
                 Name of Business,    City or
  Name of        Organization, or     County       Gift or       Approximate
  Recipient      Individual           and State    Event         Value
  ____________   __________________   __________   ___________   ___________
  ____________   __________________   __________   ___________   ___________
  ____________   __________________   __________   ___________   ___________
  ____________   __________________   __________   ___________   ___________
  __________________________________________________________________________
                                                            RETURN TO ITEM 6

SCHEDULE F-1 - BUSINESS INTERESTS.

Complete this Schedule for each self-owned or family-owned business (including rental property, a farm, or consulting work), partnership, or corporation in which you or a member of your immediate family, separately or together, own an interest having a value in excess of $10,000.

If the enterprise is owned or operated under a trade, partnership, or corporate name, list that name; otherwise, merely explain the nature of the enterprise. If rental property is owned or operated under a trade, partnership, or corporate name, list the name only; otherwise, give the address of each property. Account for business interests held in trust.

_________________________________________________________________________
 
  Name of
  Business
  Corporation,
  Partnership,               Nature of                 Gross income
  Farm;                      Enterprise
  Address of       City or   (farming,                   $50,001     More
  Rental           County    law, rental        $50,000    to        than
  Property        and State  property, etc.)    or less  $250,000  $250,000
  ______________  _________  _________________  _______  ________  ________
  ______________  _________  _________________  _______  ________  ________
  ______________  _________  _________________  _______  ________  ________
  ______________  _________  _________________  _______  ________  ________
  _________________________________________________________________________
                                                           RETURN TO ITEM 8

SCHEDULE F-2 - LOBBYIST RELATIONSHIPS AND PAYMENTS.

Complete this Schedule for each lobbyist relationship with the following:

(i) any person who is, or has been within the prior calendar year, registered as a lobbyist with the Secretary of the Commonwealth, or

(ii) any business in which you have a greater than three percent ownership interest and that business employs, or engages as an independent contractor, any person who is, or has been within the prior calendar year, registered as a lobbyist with the Secretary of the Commonwealth.

___________________________________________________________________________
 
                                                            Payments to
                                                             Lobbyist
  List each person   Describe each   Dates of          $10,000     More than
  or business        relationship    relationship      or less     $10,0001
  _________________  ______________  ______________  ___________  ___________
  _________________  ______________  ______________  ___________  ___________
  _________________  ______________  ______________  ___________  ___________
  _________________  ______________  ______________  ___________  ___________
  _________________  ______________  ______________  ___________  ___________
  ___________________________________________________________________________

THE DISCLOSURE OF A LOBBYIST RELATIONSHIP SHALL NOT (I) CONSTITUTE A WAIVER OF ANY ATTORNEY-CLIENT OR OTHER PRIVILEGE, (II) REQUIRE A WAIVER OF ANY ATTORNEY-CLIENT OR OTHER PRIVILEGE FOR A THIRD PARTY, OR (III) BE REQUIRED WHERE A MEMBER OR MEMBER-ELECT IS EMPLOYED OR ENGAGED BY A PERSON AND SUCH PERSON ALSO EMPLOYS OR ENGAGES A PERSON IN A LOBBYIST RELATIONSHIP SO LONG AS THE MEMBER OR MEMBER-ELECT HAS NO FINANCIAL INTEREST IN THE LOBBYIST RELATIONSHIP.

SCHEDULE G-1 - PAYMENTS FOR REPRESENTATION BY YOU.

List the businesses you represented before any state governmental agency, excluding any court or judge, for which you received total compensation during the past 12 months in excess of $1,000, excluding compensation for other services to such businesses and representation consisting solely of the filing of mandatory papers and subsequent representation regarding the mandatory papers filed by you.

Identify each business, the nature of the representation and the amount received by dollar category from each such business. You may state the type, rather than name, of the business if you are required by law not to reveal the name of the business represented by you.

