FOR OFFICE USE ONLY:
CHECK IF THIS IS A FILING BY A CANDIDATE
PART C -- LIABILITIES
LIABILITIES IN EXCESS OF $1,000 (See instructions on page 4):
NAME AND ADDRESS OF CREDITOR AMOUNT OF LIABILITY
JOINT AND SEVERAL LIABILITIES NOT REPORTED ABOVE:
NAME AND ADDRESS OF CREDITOR AMOUNT OF LIABILITY
FULL AND PUBLIC DISCLOSURE
OF FINANCIAL INTERESTS
FORM 6
CE FORM 6 - Effective June 2, 2022
(Continued on reverse side)
PAGE 1
Incorporated by reference in Rule 34-8.002(1), F.A.C.
NAME OF OFFICE OR POSITION HELD OR SOUGHT :
CITY : ZIP : COUNTY :
MAILING ADDRESS:
NAME OF AGENCY :
LAST NAME — FIRST NAME — MIDDLE NAME:
Please print or type your name, mailing
address, agency name, and position below:
PART B -- ASSETS
HOUSEHOLD GOODS AND PERSONAL EFFECTS:
Household goods and personal effects may be reported in a lump sum if their aggregate value exceeds $1,000. This category includes any of the
following, if not held for investment purposes: jewelry; collections of stamps, guns, and numismatic items; art objects; household equipment and
furnishings; clothing; other household items; and vehicles for personal use, whether owned or leased.
The aggregate value of my household goods and personal effects (described above) is $ ______________________________________________
ASSETS INDIVIDUALLY VALUED AT OVER $1,000:
DESCRIPTION OF ASSET (specific description is required - see instructions p.4) VALUE OF ASSET
PART A -- NET WORTH
Please enter the value of your net worth as of December 31, 2021 or a more current date. [Note: Net worth is not cal-
culated by subtracting your reported liabilities from your reported assets, so please see the instructions on page 3.]
My net worth as of ____________________, 20 _____ was $ ___________________________.
2021
PART E -- INTERESTS IN SPECIFIED BUSINESSES [Instructions on page 6]
BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3
NAME OF
BUSINESS ENTITY
ADDRESS OF
BUSINESS ENTITY
PRINCIPAL BUSINESS
ACTIVITY
POSITION HELD
WITH ENTITY
I OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
NATURE OF MY
OWNERSHIP INTEREST
IF ANY OF PARTS A THROUGH E ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE
OATH
I, the person whose name appears at the
beginning of this form, do depose on oath or affirmation
and say that the information disclosed on this form
and any attachments hereto is true, accurate,
and complete.
___________________________________________________
SIGNATURE OF REPORTING OFFICIAL OR CANDIDATE
STATE OF FLORIDA
COUNTY OF ____________________________________________
Sworn to (or affirmed) and subscribed before me by means of
physical presence or
online notarization, this __________ day of
_____________________, 20 ____ by __________________________________.
__________________________________________________________________
(Signature of Notary Public--State of Florida)
__________________________________________________________________
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known __________ OR Produced Identification _____________
Type of Identification Produced ________________________________________
If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or
she must complete the following statement:
I, ______________________________________________, prepared the CE Form 6 in accordance with Art. II, Sec. 8, Florida Constitution,
Section 112.3144, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true
and correct.
______________________________________________________ ______________________________________
Signature Date
Preparation of this form by a CPA or attorney does not relieve the ler of the responsibility to sign the form under oath.
CE FORM 6 - Effective June 2, 2022 PAGE 2
Incorporated by reference in Rule 34-8.002(1), F.A.C.
PART F - TRAINING
This section applies only to officers required to complete annual ethics training pursuant to section 112.3142, F.S. [See instructions p. 6]
I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING.
PART D -- INCOME
Identify each separate source and amount of income which exceeded $1,000 during the year, including secondary sources of income. Or attach a complete
copy of your 2021 federal income tax return, including all W2s, schedules, and attachments. Please redact any social security or account numbers before
attaching your returns, as the law requires these documents be posted to the Commission’s website.
 I elect to file a copy of my 2021 federal income tax return and all W2’s, schedules, and attachments.
[If you check this box and attach a copy of your 2020 tax return, you need not complete the remainder of Part D.]
PRIMARY SOURCES OF INCOME (See instructions on page 5):
NAME OF SOURCE OF INCOME EXCEEDING $1,000 ADDRESS OF SOURCE OF INCOME AMOUNT
SECONDARY SOURCES OF INCOME [Major customers, clients, etc., of businesses owned by reporting person--see instructions on page 5]:
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS’ INCOME OF SOURCE ACTIVITY OF SOURCE
CE FORM 6 - Effective: June 2, 2022
PAGE 3
Incorporated by reference in Rule 34-8.002(1), F.A.C.
INSTRUCTIONS FOR COMPLETING AND FILING FORM 6
FULL AND PUBLIC DISCLOSURE OF FINANCIAL INTERESTS
INSTRUCTIONS FOR COMPLETING FORM 6:
Form 6F — Final Full and Public Disclosure of Financial
Interests: Required of elected constitutional officers and others
who must file financial disclosure using Form 6; to be filed within 60
days after leaving office or employment. This form is used to report
financial interests between January 1st of the last year of office or
employment and the last day of office or employment. [s. 112.3144,
F.S.]
Form 6X — Amended Full and Public Disclosure of Financial
Interests: To be used by elected constitutional officers and
others who must file financial disclosure using Form 6 or 6F to
correct mistakes on previously filed form. [s. 112.3144, F.S.]
