Conflict Of Interest & Financial Disclosure - Utah House Of Representatives

Conflict Of Interest & Financial Disclosure - Utah House Of Representatives - 2017

UTAH HOUSE OF REPRESENTATIVES

2017 CONFLICT OF INTEREST &

FINANCIAL DISCLOSURE

All versions of this document, including amended versions, shall remain on the legislative

website and in the House main office (hard copy) for two years

from the date the completed form is received by the Chief Clerk.

NOTE:

"preceding year" means the year immediately preceding the day on which the

officeholder files a Conflict of Interest form. UCA: 20A-11-1602(6)

Name of officeholder

__________________________________________________

Employment

(2014 Gen. Session, HB 394, pg. 21: An officeholder is required to disclose each of the

officeholder's current employers, as well as employers during the preceding year.)

Name & address of CURRENT employer(s)

Brief description of

Occupation and/or job title

employment

Name & address of PRECEDING YEAR'S

Brief description of

Occupation and/or job title

employer(s)

employment

Entities in which you are an owner or officer.

[2014 Gen. Session, HB 394, pg. 21]

CURRENT YEAR: Name of entities

Type of business or activity

Your position in each entity

conducted by each entity

PRECEDING YEAR: Name of entities

Type of business or activity

Your position in each entity

conducted by each entity

Page 1 of 4

revised May 30, 2014

Conflict Of Interest & Financial Disclosure - Utah House Of Representatives - 2017