______________________________________________________________________
 
                Pur-
                pose                           Amount Received
  Name   Type   of
  of     of     Repre- Name   $1,001  $10,001 $50,001  $100,001
  Busi-  Busi-  senta- of       to      to      to       to     $250,001
  ness   ness   tion   Agency $10,000 $50,000 $100,000 $250,000 and over
  ______ ______ ______ ______ _______ _______ ________ ________ ________
  ______ ______ ______ ______ _______ _______ ________ ________ ________
  ______ ______ ______ ______ _______ _______ ________ ________ ________
  ______ ______ ______ ______ _______ _______ ________ ________ ________
  ______________________________________________________________________

If you have received $250,001 or more from a single business within the reporting period, indicate the amount received, rounded to the nearest $10,000. Amount Received: ______________.

SCHEDULE G-2 - PAYMENTS FOR REPRESENTATION BY ASSOCIATES.

List the businesses that have been represented before any state governmental agency, excluding any court or judge, by persons who are your partners, associates or others with whom you have a close financial association and who received total compensation in excess of $1,000 for such representation during the past 12 months, excluding representation consisting solely of the filing of mandatory papers and subsequent representation regarding the mandatory papers filed by your partners, associates or others with whom you have a close financial association.

Identify such businesses by type and also name the state governmental agencies before which such person appeared on behalf of such businesses.

______________________________________________________________________
 
  Type of Business                Name of State Governmental Agency
  _____________________________   ______________________________________
  _____________________________   ______________________________________
  _____________________________   ______________________________________
  _____________________________   ______________________________________
  ______________________________________________________________________

SCHEDULE G-3 - PAYMENTS FOR OTHER SERVICES GENERALLY.

Indicate below types of businesses that operate in Virginia to which services were furnished by you or persons with whom you have a close financial association pursuant to an agreement between you and such businesses, or between persons with whom you have a close financial association and such businesses and for which total compensation in excess of $1,000 was received during the past 12 months. Services reported in this Schedule shall not include services involving the representation of businesses that are reported in Schedule G-1 or G-2 above.

Identify opposite each category of businesses listed below (i) the type of business, (ii) the type of service rendered and (iii) the value by dollar category of the compensation received for all businesses falling within each category.

__________________________________________________________________________
 
                      Check 
                      if    Type
                      ser-  of              Value of Compensation
                      vices ser-
                      were  vice  $1,001  $10,001  $50,001 $100,001
                      ren-  ren-    to      to       to      to     $250,001
                      dered dered $10,000 $50,000 $100,000 $250,000 and over
  Electric utilities  _____ _____ _______ _______ ________ ________ ________
  Gas utilities       _____ _____ _______ _______ ________ ________ ________
  Telephone utilities _____ _____ _______ _______ ________ ________ ________
  Water utilities     _____ _____ _______ _______ ________ ________ ________
  Cable television
    companies         _____ _____ _______ _______ ________ ________ ________
  Interstate
    transportation
    companies         _____ _____ _______ _______ ________ ________ ________
  Intrastate
    transportation
    companies         _____ _____ _______ _______ ________ ________ ________
  Oil or gas retail
    companies         _____ _____ _______ _______ ________ ________ ________
  Banks               _____ _____ _______ _______ ________ ________ ________
  Savings
    institutions      _____ _____ _______ _______ ________ ________ ________
  Loan or finance
    companies         _____ _____ _______ _______ ________ ________ ________
  Manufacturing
    companies (state
    type of product,
    e.g., textile,
    furniture, etc.)  _____ _____ _______ _______ ________ ________ ________
  Mining companies    _____ _____ _______ _______ ________ ________ ________
  Life insurance
    companies         _____ _____ _______ _______ ________ ________ ________
  Casualty insurance
    companies         _____ _____ _______ _______ ________ ________ ________
  Other insurance
    companies         _____ _____ _______ _______ ________ ________ ________
  Retail companies    _____ _____ _______ _______ ________ ________ ________
  Beer, wine or
    liquor companies
    or distributors   _____ _____ _______ _______ ________ ________ ________
  Trade associations  _____ _____ _______ _______ ________ ________ ________
  Professional
    associations      _____ _____ _______ _______ ________ ________ ________
  Associations of
    public employees
    or officials      _____ _____ _______ _______ ________ ________ ________
  Counties, cities
    or towns          _____ _____ _______ _______ ________ ________ ________
  Labor organizations _____ _____ _______ _______ ________ ________ ________
  Other               _____ _____ _______ _______ ________ ________ ________
  __________________________________________________________________________
                                                            RETURN TO ITEM 9

SCHEDULE H - REAL ESTATE.

