Bill Text: IA SSB3097 | 2013-2014 | 85th General Assembly | Introduced

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Bill Title: A resolution amending the Senate Code of Ethics relating to employment restrictions for senators.

Spectrum: Unknown

Status: (N/A - Dead) 2014-01-23 - In Ethics [SSB3097 Detail]

Download: Iowa-2013-SSB3097-Introduced.html

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Senate Study Bill 3097 - Introduced
SENATE RESOLUTION NO. _____
BY (PROPOSED COMMITTEE ON ETHICS RESOLUTION BY
CHAIRPERSON HORN)
A Resolution amending the Senate Code of Ethics
relating to employment restrictions for senators.
BE IT RESOLVED BY THE SENATE, That the Senate Code
of Ethics, as adopted by the Senate during the 2013
Session in Senate Resolution 3, is amended to read as
follows:
SENATE CODE OF ETHICS
PREAMBLE. Every legislator owes a duty to uphold
the integrity and honor of the general assembly, to
encourage respect for the law and for the general
assembly and the members thereof, and to observe the
legislative code of ethics.
In doing so, members of the senate have a duty to
conduct themselves so as to reflect credit on the
general assembly, and to inspire the confidence,
respect, and trust of the public, and to strive to
avoid both unethical and illegal conduct and the
appearance of unethical and illegal conduct.
Recognizing that service in the Iowa general
assembly is a part-time endeavor and that members of
the general assembly are honorable individuals who
are active in the affairs of their localities and
elsewhere and that it is necessary that they maintain
a livelihood and source of income apart from their
legislative compensation, the following rules are
adopted pursuant to section 68B.31, to assist the
members in the conduct of their legislative affairs.
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1. ECONOMIC INTEREST OF SENATOR. Taking into
account that legislative service is part-time, a
senator shall not accept economic or investment
opportunity, under circumstances where the senator
knows, or should know, that there is a reasonable
possibility that the opportunity is being afforded the
senator with intent to influence the senator’s conduct
in the performance of official duties.
2. DIVESTITURE. Where a senator learns that
an economic or investment opportunity previously
accepted was offered with the intent of influencing
the senator’s conduct in the performance of official
duties, the senator shall take steps to divest that
senator of that investment or economic opportunity, and
shall report the facts of the situation to the senate
ethics committee.
3. CHARGES FOR SERVICES. A senator shall not
charge to or accept from a person, corporation,
partnership, or association known to have a legislative
interest a price, fee, compensation, or other
consideration for the sale or lease of any property or
the furnishing of services which is in excess of that
which the senator would charge another.
4. USE OF CONFIDENTIAL INFORMATION. A senator in
order to further the senator’s own economic or other
interests, or those of any other person, shall not
disclose or use confidential information acquired in
the course of official duties.
5. HONORARIA. A senator shall not accept an
honorarium from a restricted donor for a speech,
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writing for publication, or other similar activity,
except as otherwise provided in section 68B.23.
6. EMPLOYMENT. A senator shall not accept
employment, either directly or indirectly, from a
political action committee , a candidate committee,
or from an organization exempt from taxation under
section 501(c)(4), 501(c)(6), or 527 of the Internal
Revenue Code that engages in activities related to the
nomination, election, or defeat of a candidate for
public office. A senator may accept employment from
a political party, but shall disclose the employment
relationship in writing to the secretary of the senate
within ten days after the beginning of each legislative
session. If a senator accepts employment from a
political party during a legislative session, the
senator shall disclose the employment relationship
within ten days after acceptance of the employment.
For the purpose of this rule, a political action
committee means a committee , but not a candidate’s
committee, which accepts contributions, makes
expenditures, or incurs indebtedness in the aggregate
of more than seven hundred fifty dollars in any one
calendar year to expressly advocate the nomination,
election, or defeat of a candidate for public office
or to expressly advocate the passage or defeat of
a ballot issue or influencing legislative action,
or an association, lodge, society, cooperative,
union, fraternity, sorority, educational institution,
civic organization, labor organization, religious
organization, or professional organization which makes
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contributions in the aggregate of more than seven
hundred fifty dollars in any one calendar year to
expressly advocate the nomination, election, or defeat
of a candidate for public office or ballot issue or
influencing legislative action.
For the purpose of this rule, a candidate committee
means the committee designated by any candidate for
a federal, state, county, city, or school office to
receive contributions in excess of seven hundred fifty
dollars in the aggregate, expend funds in excess of
seven hundred fifty dollars in the aggregate, or incur
indebtedness on behalf of the candidate in excess of
seven hundred fifty dollars in the aggregate in any
calendar year.
