Conflict Of Interest & Financial Disclosure - Utah House Of Representatives

Conflict Of Interest & Financial Disclosure - Utah House Of Representatives - 2017 Page 3

Entity or organization for which you serve on the board of directors

or in any other type of paid leadership capacity (include current and

preceding year).

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

* (only required to list those entities not already listed in responses to questions 3,4, or 5)

Name of entity or organization

Type of business or activity conducted by

Your position in the entity or

the entity

organization

Description of any real property in which the legislator holds an

ownership or other financial interest that the legislator believes may

constitute a conflict of interest.

(optional)

[2014 Gen. Session, HB 394, pg. 22]

Description of the real property

Description of the type of interest held by the

legislator

Name of spouse and any other adult residing in your household who is

not related by blood or marriage.

[see 2014 Gen. Session, HB 394; pg. 22]]

Name of SPOUSE:

Names of

residing in home who are not related by blood or marriage:

OTHER ADULTS

Page 3 of 4

revised May 30, 2014

Conflict Of Interest & Financial Disclosure - Utah House Of Representatives - 2017 Page 3