DISCLOSURE STATEMENT

Revised January 2, 2018

Date: August 2018

Name: Kristen Cox

Employee ID #: 125248 Schedule Code:

Position Title: Executive Director

Department: Governor’s Office of Management and Budget

Agency Head or Designee Signature: ______________________________________________

Date: _____________________

Please return completed and signed statement to the HR Director/Manager or designee.

HR Field Director or Designee Review for Completeness Only:

Signature: ___________________________________________________________________

Date: ____________________

Background Check Completion

Type of background check:

( ) Applicant Background Check (ABC) ( ) Agency TAC ( ) Third Party Vendor
( ) Right of Access / Red Envelope ( ) Other _______________________________________

Completed By: _______________________________________________________________

Completed Date: _____________________

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 CONSENT AND CERTIFICATION

I consent to the release of information regarding my abilities to perform the duties of the
position to which I may be appointed. This information may be obtained from current or former
employers, schools, law enforcement agencies or other individuals or organizations and may be
used by the Agency and the Department of Human Resource Management in determining my
appointment. If appointment requires Senate consent, I also consent to the release of this
information to the Senate and the Office of Legislative Research and General Counsel.

I, Kristen Cox, certify that the information provided in this statement is to the best of my
knowledge, true and accurate. I understand that any misstatements of material facts will subject
me to disqualification or dismissal.

Signature: _________________________________________

Date: July 20, 2018

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 PERSONAL INFORMATION

NAME: Kristen Cox

RESIDENCES OUT OF THE STATE OF UTAH: In the past five years have you lived
outside of the State of Utah? No

If yes, list the city and state(s) and dates you resided there.

EMPLOYMENT HISTORY: Beginning with your current employment list all periods of full-
time, part-time, volunteer, military service, self-employment, and periods of unemployment in
chronological order over the past ten years that are not included on your resume. Include the
employer’s name, address and telephone number, dates of employment your title, and your
duties.

Executive Director, Governor’s Office of Management and Budget (Aug 2012 to present)
Executive Director, Department of Workforce Services (April 2007 to Aug 2012)
Owner, Epiphany Associates, LLC (2011 to present)

Have you ever been discharged, asked to resign, furloughed, put on inactive status for cause, or
been subject to disciplinary action while in any position of employment (except the military)? No

If yes, please explain:

Have you ever resigned after being told that your employer intended to discharge you for any
reason? No

MILITARY SERVICE: Have you served in the armed forces, National Guard, or military
reserve of the United States? No

Have you ever been the subject of any judicial or non-judicial disciplinary action or been given
the option to resign in lieu of forced separation while in the military, National Guard, or military
reserve? No

If yes, explain:

CRIMINAL BACKGROUND: Have you ever been convicted of a criminal offense related to
the area of responsibility to which you may be appointed? No

If yes, explain:

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SUBSTANCE ABUSE: Do you now use controlled substances illegally? No

VEHICLE REGISTRATION: Are your personal motor vehicles registered in Utah?

Explain why any are registered in a state other than Utah:

I do not drive

PROFESSIONAL STATE LICENSES, REGISTRATIONS, and CERTIFICATES: List the

names of any professional state licenses, registrations, and certificates you hold, including
license numbers and expiration dates that are not listed on your resume:

I hold no licenses, registrations, or certificates

ORGANIZATION AFFILIATIONS: List all local, state, and national civic, cultural,
education, charitable, or work-related organizations you have been associated with in the past
five years on the reverse side. Include any position held in the organization and the date of
service. To your knowledge, are any of these organizations or any other organization to which
you belong restricted on the basis of race, color, religion, sex, national origin, disability, marital
status, arrest, or veteran status? No

National Federation of the Blind – held several offices over the course of my membership
Fistula Foundation – no office held

If yes, explain:

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 CONFLICT OF INTEREST
ETHICAL CONDUCT: Have you ever been cited for a breach of ethics for unprofessional
conduct by, or been named in, a complaint to any court, administrative agency, professional
association, disciplinary committee, or other professional group? No

If yes, explain:

CIVIL LITIGATION/AGENCY PROCEEDINGS: Are you presently or have you ever been
a party of interest in any civil litigation or agency preceding that is related in any way to the
position to which you may be appointed? No

If yes, explain:

Has any business in which you, your spouse, immediate family member, or business associate
are or were an officer, director, or partner been a party to any civil litigation or agency
proceeding relevant to the position to which you may be appointed? No

If yes, explain:

Is anyone currently threatening to sue you or any business in which you are an officer, director,
or partner? No

If yes, explain:

FAMILY RELATIONSHIPS: Are you, your spouse, or other immediate family members
related to any state government official or employee?