7. ECONOMIC INTERESTS OF LOBBYIST. With the
exception of exercising unfettered discretion in
supporting or refusing to support proposed legislation,
a senator shall not take action intended to affect the
economic interests of a lobbyist or citizen supporting
or opposing proposed legislation.
8. APPEARANCE BEFORE GOVERNMENTAL AGENCY. A
senator may appear before a governmental agency or
board in any representation case, except that the
senator shall not act as a lobbyist. Whenever a
senator appears before a governmental agency or board,
the senator shall carefully avoid all conduct which
might in any way lead members of the general public
to conclude that the senator is using the senator’s
official position to further the senator’s professional
success or personal financial interest.
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9. CONFLICTS OF INTERESTS. In order to permit the
general assembly to function effectively, a senator
will sometimes be required to vote on bills and
participate in committee work which will affect the
senator’s employment and other monetary interests. In
making a decision relative to the senator’s activity on
given bills or committee work which are subject to the
code, the following factors shall be considered:
a. Whether a substantial threat to the senator’s
independence of judgment has been created by the
conflict situation.
b. The effect of the senator’s participation on
public confidence in the integrity of the legislature.
c. The need for the senator’s particular
contribution, such as special knowledge of the
subject matter, to the effective functioning of the
legislature.
A senator with a conflict of interest may
participate in floor debate if prior to debate the
senator indicates the conflict of interest.
10. GIFTS. Except as otherwise provided in section
68B.22, a senator, or that person’s immediate family
member, shall not, directly or indirectly, accept or
receive any gift or series of gifts from a restricted
donor.
11. DISCLOSURE REQUIRED. Each senator shall file
with the secretary of the senate within ten days after
the adoption of the code of ethics by the senate, and
within ten days after the convening of the second
session of the general assembly, a statement under
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section 68B.35 on forms provided by the secretary of
the senate setting forth the following information:
The nature of each business in which the senator
is engaged and the nature of the business of each
company in which the senator has a financial interest.
A senator shall not be required to file a report or
be assumed to have a financial interest if the annual
income derived from the investment in stocks, bonds,
bills, notes, mortgages, or other securities offered
for sale through recognized financial brokers is less
than one thousand dollars.
Disclosures required under this rule shall be as
of the date filed unless provided to the contrary,
and shall be amended to include interests and changes
encompassed by this rule that occur while the general
assembly is in session. All filings under this rule
shall be open to public inspection in the office of the
secretary of the senate at all reasonable times.
The secretary of the senate shall inform the
ethics committee of the statements which are filed
and shall report to the ethics committee the names of
any senators who appear not to have filed complete
statements. The chairperson of the ethics committee
shall request in writing that a senator who has failed
to complete the report or appears to have filed an
incomplete report do so within five days, and, upon
the failure of the senator to comply, the ethics
committee shall require the senator to appear before
the committee.
12. STATUTORY VIOLATIONS. Members of the general
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assembly are urged to familiarize themselves with
chapters 68B, 721, and 722.
13. CHARGE ACCOUNTS. Senators shall not charge any
amount or item to any charge account to be paid for by
any lobbyist or any client the lobbyist represents.
14. TRAVEL EXPENSES. A senator shall not charge
to the state of Iowa amounts for travel and expenses
unless the senator actually has incurred those mileage
and expense costs. Senators shall not file the
vouchers for weekly mileage reimbursement required
by section 2.10, subsection 1, unless the travel
was actually incurred at commensurate expense to the
senator.
15. COMPLAINTS. Complaints or charges against
any senator or any lobbyist shall be in writing, made
under oath, and filed with the secretary of the senate
or the chairperson of the ethics committee. If filed
with the secretary of the senate, the secretary shall
immediately advise the chairperson of the ethics
committee of the receipt of the complaint.
Complaint forms shall be available from the
secretary of the senate, or the chairperson of the
ethics committee, but a complaint shall not be rejected
for failure to use an approved form if the complaint
substantially complies with senate requirements.
A complainant may submit exhibits and affidavits
attached to the complaint.
