Pennsylvania > Statewide > State Ethics Commission

Statement Of Financial Interests SEC-1 - Pennsylvania

Statement Of Financial Interests Form. This is a Pennsylvania form and can be used in State Ethics Commission Statewide .
 Fillable pdf Last Modified 1/13/2014
Get this form for FREE as a print-only pdf

STATE ETHICS COMMISSION STATEMENT OF FINANCIAL INTERESTS THIS FORM IS CONSIDERED DEFICIENT IF ANY BLOCK IS NOT COMPLETED OR DO NOT USE FORMS PRINTED PRIOR IS MISSING IF SIGNATURE OR DATE TO YEAR 2012 (Rev. 01/12) THIS FORM FORM USING THE CURRENT DATE - DO NOT BACK DATE SIGNATURE SIGN THE IS CONSIDERED DEFICIENT IF ANY BLOCK IS NOT COMPLETED OR IF SIGNATURE OR DATE IS MISSING THOSETHE FORM TO FILETHE CURRENT DATE - POSITION MUSTDATEIN ALL FILING SIGN REQUIRED USING FOR MORE THAN ONE DO NOT BACK FILE SIGNATURE LOCATIONS FOR ALL SUCH POSITIONS (see COPY FOR back of form) MAKE Afiling chart onYOUR RECORDS THIS FORM MUST BE COMPLETED AND FILED BY: A B C D A former public official or former public employee must file the year after termination of service with the governmental body. E IMPORTANT: (Page 4) for proper filing location. review the filing chart SEC-1 (Rev. 01/14) American LegalNet, Inc. www.FormsWorkFlow.com List a business, governmental and/or home address and daytime telephone number. List the calendar year for which you are filing this form. For Example, if this form is being completed in the calendar year 2014, block 07 should read "2013" and all information in blocks 08 through 15 should represent financial interests for calendar year 2013. TRANSPORTATION, LODGING, OR HOSPITALITY EXPENSES: List the name and address of each source and the amount of each payment/reimbursement by the source for transportation, lodging or hospitality that you received in connection with your public position if the aggregate amount of such payments/reimbursements by the source exceeds $650 for the calendar year for which you are reporting. Do not report reimbursements made by a governmental body or by an organization/association of public officials/employees of political subdivisions that you serve in an official capacity. If you do not have any reportable expense payments/reimbursements, then check "NONE." SEC-1 (Rev. 01/04) 01/14 ADDRESS (work or home) Indicate calendar year for which form is being filed. SEE INSTRUCTIONS. DIRECT OR INDIRECT SOURCES OF INCOME including (but not limited to) all employment. , THIS FORM IS CONSIDERED DEFICIENT IF ANY BLOCK ABOVE IS NOT COMPLETED. MAKE A COPY FOR YOUR RECORDS. ORIGINAL COPY ADDITIONAL FILINGS * No additional copy required State Ethics Commission Additional copy is not required to be filed (unless serving in multiple capacities, then file with each entity as required) No additional copy required Additional copy is not required to be filed (unless serving in multiple capacities, then file with each entity as required) * FILER IS RESPONSIBLE FOR MAKING ANY ADDITIONAL COPIES. American LegalNet, Inc. www.FormsWorkFlow.com
Link/Embed this Document
URL
Embed


Popular Searches

  1. Form Interrogatories-General
  2. durable power of attorney
  3. deposition subpoena
  4. bill of costs
  5. stipulation of discontinuance
  6. Request for entry of default
  7. Preliminary Change of Ownership Report
  8. Decree of Dissolution of Marriage
  9. proof of service of summons
  10. Notice and Acknowledgment of Receipt

Bookmark and Share