Form 2 — Quarterly Client Disclosure: Required of elected
constitutional officers, local officers, state officers, and specified
state employees to disclose the names of clients represented for
compensation by themselves, or a partner or associate before
agencies at the same level of government as they serve. The
form should be filed by the end of the calendar quarter (March
31, June 30, Sept. 30, Dec. 31) following the calendar quarter in
which a reportable representation was made. [s. 112.3145, F.S.]
Form 9 — Quarterly Gift Disclosure: Required of elected
constitutional officers and others who must file financial
disclosure using Form 1 or 6 (as well as State procurement
employees) to report gifts worth more than $100. The form
should be filed by the end of the calendar quarter (March 31,
June 30, September 30, or December 31) following the calendar
quarter in which the gift was received. [s. 112.3148, F.S.]
Form 3A — Statement of Interest in Competitive Bid for Public
Business
Form 4A — Disclosure of Business Transaction, Relationship,
or Interest
Form 8A — Memorandum of Voting Conflict for State Officers
Form 8B — Memorandum of Voting Conflict for County,
Municipal, and Other Local Public Officers
Form 10 — Annual Disclosure of Gifts from Governmental
Entities and Direct Support Organizations and Honorarium
Event Related Expenses
Copies of these forms are available from the Supervisor
of Elections in your county; from the Commission on Ethics,
Post Office Drawer 15709, Tallahassee, Florida 32317-5709;
physical address: 325 John Knox Road, Building E, Suite 200,
Tallahassee, FL 32303; telephone (850) 488-7864; and at the
Commission's website: www.ethics.state.fl.us
Questions about any of these forms or the ethics laws may be
addressed to the Commission on Ethics, Post Office Drawer
15709, Tallahassee, Florida 32317-5709; physical address:
325 John Knox Road, Building E, Suite 200, Tallahassee, FL
32303; telephone (850) 488-7864.
CE FORM 6 - Effective: June 2, 2022 PAGE 6
Incorporated by reference in Rule 34-8.002(1), F.A.C.
OTHER FORMS YOU MAY NEED TO FILE
IN ORDER TO COMPLY WITH THE ETHICS LAWS
In addition to filing Form 6, you may be required to file one or more of the special purpose forms listed below, depending on your
particular position, business activities, or interests. As it is your duty to obtain and file any of the special purpose forms which may be
applicable to you, you should carefully read the brief description of each form to determine whether it applies.
NOTICE
Annual Full and Public Disclosure of Financial Interests is due July 1. If the annual form is not filed or postmarked
by September 1 an automatic fine of $25 for each day late will be imposed, up to a maximum penalty of $1,500.
Failure to file also can result in removal from public office or employment. [s. 112.3144, F.S. - applicable to officials
other than judges]
In addition, failure to make any required disclosure constitutes grounds for and may be punished by one or more
of the following: disqualification from being on the ballot, impeachment, removal or suspension from office or
employment, demotion, reduction in salary, reprimand, or a civil penalty not exceeding $10,000. [s. 112.317, F.S.]
PART E -- INTERESTS IN SPECIFIED BUSINESSES
[Required by s. 112.3145, F.S.]
The types of businesses covered in this section include: state
and federally chartered banks; state and federal savings and
loan associations; cemetery companies; insurance companies;
mortgage companies; credit unions; small loan companies;
alcoholic beverage licensees; pari-mutuel wagering companies;
utility companies; entities controlled by the Public Service
Commission; and entities granted a franchise to operate by
either a city or a county government.
You are required to make this disclosure if you own or
owned (either directly or indirectly in the form of an equitable
or beneficial interest) at any time during the disclosure period,
more than 5% of the total assets or capital stock of one of the
types of business entities listed above. You also must complete
this part of the form for each of these types of businesses for
which you are, or were at any time during 2021, an officer,
director, partner, proprietor, or agent (other than a resident agent
solely for service of process).
If you have or held such a position or ownership interest in
one of these types of businesses, list: the name of the business,
its address and principal business activity, and the position held
with the business (if any). Also, if you own(ed) more than a 5%
interest in the business, as described above, you must indicate
that fact and describe the nature of your interest.
PART F -- TRAINING CERTIFICATION
[Required by s. 112.3142, F.S.]
If you are a Constitutional or elected municipal officer whose
service began before March 31 of the year for which you are
filing, you are required to complete four hours of ethics training
which addresses Article II, Section 8 of the Florida Constitution,
the Code of Ethics for Public Officers and Employees, and the
public records and open meetings laws of the state. You are
required to certify on this form that you have taken such training.
(End of Instructions.)
WHAT TO FILE
File only the rst sheet (pages 1 and 2).
Originals are required. Photocopies,
faxed copies and emailed copies will not
be accepted. A candidate who has led
Form 6 for 2021 with the Commission, prior
to qualifying, may le a copy of that Form 6
at the time of qualifying.
WHERE TO FILE
Officeholders: Commission on Ethics, P.O.
Drawer 15709, Tallahassee, FL 32317-
5709; physical address: 325 John Knox
Road, Building E, Suite 200, Tallahassee,
FL 32303;
Candidates: The officer before whom
they qualify. If a Form 6 is filed with a
qualifying officer, it need not also be
filed with the Commission.
WHEN TO FILE
Officeholders: No later than July 1, 2022.
Candidates: During the qualifying period.