16. FILING OF COMPLAINTS.
a. Persons entitled. Complaints may be filed by any
person believing that a senator, lobbyist, or client
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of a lobbyist has violated the senate ethics code,
the joint rules governing lobbyists, or chapter 68B
of the Iowa Code. A violation of the criminal law may
be considered to be a violation of this code of ethics
if the violation constitutes a serious misdemeanor or
greater, or a repetitive and flagrant violation of the
law.
b. Committee complaint. The ethics committee
may, upon its own motion, initiate a complaint,
investigation, or disciplinary action.
c. Timeliness of filing. A complaint will be
considered to be timely filed if it is filed within
three years of the occurrence of the alleged violation
of the ethics code.
17. PERMANENT RECORD. The secretary of the senate
shall maintain a permanent record of all complaints
filed, evidence received by the committee, and any
transcripts or other recordings made of committee
proceedings, including a separate card file containing
the date filed, name and address of the complainant,
name and address of the respondent, a brief statement
of the charges made, and ultimate disposition of
the complaint. The secretary shall keep each such
complaint confidential until public disclosure is made
by the ethics committee.
18. PREHEARING PROCEDURE.
a. Defective complaint. Upon receipt of a
complaint, the chairperson and ranking member of the
ethics committee shall determine whether the complaint
substantially complies with the requirements of this
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code of ethics and section 68B.31, subsection 6. If
the complaint does not substantially comply with
the requirements for formal sufficiency under the
code of ethics, the complaint may be returned to the
complainant with a statement that the complaint is not
in compliance with the code and a copy of the code. If
the complainant fails to amend the complaint to comply
with the code within a reasonable time, the chairperson
and ranking member may dismiss the complaint with
prejudice for failure to prosecute.
b. Service of complaint on respondent. Upon
receipt of any complaint substantially complying
with the requirements of this code of ethics, the
chairperson of the ethics committee shall cause a copy
of the complaint and any supporting information to
be delivered promptly to the respondent, requesting
a written response to be filed within ten days. The
response may do any of the following:
(1) Admit or deny the allegation or allegations.
(2) Object that the allegation fails to allege a
violation of chapter 68B or the code of ethics.
(3) Object to the jurisdiction of the committee.
(4) Request a more specific statement of the
allegation or allegations.
c. Objection to member. In addition to the
items which may be included in a response pursuant
to paragraph “b”, the response may also include an
objection to the participation of any member of the
committee in the consideration of the allegation or
allegations on the grounds that the member cannot
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render an impartial and unbiased decision.
d. Extension of time. At the request of the
respondent and upon a showing of good cause, the
committee, or the chairperson and ranking member,
may extend the time for response, not to exceed ten
additional days.
e. Confidentiality. If a complaint is not
otherwise made public, the members of the committee
shall treat the complaint and all supporting
information as confidential until the written response
is received from the respondent.
f. Communications with ethics committee. After a
complaint has been filed or an investigation has been
initiated, a party to the complaint or investigation
shall not communicate, or cause another to communicate,
as to the merits of the complaint or investigation with
a member of the committee, except under the following
circumstances:
(1) During the course of any meetings or other
official proceedings of the committee regarding the
complaint or investigation.
(2) In writing, if a copy of the writing is
delivered to the adverse party or the designated
representative for the adverse party.
(3) Orally, if adequate prior notice of the
communication is given to the adverse party or the
designated representative for the adverse party.
(4) As otherwise authorized by statute, the senate
code of ethics, the joint rules governing lobbyists, or
vote of the committee.
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g. Scheduling hearing. Upon receipt of the
response, the committee shall schedule a public meeting
to review the complaint and available information, and
shall do one of the following:
(1) Notify the complainant that no further
action will be taken, unless further substantiating
information is produced.
(2) Dismiss the complaint for failure to meet the
statutory and code of ethics requirements for valid
complaints.
(3) Take action on the complaint without requesting
the appointment of an independent special counsel
if the committee determines the complaint is valid
and determines no dispute exists between the parties
regarding the material facts that establish a
violation. The committee may do any of the following:
(a) Issue an admonishment to advise against the
conduct that formed the basis for the complaint and to
exercise care in the future.
(b) Issue an order to cease and desist the conduct
that formed the basis for the complaint.
(c) Make a recommendation to the senate that
the person subject to the complaint be censured or
reprimanded.
(4) Request that the chief justice of the supreme
court appoint an independent special counsel to conduct
an investigation of the complaint and supporting
information, to make a determination of probable cause,
and to report the findings to the committee, which
shall be received within a reasonable time.
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h. Public hearing. If independent special counsel
is appointed, upon receipt of the report of independent
special counsel’s findings, the committee shall
schedule a public meeting to review the report and
shall do either of the following:
(1) Cause the complaint to be scheduled for a
public hearing.
