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PFD - Personal Financial Disclosure

Welcome to the Ethics Board’s web reporting system for Personal Financial Disclosure Statements

Iowa Code section 68B.35 requires certain executive branch employees and officials to file personal financial disclosure statements with the Iowa Ethics and Campaign Disclosure Board. These statements are due on or before April 30 of each year following a year during which the person holds a designated position, without regard to the length of time the position was occupied by the person. A person who held a designated position who leaves that position has a continuing obligation to file the statement for any year or portion of a year in which the position was held prior to termination. These statements are public records and available on the Ethics Board’s website.

It shall be considered a violation of Iowa Code section 68B.35 for an individual holding a designated position in the executive branch to file a disclosure statement containing false or fraudulent information. If the Ethics Board determines after a contested case proceeding that a false or fraudulent disclosure statement was filed, the Ethics Board may impose any of the actions under Iowa Code section 68B.32D.

Contact the Ethics Board’s staff at (515) 281-4028 if you need assistance.

Part A: Designated position(s) in the Executive Branch

The covered year is the year prior to the year the statement is due.
Your Name
*
Business Address
 
City
State
Zip
Phone Number
*
Email
*
Covered Year
*e.g. a statement due April 30, 2012 is for the 2011 covered year.

Government / Political Positions

Once you have chosen your fields, click add. You may choose more than one position if you are required to file for more than one.
State Agency
*
 
Division / Department
*If there is no division choose None/Not Applicable.
 
Position Held
*
 

Part B: Other business, occupation or profession.

Iowa Code section 68B.35 requires you to disclose each business, occupation, or profession in which you were engaged during the covered year and the nature of that business, occupation, or profession, unless already apparent.
Name of Business
*
Nature of Business
*
Position Held
*

Part C: Income Sources

You will be asked to disclose by category every source of income not already disclosed in Part A or B that produced more than $1,000 in gross income in the covered year.

You may enter multiple sources under each category if necessary.

You are not required to disclose the amount of income, just the type of income and source.

You are not required to disclose income received solely by your spouse or other family members.

You shall disclose any source of income in excess of $1,000 if the gross income is subject to federal or state income tax during the covered year. If you had no income in excess of $1,000 in a source, please check the box provided for that source of income.

1. Securities

Enter the name of each entity in which you held stocks, bonds, mutual funds or other types of securities that generated more than $1,000 in gross income for you in the covered year.
Name of Security
*
Type of Security
*e.g. stocks, bonds, mutual funds

2. Instruments of Financial Institutions

Enter the name of each financial institution in which you held financial instruments that produced gross income in excess of $1,000 for you in the covered year.
Name of Financial Institution
*e.g. Verdidian Credit Union
Type of Income Earned
*e.g. interest earned on a certificate of deposit or savings account

3. Trusts

Enter the name of each trust that generated gross income in excess of $1,000 in the covered year.
Name of Trust
*e.g. John Doe Family Trust
Trustor
*i.e. person or entity that created trust
Type of Trust
*e.g. testamentary, irrevocable

4. Real Estate

Enter the type of each real estate that generated gross income in excess of $1,000 in the covered year.
Source of Real Estate
*e.g. rent, sale, mortgage
Type of Real Estate
*e.g. agricultural, commercial, residential

5. Retirement Systems

Enter the name of each retirement system from which you received income in excess of $1,000 in the covered year.

Do NOT list retirement systems that did not generate income for you in the covered year.

Name of Retirement System
*e.g. IPERS, Social Security

6. Other Sources of Income

Enter the type and source of any other income in excess of $1,000 not already disclosed in this statement.
Source
*
Type
*

Part D: Commissions from the sale of goods or services to a political division of the State

Iowa Code section 68B.35 requires executive branch officials and employees who sell goods or services to a political subdivision of the state during the covered year to disclose whether income has been received from commissions from these sales.

If you received a commission from the sale of goods or services to a political subdivision of the state during the covered year, enter the name of each purchasing political subdivision and a description of the goods or services sold.

Name of Political Subdivision
*e.g. Warren County, City of Marshalltown
Description of Goods or Service
*

Review

Please review the information you have disclosed to ensure you have completely and accurately disclosed all of the information requested.

If you need to make changes, click the previous button to return to the page that you need to change.

Affirmation

By clicking the "submit" button below I affirm this statement is complete and accurate to the best of my knowledge. I understand I may be subject to civil and criminal penalties for failing to file a complete and accurate statement or for failing to file this statement by the required due date.

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