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Suzanne Ageton Financial Disclosure Statement - 2011 l~f Cl f!J 4 /f 1 i Copv /LC~G rat f I Scanned/File Orieinal C F PDF Posted to Web 1 . Reviewed by PA Record in Database CANDIDATE/INCUMBENT FINANCIAL DISCLOSURE STATEMENT City of Boulder Form 13-2-3, BRC, 1981 Candidate Within 3 days of Candidate's Petition is Certified Incumbent Annual September 10 filing with changes Annual September 10 filing- no changes since last filing of this statcmcnl t,- Liw Print Pull Legal Name - - Address City boo( ~ State -4> Zip The information contained in this filing is true and correct to the best of my knowledge. -5c-, 2 Signature of Candidate or Incumbent !)etc Submt fed EMPLOYER • If you are self-employed, or employed as a partner in a professional firm, so state, and state trade or business names you use and the name of the professional firm you work with. • If you have more than one job during the present calendar year, state all your employers. • If you are a homemaker, so state. • If you have no employment, so state. Note: Do not disclose the names of clients or others to whom you have a legal duty of confidentiality without their permission. A legal duty of confidentiality is one in which you could invoke the right to refuse to answer a question under oath in a trial, like a lawyer-client privilege. OCCUPATION State your occupation. • If retired or unemployed, state your occupation when you were working. • If you are a student or a homemaker, so state. • - • If you have more than one occupation, state all of them. • If you have a profession or skill which you-have used in the past, but are not now using in your job, you may state that additionally. t3-c~ v~ .v l~ It-._L,~ C_dt_ L 1 Y7~'LS Cn.LS iV~ Revised 7/28/2011 Form 13-2-3, BRC, 1981 SOURCE OF INCOME State the type and source of any other income in excess of one thousand dollars during the calendar year, besides your employer. Each source of income must be listed, regardless of its tax status. Sources must be listed specifically; that is, stocks would be insufficient; you must state stock in XY% Company. The type of income can be stated generally; capital gain, dividend, rent, etc. You are not required to disclose the amount of income from any source, but you may if you wish. Source e BUSINESS INTERESTS State the name, location, and nature of activity of any business entities or enterprises for profit, with holdings of real or personal property or with business dealings in the area encompassed by the Boulder Valley Comprehensive Plan (BVCP), in which you have any financial interest, or in which you are actively engaged as an officer, director, or partner. For each, state the nature of your interest or activity therewith, and state whether you have controlling interest in the entity. Business entity means any type of business: sole proprietorship, joint venture, partnership, corporation, trust holding or investment company, professional corporation, etc. It is immaterial whether the business is making money; if it was founded with that intent, it must be listed. Also, note that the business must be listed if it has any property, or any business dealings, within the BVCP, but that those holding and dealings do not have to be set forth (real estate holdings of businesses in which you have a controlling interest must be disclosed in the next question, however). The nature of your involvement should be stated with a degree of specificity; that is, state corporate vice president rather than simply officer. The amount of financial involvement need not be disclosed, but you may if you wish. t ~U92_0V~-k_ ~`~t1 c Nature of Activity oC [3usiness Controlling Ofganizatton's Name Interest D [t `f \ e~~ l~' t2 Z C? lt\ b4w ~C SO IF YES l ~~"ll Address ` I Naturc of Your Interest ut Bttsine~ NO city Sit to Zip s'') c°F fry v`Cti/fot_j Nature of Activity of 1Business Controlling OrPanization's Name Interest YES Address Nature of Your Interest in Business NO City State Zip Nature of .Activity of Business Controlling Organization's Name Interest YES ;Address Nature of Ynur Interest in Husine„ NO City State Zip Revised 7/28/2011 Form 13-? 3, BRC, 1981 REAL ESTATE INTERESTS State the location of any real property within Boulder County in which you, or the business entities you have a controlling interest in, have any interest. Also state the nature of your or your business entity's interest. All interests, including options, remainders, mineral rights, etc., no matter what their value, must be listed. You need not state the value of the interest, but you may do so if you wish. You need not list your personal residence, but you may if you wish. Note, If there is no street address, state the.lot number and subdivision. If none, state the sire of the parcel, the quarter section it is in, and the recording 'number of other place where the legal description can be found. INTEREST OWNED BY Owner's Name Self Street Address A trust of which I am a beneficiary A business entity I control/manage Citv State zip INTERESTED OWNED BY Owner's Name ❑ Self A trust of which I am a beneficiary start nddrrs= A business entity I control/manage Citv Slate Zip INTERESTED OWNED 13Y Owner's \+ame J Self Street Address A trust of which I am a beneficiary A business entity 1 control/manage City State Zip OTHER INFORMATION State any other information which you feel would be helpful or should be disclosed. If there is no such information, write none. to -P--_ Revised 7,2312611 1=onli 13-2-3. BRC, 19X1