All persons holding the following positions: Governor, Lieutenant
Governor, Cabinet members, members of the Legislature, State
Attorneys, Public Defenders, Clerks of Circuit Courts, Sheriffs,
Tax Collectors, Property Appraisers, Supervisors of Elections,
County Commissioners, elected Superintendents of Schools,
members of District School Boards, Mayor and members of the
Jacksonville City Council, Judges of Compensation Claims; the
Duval County Superintendent of Schools, and members of the Florida
Housing Finance Corporation Board, each expressway authority,
transportation authority (except the Jacksonville Transportation
Authority), bridge authority, toll authority, or expressway agency
created pursuant to Chapter 348 or 343, F.S., or any other general
law, and judges, as required by Canon 6, Code of Judicial Conduct.
WHO MUST FILE FORM 6:
INTRODUCTORY INFORMATION
(At Top of Form):
If your name, mailing address, public agency, and position are
already printed on the form, you do not need to provide this
information unless it should be changed. To change any of
this information, write the correct information on the form, and
contact your agency's financial disclosure coordinator. You can
find your coordinator on the Commission on Ethics website:
www.ethics.state.fl.us.
NAME OF AGENCY: The name of the governmental unit which
you serve or served, or for which you are a candidate.
OFFICE OR POSITION HELD OR SOUGHT: The title of the
office or position you hold, are seeking, or held as of December
31, 2021, even if you have since left that position. If you are a
candidate, check the box below your name and address.
PUBLIC RECORD: The disclosure form and everything
attached to it is a public record and is required by law to be
posted to the Commission's website. Your Social Security
number, bank account, and credit card numbers are not
required and you should redact them from any documents
you file. If you are an active or former officer or employee
listed in Section 119.071, F.S., whose home address or other
information is exempt from disclosure, the Commission will
maintain that confidentiality if you submit a written request.
PART A — NET WORTH
[Required by Art. II, s. 8(a)(i)(1), Fla. Const.]
Report your net worth as of December 31, 2021, or a more
current date, and list that date. This should be the same date used
to value your assets and liabilities. In order to determine your net
worth, you will need to total the value of all your assets and subtract
the amount of all of your liabilities. Simply subtracting the liabilities
reported in Part C from the assets reported in Part B will not result
in an accurate net worth figure in most cases.
To total the value of your assets, add:
(1) The aggregate value of household goods and personal
effects, as reported in Part B of this form;
(2) The value of all assets worth over $1,000, as reported in
Part B; and,
(3) The total value of any assets worth less than $1,000 that
were not reported or included in the category of "household
goods and personal effects."
To total the amount of your liabilities, add:
(1) The total amount of each liability you reported in Part C of
this form, except for any amounts listed in the "joint and several
liabilities not reported above" portion; and,
(2) The total amount of unreported liabilities (including those
under $1,000, credit card and retail installment accounts, and
taxes owed).
(CONTINUED on page 4)
Form 6 2021_instructions_FINAL.indd 1 6/2/2022 12:42:38 PM
PART B — ASSETS WORTH MORE THAN $1,000
[Required by Art. II, s. 8, Fla. Const.; s. 112.3144, F.S.]
HOUSEHOLD GOODS AND PERSONAL EFFECTS:
The value of your household goods and personal effects may
be aggregated and reported as a lump sum, if their aggregate
value exceeds $1,000. The types of assets that can be reported
in this manner are described on the form.
ASSETS INDIVIDUALLY VALUED AT MORE THAN $1,000:
Describe, and state the value of, each asset you had on the
reporting date you selected for your net worth in Part A, if the
asset was worth more than $1,000 and if you have not already
included that asset in the aggregate value of your household
goods and personal effects. Assets include, but are not limited
to, things like interests in real property; cash; stocks; bonds;
certificates of deposit; interests in businesses; beneficial interests
in trusts; money owed you (including, but not limited to, loans
made as a candidate to your own campaign); bank accounts
in which you have an ownership interest; Deferred Retirement
Option Program (DROP) accounts; and the Florida Prepaid
College Plan. Assets also include investment products held in
IRAs, brokerage accounts, and the Florida College Investment
Plan. Note that the product contained in a brokerage account,
IRA, or the Florida College Investment Plan, is your asset—not
the account or plan itself.
You are not required to disclose assets owned solely by your
spouse.
How to Identify or Describe the Asset:
Real property: Identify by providing the street address of
the property. If the property has no street address, identify
by describing the property's location in a manner sufficient
to enable a member of the public to ascertain its location
without resorting to any other source of information.
Intangible property: Identify the type of property and the
business entity or person to which or to whom it relates. Do
not list simply "stocks and bonds" or "bank accounts."
For example, list "Stock (Williams Construction Co.)," "Bonds
(Southern Water and Gas)," "Bank accounts (First National
Bank)," "Smith family trust," "Promissory note and mortgage
(owed by John and Jane Doe)."
How to Value Assets:
— Value each asset by its fair market value on the date
used in Part A for your net worth.
Jointly held assets: If you hold real or personal property
jointly with another person, your interest equals your legal
percentage of ownership in the property. However, assets
that are held as tenants by the entirety or jointly with right of
survivorship, including bank accounts held in such a manner,
must be reported at 100% of their value.
— Partnerships: You are deemed to own an interest in a
partnership which corresponds to your interest in the equity
of that partnership.
Trusts: You are deemed to own an interest in a trust
which corresponds to your percentage interest in the trust
corpus.