Randy Cox, husband, employee of the University of Utah

Miranda Jones Cox, daughter-in-law, GOMB

If the nature of employment for your spouse or other immediate family member is related in any
way to the position to which you may be appointed, please indicate the employer, the position,
and the length of time it has been held:

Miranda was already employed by GOMB when she met and married by son, Tanner. I do not
directly supervise Miranda and DHRM has confirmed that because her direct supervisor is Phil
Dean, the State of Utah nepotism rules have not been violated.

COMPENSATION: During the past five years, have you, your spouse, or other immediate
family member received any compensation or been involved in any financial transaction with the
state of Utah or with any state government official?

Only as employees of the State of Utah as identified above.

If yes, explain:

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BUSINESS RELATIONSHIPS: Describe any business relationship, dealing, or financial
transaction that you had during the past five years, whether for yourself, on behalf of a client, or
acting as an agent, that you believe may appear as or be an actual potential conflict of interest in
the position to which you may be appointed:

I recently co-authored a book entitled Stop Decorating the Fish. The book outlines in story form,
some of the concepts and ideas for improving performance through use of the Theory of
Constraints (TOC). The book can be purchased through Amazon. Any proceeds I may receive
from the book will be donated to the National Federation of the Blind. While I am employed by
the State of Utah, I will not receive any proceeds from books sales.

LOBBYING ACTIVITIES: Have you participated in any compensated lobbying activity

during the past five years in which you have engaged for the purpose of influencing the passage
defeat, or modification of any legislative or administrative action? No

If yes, explain:

Has your spouse or any immediate family member participated in any compensated lobbying
activity during the past five years in which your spouse or immediate family member has
engaged for the purpose of influencing the passage, defeat, or modification of any legislative or
administrative action that is related in any way to the position to which you may be appointed?
No

If yes, explain:

REGULATED ACTIVITIES: During the past five years have you, your spouse, or any
immediate family member been an officer, owner, director, trustee, or partner in any corporation,
firm, partnership, other business enterprise, nonprofit organization, or other institution that is
regulated by or receives direct financial benefits from any department, agency, or institution of
the State of Utah? Yes

If yes, explain: As a company operating in Utah, Epiphany Associates, LLC would be regulated
by the Department of Commerce as well as the Utah State Tax Commission

OTHER ACTIVITIES: Are there any other matters that may be incompatible with the
discharge of the duties of the position to which you may be appointed or that may impair or tend
to impair your independence of judgment or action in the performance of the duties of that
position? No

If yes, explain:

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 FINANCIAL INFORMATION
GIFTS: Have you, your spouse, or your dependents received gifts from anyone who is related in
any way to the position to which you may be appointed, exceeding $500 per year within the last
five years? No

If yes, explain, including the nature and value of the gift and donor:

TAXES: Have you regularly filed state and federal tax returns? Yes

Have you ever been convicted of tax evasion, tax fraud, or similar crime or been the subject of a
tax audit or investigation that resulted in the assessment of a penalty? No

If yes, explain:

BANKRUPTCIES: Have you, your spouse or any corporation, firm, partnership, other
business enterprise, nonprofit organization, or other institution in which you or your spouse have
served as an officer, director, trustee, or partner: (a) filed a petition for bankruptcy under the U.S.
Bankruptcy Code; (b) been adjudicated as bankrupt under the U.S. Bankruptcy Code: or (c) been
the subject of a formal or informal receivership? No

If yes, explain and include the type of bankruptcy, the court trustee, and the trustee’s address:

DELINQUENCIES: Are you delinquent on any federal, state, or local debt? No

If yes, explain and include delinquencies for taxes, governmental loans, overpayment of benefits,
required payments into or under governmental programs, and other debts or required payments to
the government plus any defaults on or under loans that are or were guaranteed, insured, or
subsidized by any unit of government.

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 EMPLOYMENT
FUTURE EMPLOYMENT INTENTIONS: Do you intend to sever all connections with your
present employers, business firms, business associations, or business organizations if you are
appointed? No

If not, explain:

I will continue to operate my private consulting company, Epiphany Associates, LLC. However,
all paid consulting work I perform as a representative of the company is performed outside the
State of Utah in order to prevent any actual or perceived conflict of interest.

Do you intend to participate in compensated lobbying activities after you leave government
service? No

If yes, explain:

FRINGE BENEFITS: Are there any employee fringe benefits that you are now receiving and
will continue to receive during your service with state government? No

If yes, explain:

OUTSIDE EMPLOYMENT: Do you have any commitments or agreements to pursue outside

employment, with or without compensation, during your service with state government? No

If yes, explain:

RESUMPTION OF EMPLOYMENT: Do you plan to resume employment, affiliation, or

practice with your previous employer, business firm, association, or organization after
completing your service with state government? Yes

If yes, explain: My private consulting company

Has anyone made an offer to employ you after you leave state government service? No

If yes, explain:

LENGTH OF SERVICE: If appointed, do you expect to serve out your full term or until the
next gubernatorial election? Yes

If no, explain:

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