Form 1 - Amended
FORM 1 X - /I;n~~e/ STATEMENT OF 2000
FINANCIAL INTERESTS \ "
.'...
LAST NAME - FIRST NAME - MIDDLE NAME: NAME OF REP.ORl\INGPERSON'S AGENCY:
#~I2/1,/A"u j),; z,.. tJ.scA ,e. L,;/ /:S; , $);'/>>;/' Isq~~A
MAILING ADDRESS: Cn"(,f tiF
/ (, e C; ..:r~~I~~~~t-.J .f4:; . CHECK~ OF THE FOLLOWlNG,(s.,,_"VY"o Must File" on page 3):
Av~ 15
0 LOCAL OFFICER 0 STATE OFFICER
/J1 /lJ//1I Ee~ i Fl. 33/~ .tlI.. CANDIDATE 0 SPECIFIEO STATE EMPLOYEE
, .,
CITY: ZIP: COUNTY: LIST OFFI~J:POSITION HELD OR SOUGHT . ,
)11 / ri-~II '. - D A {;;J3,. 'J.4 '--/ tJ "L. . ,
DISCLOSURE PERIOD: .-
.
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CJ\LENDAR YEAR OR ON
A FISCAL YEAR PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (cheCk one):
~ CI -..
DECEMBER 31,2000 QB SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: ,','
,
j:"
MANNER OF CALCULATING REPORTABLE INTERESTS:
PRIOR TO 2001, THE THRESHOLDS FOR REPORTING FINANCIAL INTERESTS WERE COMPARATIVE, USUALLY BASED ON PERCENTAGE VAL-
UES. BEGINNING IN 2001, THE LEGISLATURE HAS ALLOWED FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE
DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS (see instructions for further details). PLEASE STATE BELOW WHETHER THIS STATE-
MENT REFLECTS EITHER (check one):
0 COMPARATIVE (PERCENTAGE) THRESHOLDS (old method) QB 0 DOLLAR VALUE THRESHOLDS (new method)
PART A - PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person] ,
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADORESS PRINCIPAL BUSINESS ACTIVITY
/J1i/4/YJ,; u._ JLU IJ D,L ~ 1 ~ - - J.; 1'-. DJI'L-'.r.:J. ADVlEfi-i; $ ;iJQ
Inl itJ /1',,', PI .sS/3:J- /it:L.T: E.K.e~n'yt:::
,
.
.
PART B - SECONDARY SOURCES OF INCOME (Major customers, clients, and other sources of income to businesses owned by the reporting person]
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS'S INCOME OF SOURCE ACTIVITY OF SOURCE
""'N' n IL ~~ ....-;z:. M14r41\~ ~AL''''''''''' .."..". ,.::;. ~Ai/~ "'..... ,:er'.5/1-~m
/.JIc..(eA'-1 A. .?~/~ ~";NS.<J Jri,.Jc7./
.-
PART C - REAL PROPERTY [Land, buildings owned by the reporting person] " FILING INSTRUCTIONS for
J when and where to file this form are
~ located at the bottom of page 2.
INSTRUCTIONS on who must file
this form and how to fill it out begin
on page 3 of this packet.
OTHER FORMS you may need to
file are described on page 6.
CE FORM 1 - Elf. 1/2001
(Continued on reverse side)
PAGEl
PART D -INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposrt, etc.]
~ TYPE o. INTA""IBLF RI '>'\INF>'\S FNTITY TO WHI"H THF PROPFRTY Rei ATES
JI/A-
,
PART E - LIABILITIES [Major debts]
NAME OF CREDITOR . ADORESS OF CREDITOR
PEg d-.7/8 L/. C//rJkl ND ~4tik- 15/,/d" ~
J-f: LA.,.; p. P/ ,7..?.s//
,
PART I' - INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses]
B SINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3
NAME OF J../J
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 F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE [J
SIGNATURE: ~ /J / DATE SIGNED: q_
..---- II - OJ
/\/ ~
f/ FILING INSTRUCTIONS: I
WHAT TO FILE: WHERE TO FILE: WHEN TO FILE:
After completing all parts of this form, including If you were mailed J,he form by the Commission In/liaf.: each local officer, state officer, and
signing and dating it, send baclt only the - first on Ethics or a County Supervisor of Elections for speci ed state employee must file within 30
sheet (pages 1. and 2) for filing. , your annual disclosure filing, return the form to days of the date of his or her appointment or of
that location. the beginning of employment. Appointees who
Local officers file with the Supervisor of must be confirmed by the Senate must file prior
to confirmation, even if that is less than 30
Elections of the county in which you permanently days from the date of their appointment.
reside. (If you do not permanently reside in
NOTE: MULTIPLE FILING UNNECES- Florida, file with the Supervisor of the county Candidates for publicJy-elected local office
SARY: where your agency has its headquarters.) must file at the same time they file their quali-
Generally, a person who has filed Form 1 for a State officers or specified state employees file lying papers.
calendar or fiscal year is not required to file a sec- with the Commission on Ethics, P.O. Drawer Thereafter, local officers, state officers, and
ond Form 1 for the same year. However, a candi- 15709, Tallahassee, FL 32317-5709. specified state employees are required to file
date who previously filed Form 1 because of Candidates file this form together with your qual- by July 1 st following each calendar year in
another public position must at least file a copy of which they hold their positions.
his or her original Form 1 when qualifying. ifying papers.
To determine what category your position Finally, at the end of office or employment
each local officer, state officer, and specified
falls under, see the ''Who Must File" Instructions state employee is required to file a final disClo-
on page 3. sure form (Form 1 F) within 60 days of leaving
office or employment.
CE FORM 1 - Eff. 1/2001
PAGE 2