Real property may be valued at its market value for
tax purposes, unless a more accurate fair market value is
available.
Marketable securities which are widely traded and
whose prices are generally available should be valued based
upon the closing price on the valuation date.
Accounts, notes, and loans receivable: Value at fair market
value, which generally is the amount you reasonably expect to
collect.
Closely-held businesses: Use any method of valuation
which in your judgment most closely approximates fair market
value, such as book value, reproduction value, liquidation value,
capitalized earnings value, capitalized cash flow value, or value
established by "buy-out" agreements. It is suggested that the
method of valuation chosen be indicated on the form.
Life Insurance: Use cash surrender value less loans
against the policy, plus accumulated dividends.
The asset value of a leased vehicle is the vehicle's present
value minus the lease residual (a number found on the lease
document).
PART C— LIABILITIES
[Required by Art. II, s. 8, Fla. Const.; s. 112.312, F.S.]
LIABILITIES IN EXCESS OF $1,000 :
List the name and address of each creditor to whom you
owed more than $1,000 on the date you chose for your net worth
in Part A, and list the amount you owed. Liabilities include:
accounts, notes, and interest payable; debts or obligations
(excluding taxes, unless the taxes have been reduced to a
judgment) to governmental entities; judgments against you, and
the unpaid portion of vehicle leases.
You are not required to disclose liabilities that are solely your
spouse's responsibility.
You do not have to list on the form any of the following: credit
card and retail installment accounts, taxes owed (unless the
taxes have been reduced to a judgment), indebtedness on a life
insurance policy owed to the company of issuance, or contingent
liabilities. A "contingent liability" is one that will become an actual
liability only when one or more future events occur or fail to occur,
such as where you are liable only as a partner (without personal
liability) for partnership debts, or where you are liable only as a
guarantor, surety, or endorser on a promissory note. If you are a
"co-maker" on a note and are jointly liable or jointly and severally
liable, then it is not a contingent liability.
How to Determine the Amount of a Liability:
Generally, the amount of the liability is the face amount
of the debt.
The amount of the liability of a vehicle lease is the sum
of any past-due payments and all unpaid prospective lease
payments.
If you are the only person obligated to satisfy a liability,
100% of the liability should be listed.
If you are jointly and severally liable with another person
or entity, which often is the case where more than one person
is liable on a promissory note, you should report here only
the portion of the liability that corresponds to your percentage
of liability. However, if you are jointly and severally liable for
a debt relating to property you own with one or more others
as tenants by the entirety or jointly, with right of survivorship,
report 100% of the total amount owed.
If you are only jointly (not jointly and severally) liable with
another person or entity, your share of the liability should be
determined in the same way as you determined your share
of jointly held assets.
(CONTINUED on page 5)
CE FORM 6 - Effective: June 2, 2022 PAGE 4
Incorporated by reference in Rule 34-8.002(1), F.A.C.
Examples:
You owe $10,000 to a bank for student loans, $5,000 for
credit card debts, and $60,000 with your spouse to a savings
and loan for the mortgage on the home you own with your
spouse. You must report the name and address of the bank
($10,000 being the amount of that liability) and the name and
address of the savings and loan ($60,000 being the amount of
this liability). The credit card debts need not be reported.
You and your 50% business partner have a $100,000
business loan from a bank and you both are jointly and
severally liable. Report the name and address of the bank
and $50,000 as the amount of the liability. If your liability for
the loan is only as a partner, without personal liability, then the
loan would be a contingent liability.
JOINT AND SEVERAL LIABILITIES NOT REPORTED
ABOVE:
List in this part of the form the amount of each debt for which
you were jointly and severally liable, that is not reported in the
"Liabilities in Excess of $1,000" part of the form. Example: You and
your 50% business partner have a $100,000 business loan from a
bank and you both are jointly and severally liable. Report the name
and address of the bank and $50,000 as the amount of the liability,
as you reported the other 50% of the debt earlier.
PART D — INCOME
[Required by Art. II, s. 8, Fla. Const.]
As noted on the form, you have the option of either completing
Part D of the form or attaching a copy of your complete 2021
federal income tax return, including all schedules, W2's and
attachments, with Form 6, or. If you do not attach your tax return,
you must complete Part D.
PRIMARY SOURCES OF INCOME:
List the name of each source of income that provided you
with more than $1,000 of income during 2021, the address of that
source, and the amount of income received from that source. The
income of your spouse need not be disclosed; however, if there is
joint income to you and your spouse from property you own jointly
(such as interest or dividends from a bank account or stocks), you
should include all of that income.
"Income" means the same as "gross income" for federal
income tax purposes, even if the income is not actually taxable,
such as interest on tax-free bonds. Examples of income include:
compensation for services, gross income from business, gains
from property dealings, interest, rents, dividends, pensions, IRA
distributions, distributive share of partnership gross income,
and alimony, but not child support. Where income is derived
from a business activity you should report the income to you, as
calculated for income tax purposes, rather than the income to the
business.
Examples:
If you owned stock in and were employed by a corporation
and received more than $1,000 of income (salary, commissions,
dividends, etc.) from the company, you should list the name of
the company, its address, and the total amount of income
received from it.
If you were a partner in a law firm and your distributive
share of partnership gross income exceeded $1,000, you
should list the name of the firm, its address, and the amount
of your distributive share.
If you received dividend or interest income from
investments in stocks and bonds, list only each individual
company from which you received more than $1,000. Do not
aggregate income from all of these investments.