List real estate other than your principal residence in which you or a member of your immediate family holds an interest, including a partnership interest, option, easement, or land contract, valued at $10,000 or more. Each parcel must be listed individually.

________________________________________________________________________
 
                        Describe the type of real   
                        estate you own in each      
  List the location     location (business,         If the real estate is
  (state, and county    recreational, apartment,    owned or recorded in
  or city where you     commercial, open land,      a name other than your
  own real estate       etc.)                       own, list that name
  ___________________   _________________________   ______________________
  ___________________   _________________________   ______________________
  ___________________   _________________________   ______________________
  ___________________   _________________________   ______________________
  ___________________   _________________________   ______________________
  ________________________________________________________________________
                                                         RETURN TO ITEM 10

SCHEDULE I - REAL ESTATE CONTRACTS WITH STATE GOVERNMENTAL AGENCIES.

List all contracts, whether pending or completed within the past 12 months, with a state governmental agency for the sale or exchange of real estate in which you or a member of your immediate family holds an interest, including a corporate, partnership or trust interest, option, easement, or land contract, valued at $10,000 or more. List all contracts with a state governmental agency for the lease of real estate in which you or a member of your immediate family holds such an interest valued at $1,000 or more. This requirement to disclose an interest in a lease does not apply to an interest derived through an ownership interest in a business unless the ownership interest exceeds three percent of the total equity of the business.

_______________________________________________________________________
 
  List your real
  estate interest and
  the person or entity,
  including the type of
  entity, which is
  party to the contract.                              State the annual
  Describe any                                        income from the
  management role and      List each                  contract, and the
  the percentage           governmental agency        amount, if any, of
  ownership interest       which is a party to        income you or any
  you or your immediate    the contract and           immediate family
  family member has in     indicate the county        member derives
  the real estate          or city where the          annually from
  or entity.               real estate is located.    the contract.
  ______________________   ________________________   ___________________
  ______________________   ________________________   ___________________
  ______________________   ________________________   ___________________
  ______________________   ________________________   ___________________
  ______________________   ________________________   ___________________
  _______________________________________________________________________

B. Any legislator who makes a knowing misstatement of a material fact on the Statement of Economic Interests shall be subject to disciplinary action for such violations by the house in which the legislator sits.

C. In accordance with the rules of each house, the Statement of Economic Interests of all members of each house shall be reviewed. If a legislator's Statement is found to be inadequate as filed, the legislator shall be notified in writing and directed to file an amended Statement correcting the indicated deficiencies, and a time shall be set within which such amendment shall be filed. If the Statement of Economic Interests, in either its original or amended form, is found to be adequate as filed, the legislator's filing shall be deemed in full compliance with this section as to the information disclosed thereon.

D. Ten percent of the membership of a house, on the basis of newly discovered facts, may in writing request the house in which those members sit, in accordance with the rules of that house, to review the Statement of Economic Interests of another member of that house in order to determine the adequacy of his filing. In accordance with the rules of each house, each Statement of Economic Interests shall be promptly reviewed, the adequacy of the filing determined, and notice given in writing to the legislator whose Statement is in issue. Should it be determined that the Statement requires correction, augmentation or revision, the legislator involved shall be directed to make the changes required within such time as shall be set under the rules of each house.

If a legislator, after having been notified in writing in accordance with the rules of the house in which he sits that his Statement is inadequate as filed, fails to amend his Statement so as to come into compliance within the time limit set, he shall be subject to disciplinary action by the house in which he sits. No legislator shall vote on any question relating to his own Statement.