= -—OR'S
FLORIDA
COMMISSION ON ETHICS
JAN 17 2017
Florida Commission on Ethics
P. O. Drawer 15709, Tallahassee, Florida 32317-5709 RECEIVED
“A Public Office is a Public Trust”
Oe
1. PERSON BRINGING COMPLAINT:
Name: MATT NYE TelephoneNumber:__(321) 626-9791
Address: 1345 Bonaventure Drive
City:__Melbourne County: Brevard County state:___ FL zip Code: 32940
2. PERSON AGAINST WHOM COMPLAINT IS BROUGHT:
Use a separate complaint form for each person you wish to complain against:
Name: Jim Barfield Telephone Number: (321) 454-6601
Address: 2575 North Courtenay Parkway, Suite 200
City: Merritt Island County:____ Brevard ZipCode:_ 32953
Title of office or position held or sought: Brevard County Commissioner for District 4 / Commission Chair
3. STATEMENT OF FACTS:
Please provide a full explanation of your complaint, describing the facts and the actions of the
Person named above and why you believe he or she violated the law. Include relevant dates and
the names and addresses of persons whom you believe may be witnesses. Please do not submit
more than 15 pages, including this form. Please do not submit video or audio tapes, CDs, DVDs,
flash dri aterial will not be considered part of the complaint
and will be fe
4. OATH
|, the person bringing this complaint, do
swear or affirm that the facts set forth in
the foregoing complaint and attachments
thereto are true and correct to the best of
my knowledge and belief.
SIGNATURE IMPLAINANT
ms ‘Type, oF Stamp Soe ‘Name of Nota mo
(CE FORM 50—Effective January Personally Known ___ OR Produced Ideniication
Incorporated by reference in Fale $47-010(1)0), FAC ‘Type of Identification Produced: FLLVie
tion of Article II Section 8 of titus
Jim Barfield, Brevard County Commissioner for District 2, failed to submit complete and
accurate “Full and Public Disclosure of Financial Interests” forms (CE Form 6) for 2014 and 2015 as an
elected officer required to publicly disclose his financial interests on an annual basis as outlined in
Article II Section 8 of the Florida Constitution.
In Part D of the 2014 CE Form 6 regarding sources of income, Jim Barfield does not report or
‘make any mention of his income with regard to his position as a Brevard County Commissioner (see
Exhibits A and B). This is the case even though it is clear from Jim Barfield’s Payroll Earnings
Statement for 2014 that he earned a net total of $3,914.38 in public salary stemming from his position as
a Brevard County Commissioner (See Exhibit D). Article II, Section 8 of the Florida Constitution states
that “{a]ll elected constitutional officers and candidates for such offices and, as may be determined by
law, other public officers, candidates, and employees shall file full and public disclosure of their
financial interests.” As such, and again pursuant to Article II Section 8 of the Florida Constitution, an
elected constitutional officer who does not submit his most recent federal income tax retum together
with a CE Form 6, as was the case with respect to Jim Barfield in 2014, is required to submit a “[s]worn
statement which identifies each separate source and amount of income which exceeds $1000.” Since
Jim Barfield neglected to include his +$1000 per year salary from 2014 stemming from his County
‘Commissioner position in section D of the 2014 CE Form 6, Jim Barfield violated Article Il Section 8 of
«the Florida Constitution in 2014 in this regard,
Furthermore, with regard to both the 2014 and 2015 CE Form 6, Jim Barfield attached an
addendum for Part B concerning assets with a value of over $1000 (see Exhibits A and B). In the section
of the addendum conceming Part B for the 2014 CE Form 6, two additional assets are merely
characterized as “Money Market Account,” with a value of $1,400,000, and “Value of retirement
account — 401K Plan.” (see Exhibit A). For the 2015 CE Form 6, a reference to the “Money Market
Account,” with a value of $1,500,000 having no further description, is made (see Exhibit B). For each of
the three aforesaid asset descriptions in the 2014 and 2015 CE Form 6, no identification of the name of
any applicable entity, business, banking or otherwise, is indicated (See Exhibits A and B). In this
‘context, the relevant instructions in the CE Form 6 on how to identify intangible property assets in part
B of the CE Form 6 specifically call for one to “[iJdentify the type of property and the business entity
or person to which or whom it relates.” (see Exhibit C). As such, neither the “Money Market
Account” nor “Value of Retirement Account — 401K Plan” asset description is sufficient enough to meet
the foregoing standards, thus constituting a violation of Article II Section 8 of the Florida Constitution.