If more than $1,000 of income was gained from the sale of
property, then you should list as a source of income the name
of the purchaser, the purchaser's address, and the amount of
gain from the sale. If the purchaser's identity is unknown, such
as where securities listed on an exchange are sold through a
brokerage firm, the source of income should be listed simply
as "sale of (name of company) stock," for example.
If more than $1,000 of your income was in the form of
interest from one particular financial institution (aggregating
interest from all CD's, accounts, etc., at that institution), list the
name of the institution, its address, and the amount of income
from that institution.
SECONDARY SOURCES OF INCOME:
This part is intended to require the disclosure of major
customers, clients, and other sources of income to businesses
in which you own an interest. It is not for reporting income
from second jobs. That kind of income should be reported as a
"Primary Source of Income." You will not have anything to report
unless:
(1) You owned (either directly or indirectly in the form of an
equitable or beneficial interest) during the disclosure period,
more than 5% of the total assets or capital stock of a business
entity (a corporation, partnership, limited partnership, LLC,
proprietorship, joint venture, trust, firm, etc., doing business in
Florida); and
(2) You received more than $1,000 in gross income from that
business entity during the period.
If your ownership and gross income exceeded the two thresholds
listed above, then for that business entity you must list every
source of income to the business entity which exceeded 10% of
the business entity's gross income (computed on the basis of the
business entity's most recently completed fiscal year), the source's
address, the source's principal business activity, and the name of
the business entity in which you owned an interest. You do not
have to list the amount of income the business derived from that
major source of income.
Examples:
— You are the sole proprietor of a dry cleaning business,
from which you received more than $1,000 in gross income
last year. If only one customer, a uniform rental company,
provided more than 10% of your dry cleaning business, you
must list the name of your business, the name of the uniform
rental company, its address, and its principal business activity
(uniform rentals).
You are a 20% partner in a partnership that owns a
shopping mall and your gross partnership income exceeded
$1,000. You should list the name of the partnership, the name
of each tenant of the mall that provided more than 10% of
the partnership's gross income, and the tenant's address and
principal business activity.
(CONTINUED on page 6)
CE FORM 6 - Effective: June 2, 2022 PAGE 5
Incorporated by reference in Rule 34-8.002(1), F.A.C.
Form 6 2021_instructions_FINAL.indd 2 6/2/2022 12:43:03 PM
PART B — ASSETS WORTH MORE THAN $1,000
[Required by Art. II, s. 8, Fla. Const.; s. 112.3144, F.S.]
HOUSEHOLD GOODS AND PERSONAL EFFECTS:
The value of your household goods and personal effects may
be aggregated and reported as a lump sum, if their aggregate
value exceeds $1,000. The types of assets that can be reported
in this manner are described on the form.
ASSETS INDIVIDUALLY VALUED AT MORE THAN $1,000:
Describe, and state the value of, each asset you had on the
reporting date you selected for your net worth in Part A, if the
asset was worth more than $1,000 and if you have not already
included that asset in the aggregate value of your household
goods and personal effects. Assets include, but are not limited
to, things like interests in real property; cash; stocks; bonds;
certificates of deposit; interests in businesses; beneficial interests
in trusts; money owed you (including, but not limited to, loans
made as a candidate to your own campaign); bank accounts
in which you have an ownership interest; Deferred Retirement
Option Program (DROP) accounts; and the Florida Prepaid
College Plan. Assets also include investment products held in
IRAs, brokerage accounts, and the Florida College Investment
Plan. Note that the product contained in a brokerage account,
IRA, or the Florida College Investment Plan, is your asset—not
the account or plan itself.
You are not required to disclose assets owned solely by your
spouse.
How to Identify or Describe the Asset:
Real property: Identify by providing the street address of
the property. If the property has no street address, identify
by describing the property's location in a manner sufficient
to enable a member of the public to ascertain its location
without resorting to any other source of information.
Intangible property: Identify the type of property and the
business entity or person to which or to whom it relates. Do
not list simply "stocks and bonds" or "bank accounts."
For example, list "Stock (Williams Construction Co.)," "Bonds
(Southern Water and Gas)," "Bank accounts (First National
Bank)," "Smith family trust," "Promissory note and mortgage
(owed by John and Jane Doe)."
How to Value Assets:
— Value each asset by its fair market value on the date
used in Part A for your net worth.
Jointly held assets: If you hold real or personal property
jointly with another person, your interest equals your legal
percentage of ownership in the property. However, assets
that are held as tenants by the entirety or jointly with right of
survivorship, including bank accounts held in such a manner,
must be reported at 100% of their value.
— Partnerships: You are deemed to own an interest in a
partnership which corresponds to your interest in the equity
of that partnership.
Trusts: You are deemed to own an interest in a trust
which corresponds to your percentage interest in the trust
corpus.
Real property may be valued at its market value for
tax purposes, unless a more accurate fair market value is
available.
Marketable securities which are widely traded and
whose prices are generally available should be valued based
upon the closing price on the valuation date.
Accounts, notes, and loans receivable: Value at fair market
value, which generally is the amount you reasonably expect to
collect.
Closely-held businesses: Use any method of valuation
which in your judgment most closely approximates fair market
value, such as book value, reproduction value, liquidation value,
capitalized earnings value, capitalized cash flow value, or value
established by "buy-out" agreements. It is suggested that the
method of valuation chosen be indicated on the form.
Life Insurance: Use cash surrender value less loans
against the policy, plus accumulated dividends.