(2) Dismiss the complaint based upon a
determination by independent special counsel and the
committee that insufficient evidence exists to support
a finding of probable cause.
19. HEARING PROCEDURE.
a. Notice of hearing. If the committee causes a
complaint to be scheduled for a public hearing, notice
of the hearing date and time shall be given to the
complainant and respondent in writing, and of the
respondent’s right to appear in person, be represented
by legal counsel, present statements and evidence, and
examine and cross-examine witnesses. The committee
shall not be bound by formal rules of evidence, but
shall receive relevant evidence, subject to limitations
on repetitiveness. Any evidence taken shall be under
oath.
b. Subpoena power. The committee may require, by
subpoena or otherwise, the attendance and testimony of
witnesses and the production of such books, records,
correspondence, memoranda, papers, documents, and any
other things it deems necessary to the conduct of the
inquiry.
c. Ex post facto. An investigation shall not be
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undertaken by the committee of a violation of a law,
rule, or standard of conduct that is not in effect at
the time of violation.
d. Disqualification of member. Members of the
committee may disqualify themselves from participating
in any investigation of the conduct of another person
upon submission of a written statement that the member
cannot render an impartial and unbiased decision
in a case. A member may also be disqualified by a
unanimous vote of the remaining eligible members of the
committee.
A member of the committee is ineligible to
participate in committee meetings, as a member of the
committee, in any proceeding relating to the member’s
own official conduct.
If a member of the committee is disqualified or
ineligible to act, the majority or minority leader who
appointed the member shall appoint a replacement member
to serve as a member of the committee during the period
of disqualification or ineligibility.
e. Hearing. At the hearing, the chairperson shall
open the hearing by stating the charges, the purpose of
the hearing, and its scope. The burden of proof rests
upon the complainant to establish the facts as alleged,
by clear and convincing evidence. However, questioning
of witnesses shall be conducted by the members of the
committee, by independent special counsel, or by a
senator. The chairperson shall also permit questioning
by legal counsel representing the complainant or
respondent.
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The chairperson or other member of the committee
presiding at a hearing shall rule upon procedural
questions or any question of admissibility of evidence
presented to the committee. Rulings may be reversed by
a majority vote of the committee members present.
The committee may continue the hearing to a future
date if necessary for appropriate reasons or purposes.
f. Committee action. Upon receipt of all relevant
evidence and arguments, the committee shall consider
the same and recommend to the senate any of the
following:
(1) That the complaint be dismissed.
(2) That the senator, lobbyist, or client of a
lobbyist be censured or reprimanded, and recommend the
appropriate form of censure or reprimand.
(3) Any other appropriate sanction, including
suspension or expulsion from membership in the senate,
or suspension of lobbying privileges.
g. Disposition resolution. By appropriate
resolution, the senate may amend, adopt, or reject
the report of the ethics committee, including the
committee’s recommendations regarding disciplinary
action.
20. COMMITTEE AUTHORIZED TO MEET. The senate
ethics committee is authorized to meet at the
discretion of the chairperson to conduct hearings and
other business that properly may come before it. If
the committee submits a report seeking senate action
against a senator, lobbyist, or client of a lobbyist
after the second regular session of a general assembly
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has adjourned sine die, the report shall be submitted
to and considered by the subsequent general assembly.
However, the report may be submitted to and considered
during any special session which may take place after
the second regular session of a general assembly has
adjourned sine die, but before the convening of the
next general assembly.
21. ADVISORY OPINIONS.
a. Requests for formal opinions. A request for a
formal advisory opinion may be filed by any person who
is subject to the authority of the ethics committee.
The ethics committee may also issue a formal advisory
opinion on its own motion, without having previously
received a formal request for an opinion, on any issue
that is within the jurisdiction of the committee.
Requests shall be filed with either the secretary of
the senate or the chairperson of the ethics committee.
b. Form and contents of requests. A request for
a formal advisory opinion shall be in writing and
may pertain to any subject matter that is related
to the application of the senate code of ethics, the
joint rules governing lobbyists, or chapter 68B of the
Code to any person who is subject to the authority of
the ethics committee. Requests shall contain one or
more specific questions and shall relate either to
future conduct or be stated in the hypothetical. A
request for an advisory opinion shall not specifically
name any individual or contain any other specific
identifying information, unless the request relates
to the requester’s own conduct. However, any request
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may contain information which identifies the kind
of individual who may be affected by the subject
matter of the request. Examples of this latter kind
of identifying information may include references to
conduct of a category of individuals, such as but not
limited to conduct of legislators, legislative staff,
lobbyists, or clients of lobbyists.
c. Confidentiality of formal requests and opinions.
