Fillable 2019 Annual Financial Disclosure Statement for Employees and (City of Annapolis)

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2019 Annual Financial Disclosure Statement for Employees and (City of Annapolis)

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Revised December 19, 2019 1
2019 Annual Financial Disclosure
Statement for
Employees and Appointed Officials
Introduction
The attached financial disclosure statement seeks disclosure of potential conflicts between your duties as a municipal
representative and your personal or business interests. Under the provisions of Section 2.08.051 of the Annapolis City
Code, you must complete and file this statement in accordance with the following instructions. Please note, this Financial
Disclosure Statement is considered to be a matter of public record without the consent of the employee or appointed official
completing the form. Home addresses reported in Financial Disclosure statements will be redacted if publically examined.
Who Must File
In accordance with Section 2.08.051.A of the City Code, the following employees and appointed officials must complete
and file Financial Disclosure Statements:
1. The City Manager, City Attorney, all department directors and deputies, and all members of the exempt service, and
2. Members of the Board of Commissioners of the Housing Authority of the City of Annapolis (HACA), the Executive
Director of HACA and the Deputy Director(s) of HACA, and
3. Inspectors and investigators who enforce City Codes, City Procurement Officers and their purchasing staff, and
members of the following quasi-judicial boards and commissions: Alcohol Beverage Control Board, the Board of Appeals,
the Civil Service Board, the Building Board of Appeals, the Historic Preservation Commission, the Planning Commission,
the Board of Supervisors of Elections, the Ethics Commission, Port Wardens, and the Police and Fire Retirement Plan
Commission, and
4. All other City officials, employees, contract employees or temporary employees over pay grade 15, F15 (Fire
Department), and P15 (Police Department), or who have authority to award or recommend the award of contracts or grants,
or who provide advice or counsel to the City on matters pertaining to public policy or acquisition.
What is Filed
You must complete and file the attached questionnaire regarding your financial interests, together with any supporting
schedules required under the terms of the questionnaire. In completing the questionnaire, you are not required to provide
dollar values for the interests covered by the questions. On the Financial Disclosure Statement you must answer all
questions and sign the second page but only need to complete and sign the Schedules which apply to you, i.e.,
Schedules for the questions to which you have answered “Yes”.
When and Where to File
Fully completed statements and supporting schedules must be filed with the Ethics Commission on or before January
31, 2020. This statement must be mailed or delivered to the City Ethics Commission, c/o City of Annapolis Office of Law,
160 Duke of Gloucester Street, Annapolis, MD 21401.
City of Annapolis
Ethics Commission
c/o Office of Law
160 Duke of Gloucester Street
Annapolis, MD 21401
ethics@annapolis.gov • 410-263-7954 • Fax 410-268-3916 • TDD use MD Relay or 711 • www.annapolis.gov
Revised December 19, 2019 2
On-Line Fill-in-able PDF Forms
Fill-in-able Financial Disclosure Forms are available at www.annapolis.gov under the “Government” and “Forms, Permits,
and Licenses in Alphabetical Order” tabs. The form can be completed on-line, saved to your computer, and printed. The
printed copy of your FD Statement must be signed and then mailed or delivered to the City Ethics Commission, c/o City of
Annapolis Office of Law, 160 Duke of Gloucester Street, Annapolis, MD 21401. Adobe Reader (available as a free
download) is needed to view and fill out the form.
Additional Information
If this form is not received by the Ethics Commission on or before its due date, you may be subpoenaed to appear before
the Commission or allowable sanctions may be imposed by the Ethics Commission for non-compliance with the Ethics Law,
City Code 2.08. Incomplete forms will be returned for the missing information and a new due date provided. If you need
additional information or clarification regarding the completion of the statement, please contact the City of Annapolis Office
of Law at 410-263-7954.
Definitions
The following definitions from Annapolis City Code 2.08.020 are provided for reference in completing the attached forms:
1. "Business entity" means a corporation, limited liability company, general or limited partnership, sole proprietorship, joint
venture, unincorporated association or firm, institution, trust, foundation, or other organization, whether or not operated for
profit. "Business entity" does not include a governmental entity.
2. "Commission" means the City of Annapolis Ethics Commission as established in Section 2.08.030.
