Form A - Financial Disclosure Statement - 2016 (Page 7 of 12) in pdf

Form A - Financial Disclosure Statement - 2016 Page 7

SCHEDULE C – EARNED INCOME

Name:

Page______ of _______

List the source, type, and amount of earned income from any source (other than the filer’s current employment by the U.S. government) totaling $200 or more during the reporting period. For a spouse, list

the source and amount of any honoraria; list only the source for other spouse earned income exceeding $1,000. See examples below.

EXCLUDE: Military pay (such as National Guard or Reserve pay), federal retirement programs, and benefits received under the Social Security Act.

INCOME LIMITS and PROHIBITED INCOME: The 2016 limit on outside earned income for Members and employees compensated at or above the “senior staff” rate was $27,495. The 2017 limit is $27,765.

In addition, certain types of income (notably honoraria, director’s fees, and payments for professional services involving a fiduciary relationship) are totally prohibited.

Source (include date of receipt for honoraria)

Type

Amount

Keene State

Approved Teaching Fee

$6,000

State of Maryland

Legislative Pension

$18,000

Examples:

Civil War Roundtable (Oct. 2)

Spouse Speech