The asset value of a leased vehicle is the vehicle's present
value minus the lease residual (a number found on the lease
document).
PART C— LIABILITIES
[Required by Art. II, s. 8, Fla. Const.; s. 112.312, F.S.]
LIABILITIES IN EXCESS OF $1,000 :
List the name and address of each creditor to whom you
owed more than $1,000 on the date you chose for your net worth
in Part A, and list the amount you owed. Liabilities include:
accounts, notes, and interest payable; debts or obligations
(excluding taxes, unless the taxes have been reduced to a
judgment) to governmental entities; judgments against you, and
the unpaid portion of vehicle leases.
You are not required to disclose liabilities that are solely your
spouse's responsibility.
You do not have to list on the form any of the following: credit
card and retail installment accounts, taxes owed (unless the
taxes have been reduced to a judgment), indebtedness on a life
insurance policy owed to the company of issuance, or contingent
liabilities. A "contingent liability" is one that will become an actual
liability only when one or more future events occur or fail to occur,
such as where you are liable only as a partner (without personal
liability) for partnership debts, or where you are liable only as a
guarantor, surety, or endorser on a promissory note. If you are a
"co-maker" on a note and are jointly liable or jointly and severally
liable, then it is not a contingent liability.
How to Determine the Amount of a Liability:
Generally, the amount of the liability is the face amount
of the debt.
The amount of the liability of a vehicle lease is the sum
of any past-due payments and all unpaid prospective lease
payments.
If you are the only person obligated to satisfy a liability,
100% of the liability should be listed.
If you are jointly and severally liable with another person
or entity, which often is the case where more than one person
is liable on a promissory note, you should report here only
the portion of the liability that corresponds to your percentage
of liability. However, if you are jointly and severally liable for
a debt relating to property you own with one or more others
as tenants by the entirety or jointly, with right of survivorship,
report 100% of the total amount owed.
If you are only jointly (not jointly and severally) liable with
another person or entity, your share of the liability should be
determined in the same way as you determined your share
of jointly held assets.
(CONTINUED on page 5)
CE FORM 6 - Effective: June 2, 2022 PAGE 4
Incorporated by reference in Rule 34-8.002(1), F.A.C.
Examples:
You owe $10,000 to a bank for student loans, $5,000 for
credit card debts, and $60,000 with your spouse to a savings
and loan for the mortgage on the home you own with your
spouse. You must report the name and address of the bank
($10,000 being the amount of that liability) and the name and
address of the savings and loan ($60,000 being the amount of
this liability). The credit card debts need not be reported.
You and your 50% business partner have a $100,000
business loan from a bank and you both are jointly and
severally liable. Report the name and address of the bank
and $50,000 as the amount of the liability. If your liability for
the loan is only as a partner, without personal liability, then the
loan would be a contingent liability.
JOINT AND SEVERAL LIABILITIES NOT REPORTED
ABOVE:
List in this part of the form the amount of each debt for which
you were jointly and severally liable, that is not reported in the
"Liabilities in Excess of $1,000" part of the form. Example: You and
your 50% business partner have a $100,000 business loan from a
bank and you both are jointly and severally liable. Report the name
and address of the bank and $50,000 as the amount of the liability,
as you reported the other 50% of the debt earlier.
PART D — INCOME
[Required by Art. II, s. 8, Fla. Const.]
As noted on the form, you have the option of either completing
Part D of the form or attaching a copy of your complete 2021
federal income tax return, including all schedules, W2's and
attachments, with Form 6, or. If you do not attach your tax return,
you must complete Part D.
PRIMARY SOURCES OF INCOME:
List the name of each source of income that provided you
with more than $1,000 of income during 2021, the address of that
source, and the amount of income received from that source. The
income of your spouse need not be disclosed; however, if there is
joint income to you and your spouse from property you own jointly
(such as interest or dividends from a bank account or stocks), you
should include all of that income.
"Income" means the same as "gross income" for federal
income tax purposes, even if the income is not actually taxable,
such as interest on tax-free bonds. Examples of income include:
compensation for services, gross income from business, gains
from property dealings, interest, rents, dividends, pensions, IRA
distributions, distributive share of partnership gross income,
and alimony, but not child support. Where income is derived
from a business activity you should report the income to you, as
calculated for income tax purposes, rather than the income to the
business.
Examples:
If you owned stock in and were employed by a corporation
and received more than $1,000 of income (salary, commissions,
dividends, etc.) from the company, you should list the name of
the company, its address, and the total amount of income
received from it.
If you were a partner in a law firm and your distributive
share of partnership gross income exceeded $1,000, you
should list the name of the firm, its address, and the amount
of your distributive share.
If you received dividend or interest income from
investments in stocks and bonds, list only each individual
company from which you received more than $1,000. Do not
aggregate income from all of these investments.
If more than $1,000 of income was gained from the sale of
property, then you should list as a source of income the name
of the purchaser, the purchaser's address, and the amount of
gain from the sale. If the purchaser's identity is unknown, such
as where securities listed on an exchange are sold through a
brokerage firm, the source of income should be listed simply
as "sale of (name of company) stock," for example.
If more than $1,000 of your income was in the form of
interest from one particular financial institution (aggregating
interest from all CD's, accounts, etc., at that institution), list the
name of the institution, its address, and the amount of income
from that institution.