Therefore, by failing to submit complete and accurate “Full and Public Disclosure of Financial
Interests” forms for 2014 and 2015, Jim Barfield violated Article II Section 8 of the Florida Constitution
on the foregoing grounds.EXHIBIT AFORM 6 FULL AND PUBLIC DISCLOSURE
BSS OF FINANCIAL INTERESTS
See eee
Se
meme
Po RECEIVED
af amr
4
Bam
Brevard County Commission
SE seer PROCESSED
PART A-NET WORTH
Please enter the value of your net worth as of December 31, 2014. [Note: Net worth is not calculated by
‘subtracting your reported liabilities from your reported assets, so please see the instructions on page 3.)
My net worth as of December 31, 2014 was $_6.881,758
PART B— ASSETS
HOUSEHOLD GOODS AND PERSONAL EFFECTS:
‘Hausen goods and personal eects may be reported in sharp sum if hl agorgate value exceeds $1,000. Thi catagory ices sry ot the
{otowing, tot hel tor investment purposes: jwery colocone of stripe, guns, snd umlmatic Nene; at cbecs; Roussos equpmert and
Aiamitnge: obing: her household hme ed voices fr perscra use, wer Cwned er fased
‘The sogregste va of my houtshot! good ae pervonal eects Goscrb above) is $ 200,000
‘ASSETS INDIVIDUALLY VALUED AT OVER $1,000:
[DESCRIPTION OF ASSET (specific description bs required - ee Instructions pA)
‘Checking/ savings account with Bank of America
PART C— LIABILITIES
Lapis w Excess OF 61,000 (ee lnetrictlons on page 4):
NAME AND ADDRESS OF CREDITORPART D - INCOME.
‘You may EITHER (1) te 2 complete copy of you 2014 federal Income tmx retum, Inching af W2's, schedules, snd atechments, OR (2) Me 8 swom
‘Retemerk Kenai each separate source and amourt of come which exceeds 81,000, chung secondary sources of income, by completing the
‘rminer ef Pan boon
CL eeet to ee ospy of my 2014 adore income tux return and all W2', echedules, and altace
[WiyousdiecR Bis box and atachw copy of your 2014 lax retur, you Reed not carpets fhe remainder of Part
‘PRIMARY SOURCES OF INCOME (See Inatructions on page 8}:
oF
Luke & Astociates, Inc- Salary ‘375 Commerce Parkway, Ste 103, Rockledge, FL | __$ 165,200
‘SECONDARY SOURCES OF INCOME [Malor customers, Sans, tc. of butlessea owned by reporting pereon-eeehaiuctions on page 6:
NAME OF [NAME OF MAJOR SOURCES: ‘ADORESS, PRINCIPAL BUSINESS
BUSNESS ENTITY ‘OF BUSINESS INCOME OF SOURCE, ACTIVITY OF SOURCE,
a & Ae, me anes Be Stig 7002 Pesaree Re San Ari
Ta bp aed Saas hy Varn Wy aes Peas
PART E — INTERESTS IN SPECIFIED BUSINESSES [Instructions on page 6]
BUSINESS ENTITY BUSINESS ENTITY #2 BUSINESS ENTITY 63
TAME OF.
BUSINESS ENTITY
‘ADORESS OF
BUSINESS ENTITY
PRINGPPAL BUSINESS
Act
POSITION FELD
Soares ENT
TOWN MORE TENA GR
LIne BUSHESS,
"NATURE OF Rev
OWNERSHIP BTEREST
PART F- TRAINING
For officers required to complete annual ethics training pursuant to section 112.3142, F.8.
(_I CERTIFY THAT | HAVE COMPLETED THE REQUIRED TRAINING.
OATH connor Bee vee
Ihe penton whose name appears at the ‘Swom to (oafirmed) and subscribed before me tie 173: aay of
bering oe fom, de depone on cath er inaon
se eay at oration cdsed on bef
sed any stachrarts ert tue, acct,
acon.
