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Please answer Questions 1 through 7 for each debt to be disclosed. The Ethics Law requires that you

identify the person or entity to whom the debt is owed, the date the debt was incurred, the terms of payment of

the debt, the amount of the debt owed as of the last day of the calendar year, the extent to which the principal

amount of the debt increased or decreased during the calendar year, and a description of any security given for

the debt. Additionally, if this transaction resulted in a debt being owed by your spouse or dependent child, you

need to identify your spouse and/or child and describe the transaction.

SCHEDULE G. Family Members Employed by the State

Please answer Questions 1 through 3 as appropriate listing all members of your immediate family

(spouse and dependent children) who were employed by the State in any capacity at any time during the

reporting period. Include the name of the agency where employed.

SCHEDULE H. Employment and Business Ownership

Please answer Questions 1 and 2 as appropriate listing: 1) the name and address of any places of

employment for you, your spouse or a dependent child, and 2) business entities wholly or partially

owned by you, your spouse or a dependent child, and from which income was earned during the reporting

period whether or not the entity did business with the State. For example, you should disclose salaried

employment, individual consulting activities, private practices, and business activities involving income-

producing real property. With regard to dependent children, you need report only earned income from

employment or an interest in a business entity if that employment or business entity did business in excess of

$10,000 with your agency or was regulated by your agency. For example, if your dependent child had summer

employment as a lifeguard or in a local restaurant, you need not report that child’s employment.

For statements filed on or after January 1, 2019, if your spouse is an individual regulated lobbyist, you

must identify each entity that has engaged your spouse for lobbying purposes (i.e., your spouse’s clients).

SCHEDULE I. Optional

You may use this Schedule for any interest or transactions you have not been required to disclose on

Schedule A through H but wish to disclose. This Schedule may also be used to further explain any prior entry.

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October 1, 2017

Financial Disclosure Statement Instructions (Form 1) - Maryland State Ethics Commission Page 8