The numbers listed below correspond directly to the numbers listed on the form. If you have additional questions, please contact the University Ethics and Compliance Office on the Ethics Line at: 866-758-2146 or via e-mail at: email@example.com
Items typically listed under business entity include:
- any single block of stock worth $5,000 or more in one company (name only - NOT THE AMOUNT)
- real estate (other than your personal residence - list the address)
- rental property (list the address)
- farm land (provide a brief description and the name of the county where it is located)
- mutual funds (you do not need to list individual funds, just the group you have invested with: i.e., Merrill Lynch, Fidelity, etc. - AMOUNT IS NOT NECESSARY)
YOU DO NOT NEED TO LIST savings accounts, CD's, tax exempt bonds, retirement accounts, or bank accounts.
Items typically listed as the corresponding instrument of ownership include:
- sole owner
- stock holder/shareholder
- joint-ownership by spouse or immediate family member
- ownership by spouse or immediate family member
The types of professions that would typically be listed include, but are not limited to:
- clinical psychologists
The most common answer here would relate to consulting work. You do not have to list your clients - you just need to document the name of the consulting company or practice.
Capital gains are before taxes or re-investment. Examples include:
- sale of land, home, or other property (only the address must be listed - NOT THE AMOUNT)
- sale of single blocks of stock (only the name of the stock must be listed - NOT THE AMOUNT)
- Car sales DO NOT need to be listed.
This question basically asks whether or not the individual knows or has connections to a lobbyist. For example, if your spouse is a lobbyist, this must be listed.
Often times, you can respond "see number 1" for this question if you have completed #1 on the previous page. Here you need to list instruments of ownership that gross over $1,200 per year in income. Examples include businesses, rental properties, book royalties and stock dividends.
Here, you need to list any other government employment you hold, such as:
- School Board (IF PAID)
- Zoning Board (IF PAID)
- County Board (IF PAID)
- Park Board (IF PAID)
- Army Guard
- Air Guard
- employment by other state agencies or state Universities
- previously held positions with other state agencies
If it is paid from or controlled by tax dollars, it should be listed.
For this question, you must list any gift received where the value was greater than $500. You do not need to list the amount, just the name of the giver. Inheritances must be listed (example: Inheritance from the Estate of John Doe), but not their amounts. Personal gifts must also be listed here.
For information specific to the Supplemental Statement form, please visit the Supplemental Statement of Economic Interest Form page of our website.