SECONDARY SOURCES OF INCOME:
This part is intended to require the disclosure of major
customers, clients, and other sources of income to businesses
in which you own an interest. It is not for reporting income
from second jobs. That kind of income should be reported as a
"Primary Source of Income." You will not have anything to report
unless:
(1) You owned (either directly or indirectly in the form of an
equitable or beneficial interest) during the disclosure period,
more than 5% of the total assets or capital stock of a business
entity (a corporation, partnership, limited partnership, LLC,
proprietorship, joint venture, trust, firm, etc., doing business in
Florida); and
(2) You received more than $1,000 in gross income from that
business entity during the period.
If your ownership and gross income exceeded the two thresholds
listed above, then for that business entity you must list every
source of income to the business entity which exceeded 10% of
the business entity's gross income (computed on the basis of the
business entity's most recently completed fiscal year), the source's
address, the source's principal business activity, and the name of
the business entity in which you owned an interest. You do not
have to list the amount of income the business derived from that
major source of income.
Examples:
— You are the sole proprietor of a dry cleaning business,
from which you received more than $1,000 in gross income
last year. If only one customer, a uniform rental company,
provided more than 10% of your dry cleaning business, you
must list the name of your business, the name of the uniform
rental company, its address, and its principal business activity
(uniform rentals).
You are a 20% partner in a partnership that owns a
shopping mall and your gross partnership income exceeded
$1,000. You should list the name of the partnership, the name
of each tenant of the mall that provided more than 10% of
the partnership's gross income, and the tenant's address and
principal business activity.
(CONTINUED on page 6)
CE FORM 6 - Effective: June 2, 2022 PAGE 5
Incorporated by reference in Rule 34-8.002(1), F.A.C.
Form 6 2021_instructions_FINAL.indd 2 6/2/2022 12:43:03 PM
CE FORM 6 - Effective: June 2, 2022
PAGE 3
Incorporated by reference in Rule 34-8.002(1), F.A.C.
INSTRUCTIONS FOR COMPLETING AND FILING FORM 6
FULL AND PUBLIC DISCLOSURE OF FINANCIAL INTERESTS
INSTRUCTIONS FOR COMPLETING FORM 6:
Form 6F — Final Full and Public Disclosure of Financial
Interests: Required of elected constitutional officers and others
who must file financial disclosure using Form 6; to be filed within 60
days after leaving office or employment. This form is used to report
financial interests between January 1st of the last year of office or
employment and the last day of office or employment. [s. 112.3144,
F.S.]
Form 6X — Amended Full and Public Disclosure of Financial
Interests: To be used by elected constitutional officers and
others who must file financial disclosure using Form 6 or 6F to
correct mistakes on previously filed form. [s. 112.3144, F.S.]
Form 2 — Quarterly Client Disclosure: Required of elected
constitutional officers, local officers, state officers, and specified
state employees to disclose the names of clients represented for
compensation by themselves, or a partner or associate before
agencies at the same level of government as they serve. The
form should be filed by the end of the calendar quarter (March
31, June 30, Sept. 30, Dec. 31) following the calendar quarter in
which a reportable representation was made. [s. 112.3145, F.S.]
Form 9 — Quarterly Gift Disclosure: Required of elected
constitutional officers and others who must file financial
disclosure using Form 1 or 6 (as well as State procurement
employees) to report gifts worth more than $100. The form
should be filed by the end of the calendar quarter (March 31,
June 30, September 30, or December 31) following the calendar
quarter in which the gift was received. [s. 112.3148, F.S.]
Form 3A — Statement of Interest in Competitive Bid for Public
Business
Form 4A — Disclosure of Business Transaction, Relationship,
or Interest
Form 8A — Memorandum of Voting Conflict for State Officers
Form 8B — Memorandum of Voting Conflict for County,
Municipal, and Other Local Public Officers
Form 10 — Annual Disclosure of Gifts from Governmental
Entities and Direct Support Organizations and Honorarium
Event Related Expenses
Copies of these forms are available from the Supervisor
of Elections in your county; from the Commission on Ethics,
Post Office Drawer 15709, Tallahassee, Florida 32317-5709;
physical address: 325 John Knox Road, Building E, Suite 200,
Tallahassee, FL 32303; telephone (850) 488-7864; and at the
Commission's website: www.ethics.state.fl.us
Questions about any of these forms or the ethics laws may be
addressed to the Commission on Ethics, Post Office Drawer
15709, Tallahassee, Florida 32317-5709; physical address:
325 John Knox Road, Building E, Suite 200, Tallahassee, FL
32303; telephone (850) 488-7864.
CE FORM 6 - Effective: June 2, 2022 PAGE 6
Incorporated by reference in Rule 34-8.002(1), F.A.C.
OTHER FORMS YOU MAY NEED TO FILE
IN ORDER TO COMPLY WITH THE ETHICS LAWS
In addition to filing Form 6, you may be required to file one or more of the special purpose forms listed below, depending on your
particular position, business activities, or interests. As it is your duty to obtain and file any of the special purpose forms which may be
applicable to you, you should carefully read the brief description of each form to determine whether it applies.
NOTICE
Annual Full and Public Disclosure of Financial Interests is due July 1. If the annual form is not filed or postmarked
by September 1 an automatic fine of $25 for each day late will be imposed, up to a maximum penalty of $1,500.
Failure to file also can result in removal from public office or employment. [s. 112.3144, F.S. - applicable to officials
other than judges]
In addition, failure to make any required disclosure constitutes grounds for and may be punished by one or more
of the following: disqualification from being on the ballot, impeachment, removal or suspension from office or
employment, demotion, reduction in salary, reprimand, or a civil penalty not exceeding $10,000. [s. 112.317, F.S.]