STURE OF ‘OFFICIAL OR CANDIDATE
2 ceri pubic accountant Hcensed under Chapter 473, or atfomey in good standing withthe Florida Bar prepared this frm for you, he or
‘she must compete the folowing statement
prepared the CE Form 8 in accordance with tI, Sec. 8, lox Constiuion,
‘Szcion FIES1aa, Foi Sia, end We atrocons To he fom. Upon my reasonable Knowledpe and beet, Se Sioere here tue
‘nd correc.
‘Sinanre Date
Preparation ofthis form by a CPA or attorney does not relive the filer of the to sign the form under oath.
TF ANY OF PARTS A THROUGH E ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE
Ea ae PRET
Seedy sets ae Sa. A. b
oJIM BARFIELD
ATTACHMENT TO FORM 6, PART B-ASSETS
CONTINUATION SCHEDULE
[PART B]- ASSETS INDIVIDUALLY AT OVER $1,000:
Description of Asset
Real Estate a flows:
435 Sims Way, Merrit Island, FL ‘$290,060
2900 Warrensburg Rd., Greeneville, TN $95,000
Bowers Rd., Greeneville, TN ‘$100,000
Pinnacte Mountain, #13, Rutherford County, NC $100,000
‘TOTAL VALUE OF ALL REAL ESTATE- $585,060
> Money Market Account $1,400,000
> Value of retirement account- 401K Plan $160,000
> Loan due from Luke & Associates, nc. $816,003
‘TOTAL VALUE OF ASSETS USTED ON THE ATTACHMENT > | $2,961,063,EXHIBIT BFULL AND PUBLIC DISCLOSURE
OF FINANCIAL INTERESTS FOR OFFICE USE ONLY:
Sa aera nar SOTA 29 5034
Barfield, Jim FLORIDA
‘WAILING ADDRESS: COMMISSION ON ETHIC
m1 a
HY’ a. COUNTY
| Merritt Island 32952 Brevard
RECEIVED
PROCESSED
THAME OF OFFICE OR POSITION HELD OR SOUGHT
County Comiissioner, District 2
‘CHECK IF THIS ISAFILING BYAGANDDATE Ol
PART A~NET WORTH
Please enter the value of your net worth as of December 31, 2015 or @ more current date. [Note: Net worth isnot cal
culated by subtracting your repored ables from your reporied assets, so please see the Insrucions on page 3}
My net worth as of Desanter3t 2015 __was $ 2715807
PART B— ASSETS
HOUSEHOLD GOODS AND PERSONAL EFFECTS:
‘usec goods end personal fects may be reported na ump sum if hlr aggregate vale excoeds $1,000. This catagory incides any of he
{folowing rol eld for invesiment purposes: jewelry, colectons of samp, guns, and numismatc Hens; art object: hoveebeld equipment and
‘umltlgs: ction; ober hovseekd lems; and vehicies for personal use, wher owned or leased.
“The agoregte vale of my houschld goods and persona fects (described shove) is § 200.000
ASSETS INDIVIBUALLY VALUED AT OVER $1,000:
[DESCRIPTION OF ASSET (apectic ascripton ls raquired- sae Instructions pA)
‘CheckiogSavingsuccount with Bank of America
Lake & Associates, In. (0% owner closly-eld FL corporation, vali estimated vale)
2011 Tiffin Allegro Bus
‘See atached continuation of esc for detail
PART C ~ LIABILITIES
LIABILITIES IN EXCESS OF $1,000 (See Instructions on page 4):
[NAME AND ADORESS OF CREDITOR [AMOUNT OF ABILITY
Bank of Amen Lows sionaes
‘JOUNT AND SEVERAL LABILITIES NOT REPORTED ABOVE:
NAME AND ADDRESS OF CREDITOR [AMOUNT OF LABILITY
"SEroRu ciagre sou SS Tt enero oT
‘mpomed by rors a Ra POU) FAS. 7 TAGPART D— INCOME
‘deny each separate source and amount oncom which exceeded $1,000 during the yar, chang waconday sources of nome. Or sac a. comple
{apy of your 2013 federal Income fx fun, nung al Ws, schedules, and atachnenis. Passe Fede! any socal seco Beco rane belts
‘Mtncing your rture, asthe law requires Ghee documents be posted tothe Commons wabate.