Requests for formal opinions are not confidential and
any deliberations of the committee regarding a request
for a formal opinion shall be public. Opinions issued
in response to requests for formal opinions are not
confidential, shall be in writing, and shall be placed
on file in the office of the secretary of the senate.
Persons requesting formal opinions shall personally
receive a copy of the written formal opinion that is
issued in response to the request.
22. CALCULATION OF TIME —— DAYS. For purposes of
these rules, unless the context otherwise requires,
the word “day” or “days” shall mean a calendar day
except that if the day is the last day of a specific
time period and falls upon a Saturday, Sunday, or legal
holiday, the time prescribed shall be extended so as to
include the whole of the next day in which the offices
of the senate and the general assembly are open for
official business.
23. COMPLAINT FILING FORM. The following form
shall be used to file a complaint under these rules:
THE SENATE
Ethics Complaint Form
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Re: ______________________________
(Senator/Lobbyist/Client of Lobbyist), of
_____________________, Iowa.
I, ________________________ (Complainant),
residing at ____________________, in the City of
______________, State of ________________________,
hereby complain that _____________________________
(Senator/Lobbyist/Client of Lobbyist), whose address
is ___________________________________________, has
violated the Senate Code of Ethics or Joint Rules
Governing Lobbyists in that:
(Explain the basis for the complaint here. Use
additional pages, if necessary.)
Under penalty of perjury, I certify that the above
complaint is true and correct as I verily believe.
___________________________
Signature of Complainant
SUBSCRIBED AND AFFIRMED to before me this __________
day of ________________________, _______.
________________________________
Notary Public in and for the
State of ______________________
24. COMPLAINT NOTICE FORM. The following form
shall be used for notice of a complaint under these
rules:
STATE OF IOWA
THE SENATE
COMMITTEE ON ETHICS )
IOWA STATE SENATE )
)
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On The Complaint Of ) NOTICE OF COMPLAINT
)
___________________________ )
)
And Involving )
)
___________________________ )
)
TO ________________________________,
Senator or Lobbyist or Client of Lobbyist named
above:
You are hereby notified that there is now on file
with the Secretary of the Senate, State Capitol, Des
Moines, Iowa, a complaint which alleges that you have
committed a violation of the Senate’s Code of Ethics or
Joint Rules Governing Lobbyists.
A copy of the complaint and the Senate rules for
processing the same are attached hereto and made a part
of this notice.
You are further notified and requested to file your
written answer to the complaint within ten days of the
date upon which the notice was caused to be delivered
to you, (date) ________________________, ________.
Your answer is to be filed with the Secretary of the
Senate, State Capitol, Des Moines, Iowa.
Dated this ________ day of ________________, ______.
________________________________
Chair, Senate Ethics Committee,
or Secretary of the Senate
25. HEARING NOTICE FORM. The following form shall
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be used for notice of a hearing under these rules:
STATE OF IOWA
THE SENATE
COMMITTEE ON ETHICS )
IOWA STATE SENATE )
)
On The Complaint Of ) NOTICE OF HEARING
)
___________________________ )
)
And Involving )
)
___________________________ )
)
TO ________________________________,
Senator or Lobbyist or Client of Lobbyist named
above:
You are hereby notified that there is now on file
with the Secretary of the Senate, State Capitol, Des
Moines, Iowa, a complaint which alleges that you have
committed a violation of the Senate’s Code of Ethics or
Joint Rules Governing Lobbyists.
A copy of the complaint and the Senate rules for
processing the same are attached hereto and made a part
of this notice.
You are further notified that, after preliminary
review, the committee has caused a public hearing to be
scheduled on (date)___________________, ________, at
(hour) ___________ (a.m.) (p.m.), in Room ____, State
Capitol, Des Moines, Iowa.
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At the hearing, you will have the right to appear
in person, be represented by legal counsel at your own
expense, present statements and evidence, and examine
and cross-examine witnesses. The committee shall
not be bound by formal rules of evidence, but shall
receive relevant evidence, subject to limitations on
repetitiveness. Any evidence taken shall be under
oath.
The committee may continue the hearing to a future
date if necessary for appropriate reasons or purposes.
