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SEC - 1 Statement of Financial Interests Rev 01_14

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(1 oI 4) STATE ETHICS COMMISSION SEC-1 (Rev. 01/1) A STATE ETHICS COMMISSION STATEMENT OF FINANCIAL INTERESTS COMMONWEALTH OF PENNSYLVANIA P.O. BOX 11470 ROOM 309 FINANCE BUILDING HARRISBURG, PA 17108-1470 (717) 783-1610 or Toll Free 1-800-932-0936 www.ethics.state.pa.us THIS FORM MUST BE COMPLETED AND FILED BY: This Form is required to be Iiled pursuant to the provisions oI the Public OIIicial and Employee Ethics Act, 65 Pa C.S. 1101 et seq. IMPORTANT: Please read all instructions careIul
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             A STATE ETHICS COMMISSIONSTATEMENT OF FINANCIAL INTERESTS                THIS FORM MUST BE COMPLETED AND FILED BY:                         IMPORTANT :              review the filing chart(Page 4) for proper filing location.                                                                                                                                                                    A former public official or former public employee must file the year after termination of service with the governmental body.                BCDEDO NOT USE FORMS PRINTED PRIOR TO YEAR 2012 (Rev. 01/12)THIS FORM IS CONSIDERED DEFICIENT IF ANY BLOCK IS NOT COMPLETED OR IF SIGNATURE OR DATE IS MISSING SIGN THE FORM USING THE CURRENT DATE - DO NOT BACK DATE SIGNATUREMAKE A COPY FOR YOUR RECORDS   THIS FORM IS CONSIDERED DEFICIENT IF ANY BLOCK IS NOT COMPLETED ORIF SIGNATURE OR DATE IS MISSINGSIGN THE FORM USING THE CURRENT DATE - DO NOT BACK DATE SIGNATURETHOSE REQUIRED TO FILE FOR MORE THAN ONE POSITION MUST FILE IN ALL FILINGLOCATIONS FOR ALL SUCH POSITIONS(see filing chart on back of form) SEC-1 (Rev. 01/14)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        List a business, governmental and/or home address and daytime telephone number. SEC-1 (Rev. 01/04) 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 pay-ment/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 sub-divisions that you serve in an official capacity. If you do not have any reportable expense payments/reimbursements, then check “NONE.”                                                                                                                                                                                                                                                                                                                                                                                                                                                               ADDRESS (work or home) 01/14 Indicate calendar year for which form is being led. 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