Deer to te» copy ot my 2015 feral incom tax rots and a Vi, echedules, an stachmerts
‘OF BUSINESS INCOME
Lake &Ass0e le Nurses Et. Stafing
United States Army
‘PART E ~ INTERESTS IN SPECIFIED BUSINESSES [Instructions on page 6]
BUSINESS ENTITY # 1 BUSINESS ENTTY#2 [BUSINESS ENTITY #3
For officers required to complete annus ethics training pursuant to section 112.3142, FS.
@_I CERTIFY THAT | HAVE COMPLETED THE REQUIRED TRAINING.
ISTATE OF FLORIOA
county oF BREvA‘D
Swam (atime an sctbd hae me is Y. ceyot
GiGRATORE OF REPORTING OFFICIAL OR CANDIDATE.
a certed puble sccountant lensed under Chapter 473, or atiomey in goed standing withthe Flr Bar prepared ths form for you, he or
sterencomate teak stern
ropered the CE Form 6 in accordence wth Aft I, Se. 8, Floriés Constiuton,
Sacion TESTA, Pest Sas, a earls het, Upon ny fesonbleoewage sn biel he dione heron 8 YeJIM BARFIELD
ATTACHMENT TO FORM 6, PART B-ASSETS
[PART
|~ ASSETS INDIVIDUALLY AT OVER $1,000:
Description of Asset
Real Estate:
435 Sims Way, Merritt Island, FL
72900 Warrensburg Rd. Greeneville, TN
Bowers Rd, Greeneville, TN
Pinnacle Mountain, #13, Rutherford County, NC
‘Total Value of Real Estate:
‘Money Market Account
‘401k Scudder $185,000,
Loan due from Luke & Associates, Inc. $425,335
"TOTAL VALUE OF ASSETS LISTED ON THE ATTACHMENT. $2,534,185,EXHIBIT CTICE
Annual Full and Public Disclosure of Financial Interests is due July 1. If the annual form is not filed or postmarked
by September 4, 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 exceas
1g $10,000. [s. 112.317, FS]
INSTRUCTIONS FOR COMPLETING AND FILING FORM 6
FULLAND PUBLIC DISCLOSURE OF FINANCIAL INTERESTS
WHAT TO FILE WHERE TO FILE WHEN TO FILE
Fle ony te fat sheet (pages 1 anc 2) Ofcholig: Commision on Ethics, P.O, Oficanalirs: No alr than dy 1, 2016,
Facsimiles will not be accepted. A Drawer , Telshassee, candidat Juring the qualifying peric
Fae et tome ren z0ie S708, physical’ adaress” 325 John Knox SaAddates: During the qualiving pei.
Cae ae ee oe ehiginy, Road, Busing E Suite 200, Talanassee,
may file a copy of that Form 6 at the time FL 32303;
of qual Candidates: The officer before whom they
ually. Ha Form 6 fled wt a qualfying
Stcet need not also be fled wih the
‘Commission.
WHO MUST FILE FORM 6:
‘All persons holding the folowing positions: Govemor, Lieutenant
Governor, Cabinet members, members of the Legislature, State
‘Attomeys, Public Defenders, Clerks of Circuit Courts, Sherits,
Tax Collectors, Property Appraisers, Supervisors of Elections,
County Commissioners, elected Superintendents of Schoo's,
members of District School Boards, Mayor and members of
the Jacksonville City Council, Judges of Compensation Claims;
‘he Duval County Superintendent of Schools, and members ofthe
Florida Housing Finance Corporation Board, the Florida Prepaid
College Board, and each expressway author, transportation
authority (except the Jacksonvile Transportation Authority), bridge
authority, or toll authority created pursuant to Chapter 248 or 343,
FS,, or any other general lav.
INSTRUCTIONS FOR COMPLETING FORM 6:
INTRODUCTORY INFORMATION (41 109 of Form):
your name, mailing address, public agency, and postion are
aeady printed on the form, you do not need to provide this
information uniess it should be changed. To change any of
this information, write the correct information on the form, and
contact vour agency’ fnancial disclosure coordinator, You can
find your coordinator on the Commission on Ethics website:
wowethics state fu.