You are further notified that the committee will
receive such evidence and take such action as warranted
by the evidence.
Dated this _____ day of ________________, ______.
________________________________
Chair, Senate Ethics Committee,
or Secretary of the Senate
26. PERSONAL FINANCIAL DISCLOSURE FORM. The
following form shall be used for disclosure of economic
interests under these rules and section 68B.35:
STATEMENT OF ECONOMIC INTERESTS
Name:________________________________________________
(Last) (First) (Middle Initial)
Address:_____________________________________________
(Street Address, Apt.#/P.O. Box)
______________________________________________
(City) (State) (Zip)
Phone:(Home) ____/____-_____(Business) ____/____-_____
******************************************************
a. Please list each business, occupation, or
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profession in which you are engaged. In listing
the business, occupation, or profession, it is
not necessary that your employer or the name of
the business be listed, although all businesses,
occupations, or professions must be listed, regardless
of the amount of income derived or time spent
participating in the activity. (Examples of types
of businesses, occupations, or professions that may
be listed: teacher, lawyer, legislator, real estate
agent, insurance adjuster, salesperson....)
(1) __________________________________________________
(2) __________________________________________________
(3) __________________________________________________
(4) __________________________________________________
(5) __________________________________________________
b. Please list the nature of each of the
businesses, occupations, or professions which you
listed in paragraph “a”, above, unless the nature of
the business, occupation, or profession is already
apparent from the information indicated above. The
descriptions in this paragraph should correspond by
number to the numbers for each of the businesses,
occupations, or professions listed in paragraph “a”.
(Examples: If you indicated, for example, that you
were a salesperson in subparagraph (1) of paragraph
“a”, you should list in subparagraph (1) of this
paragraph the types of goods or services sold in this
item. If you indicated that you were a teacher in
subparagraph (2) of paragraph “a”, you should indicate
in subparagraph (2) of this paragraph the type of
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school or institution in which you provide instruction
or whether the instruction is provided on a private
basis. If you indicated that you were a lawyer in
subparagraph (3) of paragraph “a”, you should indicate
your areas of practice and whether you are in private,
corporate, or government practice in subparagraph (3)
of this paragraph. If you indicated in subparagraph
(4) of paragraph “a” that you were a consultant, in
subparagraph (4) of this paragraph you should indicate
the kind of services provided and types of clients
served.)
(1) __________________________________________________
(2) __________________________________________________
(3) __________________________________________________
(4) __________________________________________________
(5) __________________________________________________
c. Please list each source, by general description,
from which you receive, or which generates, more than
one thousand dollars in gross annual income in the
categories listed below. For purposes of this item,
a source produces gross annual income if the revenue
produced by the source is subject to federal or state
income taxes. In completing this item, it is not
necessary to list the name of the company, business,
financial institution, corporation, partnership, or
other entity which constitutes the source of the income
and the amount or value of the holding should not be
listed.
(1) Securities (Here for example, you need not
state that you own X number of shares of any specific
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S.R. _____
company by brand or corporate name, or that the stock
is of a certain value, but may instead state that you
possess stock in a company and indicate the nature of
the company’s business.):
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
(2) Instruments of Financial Institutions (You
need not indicate, for example, in which institutions
you hold certificates of deposit that produce annual
income over the one thousand dollar threshold, but
simply listing the nature of the institution will
suffice, e.g., bank, credit union, or savings and loan
association.):
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
(3) Trusts (The name of the particular trust need
not be listed. However, if the income is received from
a charitable trust/foundation, such as the Pugh Pew
Charitable Trust, in the form of a grant, the fact that
the trust is a charitable trust should be noted here.):
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
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______________________________________________________
(4) Real Estate (When listing real estate, it is
not necessary to list the location of the property, but
the general nature of the real estate interest should
be indicated, e.g., residential leasehold interest or
farm leasehold interest.):
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
(5) Retirement Systems (When listing retirement
benefits, it is not necessary to list the name of
the particular pension system or company, but rather
the type of benefit should be listed, e.g., health
benefits, life insurance benefits, private pension, or
government pension.):
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
(6) Other Income Categories Specified in State or
Federal Income Tax Regulations (List description of
other sources of income producing over one thousand
dollars in annual income not previously reported above,
but which must be reported for income tax purposes.):
______________________________________________________
______________________________________________________
______________________________________________________
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______________________________________________________
______________________________________________________
______________________________________________________
_______________________________ ___________________
(Signature of filer) (Date)
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