3. "Compensation" means any money or thing of value, regardless of form, received or to be received by any individual
covered by this chapter from an employer for service rendered. For the purposes of Section 2.08.070 of this chapter, if
lobbying is only a portion of a person's employment, "compensation" means a prorated amount based on the time devoted
to lobbying compared to the time devoted to other employment duties.
4. "Doing business with" means:
a. Having or negotiating a contract that involves the commitment (either in a single or combination of transactions) of
one thousand dollars or more of City controlled funds; or
b. Being regulated by or otherwise under the authority of the City; or
c. Being registered as a lobbyist in accordance with Section 2.08.070 of this chapter.
5. "Elected official" includes the Mayor and members of the City Council.
6. "Employee" means an individual who is employed by City of Annapolis. "Employee" does not include an elected official.
7. "Financial interest" means:
a. Ownership of any interest as the result of which the owner has received, within the past three years, or is presently
receiving, or in the future is entitled to receive, more than one thousand dollars per year any compensation; or
b. Ownership, or the ownership of securities of any kind representing or convertible into ownership, of more than three
percent of a business entity by a City official or employee, or the spouse of an official or employee.
8. "Gift" means the transfer of anything of economic value regardless of the form without adequate and lawful consideration,
whether or not it relates to the performance of official duties. However, "gift" does not include the solicitation, acceptance
or receipt of any campaign contributions regulated in accordance with any law pertaining to the conduct of elections or the
receipt of political campaign contributions.
9. "Interest" means any legal or equitable economic interest, whether or not subject to an encumbrance or a condition, which
was owned or held, in whole or in part, jointly or severally, directly or indirectly. for purposes of Section 2.08.050 of this
chapter, "interest" applies to any interests held at any time during the calendar year for which a required statement is to be
filed. "Interest" does not include:
a. An interest held in the capacity of a personal agent, representative custodian, fiduciary, or trustee, unless the holder
has an equitable interest therein;
b. An interest in a time or demand deposit in a financial institution;
Revised December 19, 2019 3
c. An interest in an insurance or endowment policy or annuity contract under which an insurance company promises to
pay a fixed number of dollars either in a lump sum or periodically for life or some other specified period;
d. A common trust fund or a trust which forms part of a pension or profit sharing plan which has more than twenty-five
participants and which has been determined by the internal revenue service to be a qualified trust under §§ 401 and 501
of the Internal Revenue Code of 1954; or
e. An interest in a City pension plan, City deferred compensation plan or a college savings plan under the Internal
Revenue Code.
f. An interest in any mutual fund or exchange-traded fund that is publicly traded on a national scale unless the mutual
fund or exchange-traded fund is composed primarily of holdings of stock and interests in a specific sector or area that is
regulated by the City of Annapolis.
10. "Lobbyist" or "lobbying" means the person or act of communicating in the presence of a City official or employee with
the intent to influence any official action of that official or employee; or the person or act of engaging in activities having the
express purpose of soliciting others to communicate with a City official or employee with the intent to influence that official
or employee; and who expends (exclusive of personal travel and subsistence) in excess of two hundred fifty dollars per
calendar year on food, entertainment or gifts for any officials or employees of the City.
11. "Official" means an elected official, an employee of the City directly or by contract, or a person appointed to or employed
by a City agency, board, commission, or similar entity whether or not paid in whole or in part with City funds and whether or
not compensated. Members of the Board of Commissioners of the Housing Authority of the City of Annapolis (HACA), the
Executive Director of HACA and the Deputy Director(s) of HACA are part of a separate entity; however, in accordance with
State law, and for purposes of the City Ethics law, the individuals in these HACA positions are considered City officials.
12. "Person" includes any natural person, or business entity.
13. "Qualified relative" means spouse, siblings, parents, children, and their spouses.
14. “Immediate family” means a spouse and dependent children, and anyone else living in an official’s residence.
Other Reportable Interests
In addition to interests held directly, you must also disclose the following indirect interests:
1. An interest held by a member of your immediate family, if the interest was, at any time during the reporting period,
directly or indirectly controlled by you.
2. An interest held by a business entity in which the individual held a thirty percent or greater interest at any time during
the reporting period.
3. An interest held by a trust or an estate in which, at any time during the reporting period, you held a reversionary interest
or was a beneficiary; or, if a revocable trust, you were a settlor.