NAME OF AGENCY: The name ofthe governmental unit which
You serve or served, or for which you are a candidate,
OFFICE OR POSITION HELD OR SOUGHT: The tite of the
‘office oF position you hold, are seeking, or held as of December
31, 2075, even if vou have since left that postion. Ifyou are @
candidate, chedk the box below your name and address.
PUBLIC RECORD: The disclosure form and everything
attached to it isa pubic record and is required by law to be
posted to the Commission's website. Your Social Security
‘number and bank account and credit card numbers arenot
‘required and you should redact them from any documents
‘you file, If you are an active or former officer or employee
listed in Section 118.071, FS., whose home address or other
information is exempt from disclosure, the Commission will
‘maintain that configentaty if vou submit a written request,
PART A — NET WORTH
[Required by Art I, s. 82)()(1), Fla. Const]
Report your net worth as of December 31, 2018, or a more
current date, and lst that date, This should be the same date used
to value your assets and lables. n order to determine your net
wort, you will nee to total he valve ofall your assets and subtract
the amount of all of your fables. Simply subiracting the lables
reported in Part in Part B wil not result
‘nan acourate net wort foure in most cases.
“To total the value of our asses, ade:
(1) The aggregate value of household goods and personal
effects, as reported in Part B ofthis form
(2) The value of all assets worth over $1,000, as reported in
Port 8; and
(3) The total value of any assets worth less than $1,000 that
were not reported oF included in the category of "household
goods and personal eects"
To total the amount of your lables, ade
(1) The total amount of each Kiblity you reported in Part C of
{his form, except or any amounts listed in the "Joint and several
Tabilies not reported above" portion; and
(2). The total amount of unreported fables (including those
under $7,000, cect card and retail instalment accounts, and
taxes owed).
(CONTINUED on page 4) ae
Spouse Dus, FAG
FACES
(dePART B—ASSETS WORTH MORE THAN $1,000
[Required by Art. Ils. 8, Fla, Const; s. 112.3144, FS.)
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 deseribed on the form.
ASSETS INDIVIDUALLY VALUED AT MORE THAN $1,001
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
fo, things lke interests in real property; cash; stocks; bonds;
certificates of deposit, interests in businesses; beneficial interests,
in trusts; money owed you: bank accounts; Deferred Retirement
Option Program (OROP) 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 itset.
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. Ifthe properly has no street address, identify
by desorioing the property's location in a manner sulficient
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
ist si " of “bar "
For example, list “Stock (Wiliams Construction Co.)
(Southem Water and Gas)," “Bank accounts (First National
Bank),” "Smith family trust," "Promissory note and mortage
(owed by John and Jane Doe),
How to Value Assets:
— Value each asset by its fair market value on the date
Used in Part 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 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, 7 _—_ _
— "Real property may be valued at its market value for tax
purposes, unless @ more accurate appraisal ofits fair market
vvalue 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 teasonably expect 0
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 eamings 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 Is. 8, Fla. Const; s. 112.312, FS)
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. Liablties include:
accounts, notes, and interest payable; debis 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 responsibilty
You do not have to list onthe form any of the following: credit
card and retail instalment 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 lability” is one that will become an actual
liability only when one or more future events occur or fall to occur,
such as where you are liable only as @ partner (without personal
liability) for partnership debts, or where you are liable only as @
{quarantor, surety, or endorser on a promissory note. If you are 2
“oo-maker" on a note and are jointly liable or jointly and severally
liable, then itis not a contingent la
How to Determine the Amount of a Liability
= Generally, the amount of the labilty is the face amount,
of the debt
— The amount of the lability 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% ofthe liability should be listed.
— Ifyou are jointly and severally lable with another person,
or entity, which often isthe 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 liabilly. However, if you are jointly and severally liable for,
1 debt relating to property you own with one or more others
28 tenants by the entirety or jointly with right of survivorship,
‘eport 100% of the total amount owed,
— Ifyou are only jointly (not jointly and severally) lable 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)
{nonpayment S003"). FAC.