PART E -- INTERESTS IN SPECIFIED BUSINESSES
[Required by s. 112.3145, F.S.]
The types of businesses covered in this section include: state
and federally chartered banks; state and federal savings and
loan associations; cemetery companies; insurance companies;
mortgage companies; credit unions; small loan companies;
alcoholic beverage licensees; pari-mutuel wagering companies;
utility companies; entities controlled by the Public Service
Commission; and entities granted a franchise to operate by
either a city or a county government.
You are required to make this disclosure if you own or
owned (either directly or indirectly in the form of an equitable
or beneficial interest) at any time during the disclosure period,
more than 5% of the total assets or capital stock of one of the
types of business entities listed above. You also must complete
this part of the form for each of these types of businesses for
which you are, or were at any time during 2021, an officer,
director, partner, proprietor, or agent (other than a resident agent
solely for service of process).
If you have or held such a position or ownership interest in
one of these types of businesses, list: the name of the business,
its address and principal business activity, and the position held
with the business (if any). Also, if you own(ed) more than a 5%
interest in the business, as described above, you must indicate
that fact and describe the nature of your interest.
PART F -- TRAINING CERTIFICATION
[Required by s. 112.3142, F.S.]
If you are a Constitutional or elected municipal officer whose
service began before March 31 of the year for which you are
filing, you are required to complete four hours of ethics training
which addresses Article II, Section 8 of the Florida Constitution,
the Code of Ethics for Public Officers and Employees, and the
public records and open meetings laws of the state. You are
required to certify on this form that you have taken such training.
(End of Instructions.)
WHAT TO FILE
File only the rst sheet (pages 1 and 2).
Originals are required. Photocopies,
faxed copies and emailed copies will not
be accepted. A candidate who has led
Form 6 for 2021 with the Commission, prior
to qualifying, may le a copy of that Form 6
at the time of qualifying.
WHERE TO FILE
Officeholders: Commission on Ethics, P.O.
Drawer 15709, Tallahassee, FL 32317-
5709; physical address: 325 John Knox
Road, Building E, Suite 200, Tallahassee,
FL 32303;
Candidates: The officer before whom
they qualify. If a Form 6 is filed with a
qualifying officer, it need not also be
filed with the Commission.
WHEN TO FILE
Officeholders: No later than July 1, 2022.
Candidates: During the qualifying period.
All persons holding the following positions: Governor, Lieutenant
Governor, Cabinet members, members of the Legislature, State
Attorneys, Public Defenders, Clerks of Circuit Courts, Sheriffs,
Tax Collectors, Property Appraisers, Supervisors of Elections,
County Commissioners, elected Superintendents of Schools,
members of District School Boards, Mayor and members of the
Jacksonville City Council, Judges of Compensation Claims; the
Duval County Superintendent of Schools, and members of the Florida
Housing Finance Corporation Board, each expressway authority,
transportation authority (except the Jacksonville Transportation
Authority), bridge authority, toll authority, or expressway agency
created pursuant to Chapter 348 or 343, F.S., or any other general
law, and judges, as required by Canon 6, Code of Judicial Conduct.
WHO MUST FILE FORM 6:
INTRODUCTORY INFORMATION
(At Top of Form):
If your name, mailing address, public agency, and position are
already printed on the form, you do not need to provide this
information unless it should be changed. To change any of
this information, write the correct information on the form, and
contact your agency's financial disclosure coordinator. You can
find your coordinator on the Commission on Ethics website:
www.ethics.state.fl.us.
NAME OF AGENCY: The name of the governmental unit which
you serve or served, or for which you are a candidate.
OFFICE OR POSITION HELD OR SOUGHT: The title of the
office or position you hold, are seeking, or held as of December
31, 2021, even if you have since left that position. If you are a
candidate, check the box below your name and address.
PUBLIC RECORD: The disclosure form and everything
attached to it is a public record and is required by law to be
posted to the Commission's website. Your Social Security
number, bank account, and credit card numbers are not
required and you should redact them from any documents
you file. If you are an active or former officer or employee
listed in Section 119.071, F.S., whose home address or other
information is exempt from disclosure, the Commission will
maintain that confidentiality if you submit a written request.
PART A — NET WORTH
[Required by Art. II, s. 8(a)(i)(1), Fla. Const.]
Report your net worth as of December 31, 2021, or a more
current date, and list that date. This should be the same date used
to value your assets and liabilities. In order to determine your net
worth, you will need to total the value of all your assets and subtract
the amount of all of your liabilities. Simply subtracting the liabilities
reported in Part C from the assets reported in Part B will not result
in an accurate net worth figure in most cases.
To total the value of your assets, add:
(1) The aggregate value of household goods and personal
effects, as reported in Part B of this form;
(2) The value of all assets worth over $1,000, as reported in
Part B; and,
(3) The total value of any assets worth less than $1,000 that
were not reported or included in the category of "household
goods and personal effects."
To total the amount of your liabilities, add:
(1) The total amount of each liability you reported in Part C of
this form, except for any amounts listed in the "joint and several
liabilities not reported above" portion; and,
(2) The total amount of unreported liabilities (including those
under $1,000, credit card and retail installment accounts, and
taxes owed).
(CONTINUED on page 4)
Form 6 2021_instructions_FINAL.indd 1 6/2/2022 12:42:38 PM