Revised December 19, 2019 4
(Page Intentionally Left Blank)
Revised December 19, 2019 Page 1 of 10
2019 Financial Disclosure
Statement for
Employees and Appointed Officials
Name
Office/Position
Reporting period: January 1, 2019 through December 31, 2019
This Financial Disclosure Statement, together with any required supporting schedules, describes all financial interests and
related transactions and other matters required to be disclosed by me under Section 2.08.051 of the Annapolis City Code.
1. Did you during this reporting period hold interest(s) in real property located in the State of Maryland? This includes all
properties located in Maryland that you lease from others or own, including your residence.
If yes, complete the attached Schedule 1, using one page for each property or interest. Yes No
If no, please explain:
2. Did you during this reporting period hold interest(s) in a business entity, whether or not the business entity did business
with the City of Annapolis? This includes ownership of public and privately held corporation stock, trusts, and the
participation in partnerships but not the ownership of publicly traded mutual funds or exchange-traded funds. Business
entity is defined on page 2 of the instructions.
If yes, complete the attached Schedule 2. Yes No
3. Did you or another person at your direction during this reporting period receive a gift of property or a gift of monetary
value from a regulated lobbyist, from a person doing or seeking to do business with the City of Annapolis, or from a
business entity regulated or controlled by the City? Reportable gifts include meals and beverages costing more than
$35.00 each and each gift in excess of $20.00 or a series of lesser valued gifts totaling over $100.00 from any one
person within the calendar year. Gifts received from a qualified relative or from your immediate family need not be
reported.
If yes, complete the attached Schedule 3. Yes No
4. Did you or a member of your immediate family during this reporting period hold interest(s) in or hold an office, directorship
or salaried position in a business entity doing business with the City of Annapolis?
If yes, complete the attached Schedule 4. Yes No
5. Did you or a member of your immediate family during this reporting period have indebtedness (excluding retail credit
accounts) to persons doing business with the City of Annapolis?
If yes, complete the attached Schedule 5. Yes No
6. Was a member of your immediate family at any time during this reporting period employed by the City of Annapolis?
If yes, complete the attached Schedule 6. Yes No
This Form Continues with Question 7 on Back Side of this Page
City of Annapolis
Ethics Commission
c/o Office of Law
160 Duke of Gloucester Street
Annapolis, MD 21401
ethics@annapolis.gov • 410-263-7954 • Fax 410-268-3916 • TDD use MD Relay or 711 • www.annapolis.gov
Revised December 19, 2019 Page 2 of 10
7. Did you or any member of your immediate family (except for a minor child’s employment) receive earned income from
business entities other than the City of Annapolis during this reporting period?
If yes, complete the attached Schedule 7. Yes No
8. Do you wish to disclose any additional interest(s) or information?
If yes, complete the attached Schedule 8. Yes No
Please note that questions 1 to 8 above must all be answered. If you answer “yes” to any question, you must also
complete, date, and sign the corresponding schedule. If this form is not received by the Ethics Commission on
or before January 31, 2020, you may be subpoenaed to appear before the Ethics Commission or allowable
sanctions may be imposed by the Ethics Commission for non-compliance with the Ethics Law, City Code 2.08.
I HEREBY CERTIFY AND AFFIRM, UNDER PENALTY OF PERJURY, THAT THE INFORMATION CONTAINED IN THIS
STATEMENT AND ITS ATTACHED SCHEDULES (IF ANY) IS ACCURATE AND COMPLETE TO THE BEST OF MY
KNOWLEDGE AND BELIEF.
Signature Date
Mail address *
City ST Zip
Phone(s), day
* Home addresses reported in Financial Disclosure statements will be redacted if publically examined.
Statement of Financial Interests
Name
Reporting period: January 1, 2019 through December 31, 2019
Date Signature
Revised December 19, 2019 Page 3 of 10
SCHEDULE 1
Interests in Real Property Located in Maryland
1. Property Information
Use one sheet for each property reported; photocopies of this form are acceptable. Home addresses reported in
Financial Disclosure statements will be redacted if publically examined.
Location by street address, mailing address, and description of property:
2. Interest Held
Nature of interest, e.g., owner in fee, lessee, etc.