PAGES
‘3Examples:
— You owe $10,000 to a bank for student loans, $6,000 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 ofthat liability) and the name and
‘address of the savings and loan ($60,000 being the amount
(of this liabliy). 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 ofthe liability. If your lability for
the loan is only as a partner, without personal liability, then
the loan would be a contingent liabiity.
JOINT AND SEVERAL LIABILITIES NOT REPORTED ABOVE:
List inthis part of the form the amount of each debt for which
you were jointly and severally lable, that is not reported in the
“Liabilities in Excess of $1,000" part of the form. Example: You
‘and your 50% business partner have @ $100,000 business loan
{rom 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 liabilly, as you reported the other 50% of the debt earlier.
PART D — INCOME
[Required by Art. Is, 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 2015
federal income tax return, including all schedules W2's_and
allachments, 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 2015, the address of that
source, and the amount of income received from that source. The
income of your spouse need not be disclosed; however, ifthere is
joint income to you and your spouse from property you own jointly
(uch as interest or dividends from a bank account or stocks), you
should include all ofthat income.
“Income” means the same as "gross income” for federal
income tax purposes, even ifthe 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 @
‘corporation and received more than $1,000 of income
(Galary, 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
— Ifyou 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 ofthese investments.
=f 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 secures listed on an exchange
are sold through @ brokerage firm, the source of income
should be listed simply as "sale of (name of company) stock.’
for example.
— I more than $1,000 of your income was in the form of
interest from one particular financial institution (agoregating
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 institation
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 @
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
fof @ business entity (2 corporation, partnership, timited
partnership, LLC, proprietorship, joint venture, trust, firm,
etc., doing business in Floriday; 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 entily 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 inoome
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 ofthe uniform,
rental company, its address, and its principal business
activity (uniform rentals)
— You are a 20% partner in a partnership that owns 2
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,
40% of the partnership's gross income, and the tenant's
address and principal business activity
(CONTINUED on page 6) o-
‘eons ronerce n e 3482, FAG
PAGES
igPART E - INTERESTS IN SPECIFIED BUSINESSES
[Required by s. 112.3145, FS]
The types of businesses covered inthis 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;
uilty 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
cr 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 2045, an officer,
director, partner, proprietor, or agent (other than a resident agent
solely for service of process).
Ifyou have or held such a postion or ownership interest in
one of these types of businesses, list: the name ofthe business,
its address and principal business activity, and the position held
withthe business (if any). Also, if you own(ed) more than 3 6%
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, FS]
Ifyou are a Constitutional or elected municipal officer whose
term began before March 31 of the year for which you are fing,
Yyou are required to complete four hours of ethics training which
addresses Article I, Section 8 of the Florida Constitution, the
Code of Ethies for Public Officers and Employees, and the public
records and open meetings laws of the state, You are required
10 certify on this form that you have taken such training,
(End of Instructions.)
OTHER FORMS YOU MAY NEED TO FILE
IN ORDER TO COMPLY WITH THE ETHICS LAWS
In dation to fling Form 8, you may be required to file one or more of the special purpose forms lsted below, depending on your
particular postion, business activites, or interests. As it Is your duty to obtain and fle any of the special purpose forms which may be
‘pplieable to you, you should carefully read the brief description of each form to determine whether it apples.
Form 6F — Final Full and Public Disclosure of Financial
Interests: Requited of elected constitutional offcers and others
who must fle nancial disclosure using Form 6; tobe fled within 60
days after leaving office or employment. This form is used to report
financial intorests betwoen January 1st ofthe lst year of office oF
‘employment and the last day of office or employment [s. 112.3144,
Fs]
Form 6X — Amended Full and Public Disclosure of Financial
Interests: To be used by elected constitutional offcers and
‘others who must file Francia disclosure using Form 6 or 6F to
‘correct mistakes on previously fled form. [s. 112.3144, FS]
Form 2— Quarterly Cllont Disclosure: Required of elected
constitutional officers, local offcers, state officers, and specified
state employees to disclose the names of clients represented for,
compensation by themselves, or a pariner or associate before
agencies atthe 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. 112.9145, FS]
Form 9 — Quarterly Gift Disclosure: Required of elected
‘constitutional offers and others who must fe fnancial
ssok
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