Extent of interest held, i.e. 1/3, 50%; do not
include dollar value:
If your interest is attributed to you, rather than held directly by you (i.e., you hold indirectly, such as through a trust), explain
the basis of the attribution below.
List below any conditions and the name of the holder(s) of any encumbrances on the property (mortgages, leases, etc., not
including dollar value:
3. Acquisition Information
Date acquired:
From: Name(s):
Address:
Manner of acquisition, e.g. purchased, rented, etc.
4. Other Holders with Interest in this Property
Name(s):
5. If Interest Transferred During This Reporting Period
Description of transferal if sold, gifted, or transferred during this period.
Method of Transfer:
Date of Transfer:
Transferred to:
Name(s):
Address:
Statement of Financial Interests
Name
Reporting period: January 1, 2019 through December 31, 2019
Date Signature
Revised December 19, 2019 Page 4 of 10
SCHEDULE 2
Interest in Business Entities *
* The value of your interest in business entities does not need to be reported. Your interest in publicly traded mutual funds
or exchange-traded funds need not be reported.
Name of Business Entity, i.e., of the corporation, partnership, limited liability partnership, or limited liability corporation
Statement of Financial Interests
Name
Reporting period: January 1, 2019 through December 31, 2019
Date Signature
Revised December 19, 2019 Page 5 of 10
SCHEDULE 3
Gifts from Persons Doing Business with or Regulated by the City of Annapolis *
* Reportable gifts include meals and beverages costing more than $35.00 each and each gift in excess of $20.00 or a
series of lesser valued gifts totaling over $100.00 from any one person within the calendar year. Gifts received from a
qualified relative or from your immediate family need not be reported.
Identity of person
from whom gift was received
Identity of recipient of gift if not yourself
Statement of Financial Interests
Name
Reporting period: January 1, 2019 through December 31, 2019
Date Signature
Revised December 19, 2019 Page 6 of 10
SCHEDULE 4
Offices, Directorships and Salaried Employment Held by you or Members of your Immediate Family in
Business Entities Doing Business with the City of Annapolis
Name of person and
relationship if other
than yourself
Name and address of
principal office of
Business Entity
Title and nature of Office,
Directorship or
Salaried Employment held and
date it commenced
City Agency with which involved as
defined in Doing business with,
paragraph 4 of the provided definitions
*
Listings of businesses and financial institutions doing business with the City are available at www.annapolis.gov
under Ethics Commission Documents.
Statement of Financial Interests
Name
Reporting period: January 1, 2019 through December 31, 2019
Date Signature
Revised December 19, 2019 Page 7 of 10
SCHEDULE 5
Debts Owed by You or Your immediate Family to
Entities Doing Business with the City of Annapolis *
*
Do not include retail credit accounts, which do not have to be reported. Listings of businesses and financial institutions
doing business with the City are available at www.annapolis.gov under Ethics Commission Documents.
Name of person and
relationship if other
than yourself
Identity of person to
whom debt owed and
date liability was incurred
Amount of liability
owed at end of
reporting period
Terms of payment, extent to which liability
increased or reduced during the year,
identification of security given, if any
Statement of Financial Interests
Name
Reporting period: January 1, 2019 through December 31, 2019
Date Signature
Revised December 19, 2019 Page 8 of 10
SCHEDULE 6
Members of Immediate Family Employed by the City of Annapolis
In any capacity at any time during the reporting period
Nature and title of position held
Length of employment
Statement of Financial Interests
Name
Reporting period: January 1, 2019 through December 31, 2019
Date Signature
Revised December 19, 2019 Page 9 of 10
SCHEDULE 7
Earned Income by you or Members of your Immediate Family*
from Business Entities other than the City of Annapolis
* A minor child's employment or business ownership need not be disclosed if the agency that employs the individual does
not regulate, exercise authority over, or contract with the place of employment or business entity of the minor child.
Name of person and relationship if other
than yourself
Name and address of each employer or business entity providing earned
income during the reporting period
Statement of Financial Interests
Name
Reporting period: January 1, 2019 through December 31, 2019
Date Signature
Revised December 19, 2019 Page 10 of 10
SCHEDULE 8
Additional interest(s) or Information Disclosure
Nature of interest or transaction
Other pertinent information
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2019 Annual Financial Disclosure Statement for Employees and (City of Annapolis)

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