Form 1F - 2019 FORM 1F FINAL STATEMENT OF 2019
FINANCIAL INTERESTS
(TO BE FILED WITHIN 60 DAYS OF LEAVING PUBLIC OFFICE OR EMPLOYMENT)
LAST NAME—FIRST NAME—MIDDLE NAME: NAME OF REPORTING PERSON'S AGENCY:
MAILING ADDRESS:
CHECK ONE OF THE FOLLOWING(see"Who Must File"on page 3):
❑ LOCAL OFFICER ❑ STATE OFFICER
❑ SPECIFIED STATE EMPLOYEE
LIST OFFICE OR POSITION HELD:
CITY: ZIP: COUNTY:
"""BOTH PARTS OF THIS SECTION MUST BE COMPLETED'
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS MY FINANCIAL INTERESTS FOR THE PERIOD BETWEEN JANUARY 1,2019 AND THE LAST DATE I HELD THE PUBLIC
OFFICE OR EMPLOYMENT DESCRIBED ABOVE,WHICH DATE WAS 2019. (Date must be prior to 12/31/19)
MANNER OF CALCULATING REPORTABLE INTERESTS:
FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER
CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further
details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER(must check one):
❑ COMPARATIVE(PERCENTAGE)THRESHOLDS OR ❑ DOLLAR VALUE THRESHOLDS
PART A--PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person-See instructions]
(If you have nothing to report,write"none"or"Irl
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
PART B --SECONDARY SOURCES OF INCOME
[Major customers, clients, and other sources of income to businesses owned by reporting person-See instructions]
(If you have nothing to report,write"none"or"Irl
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE
PART C --REAL PROPERTY [Land, buildings owned by the reporting person-See instructions] FILING INSTRUCTIONS for when
(If you have nothing to report,write"none"or"Irl and where to file this form are
located at the bottom of page 2.
INSTRUCTIONS on who must file
this form and how to fill it out
begin on page 3 of this packet.
CE Form 1F Effective:January 1,2019 (Continued on reverse side) PAGE 1
Incorporated by reference in Rule 34-8.208(2),F.A.C.
PART D—INTANGIBLE PERSONAL PROPERTY[Stocks, bonds,certificates of deposit,etc.-See instructions]
(If you have nothing to report,write"none"or"n/a")
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
PART E—LIABILITIES [Major debts-See instructions]
(If you have nothing to report,write"none"or"n/a")
NAME OF CREDITOR ADDRESS OF CREDITOR
PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses-See instructions]
(If you have nothing to report,write"none"or"n/a")
BUSINESS ENTITY# 1 BUSINESS ENTITY#2
NAME OF BUSINESS ENTITY
ADDRESS OF BUSINESS ENTITY
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5% INTEREST IN THE BUSINESS
NATURE OF MY OWNERSHIP INTEREST
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑
SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY
If a certified public accountant licensed under Chapter 473, or
Signature: attorney in good standing with the Florida Bar prepared this form
for you, he or she must complete the following statement:
I, , prepared
the CE Form 1 in accordance with Section 112.3145, Florida
Statutes, and the instructions to the form. Upon my reasonable
knowledge and belief, the disclosure herein is true and correct.
Date Signed:
CPA/Attorney Signature
Date Signed
FILING INSTRUCTIONS:
WHEN TO FILE: may file by mail or email.Contact your Supervisor To determine what category your position
At the end of office or employment each of Elections for the mailing address or email falls under,see the"Who Must File"Instructions
local officer, state officer, and specified address to use. Do not email your form to the on page 3.
state employee is required to file a final Commission on Ethics, it will be returned. NOTE:
disclosure form (Form 1F) within 60 days State officers or specified state If you areleaving office or employment
of leaving office or employment, unless he employees who file with the Commission on during the first half of 2019,you may not
or she takes another position within the Ethics may file by mail or email. To file by mail, have filed Form 1 for 2018. In that case,
60-day period that requires filing financial send the completed form to P.O. Drawer 15709, this is not the last form you will file. Form
disclosure on Form 1 or Form 6. Tallahassee, FL 32317-5709; physical address: 1F covers January 1, 2019, through your
WHERE TO FILE: 325 John Knox Rd, Bldg E,Ste 200,Tallahassee, last day of office or employment. You
Local officers file with the Supervisor of FL 32303. To file with the Commission by email, will be required to file Form 1 for 2018 by
Elections of the county in which they permanently scan your completed form and any attachments July 1, 2019, and risk being fined if you
reside. (If you do not permanently reside in as a pdf(do not use any other format)and send do not file Form 1 by the filing deadline,
Florida, file with the Supervisor of the county it to CEForml @leg.state.fl.us. Do not file by both even if you have already filed the CE
where your agency has its headquarters.) Form mail and email. Choose only one filing method. Form 1 F.
1 filers who file with the Supervisor of Elections
CE Form 1F Effective:January 1,2019 PAGE 2
Incorporated by reference in Rule 34-8.208(2),F.A.C.
WHO MUST FILE FORM IF, Final Statement of Financial Interests:
All persons who fall within the categories of"state officers," "local officers," and "specified state employees" are required to file Form 1F
within 60 days of leaving that position unless they take another position within the 60-day period that requires filing either Form 1 or Form 6.
Positions within these categories are listed below. Persons required to file full financial disclosure(Form 6--see that form for a list of persons
who are required to file it) should file Form 6F rather than Form 1 F as their final financial disclosure.
1) Elected public officials not serving in a political subdivision of the of a county, municipality, or other political subdivision; county or municipal
state and any person appointed to fill a vacancy in such office, unless attorney; chief county or municipal building inspector; county or municipal
required to file full disclosure on Form 6. water resources coordinator; county or municipal pollution control director;
2) Appointed members of each board, commission, authority, or county or municipal environmental control director; county or municipal
council having statewide jurisdiction, excluding members of solely advisory administrator with power to grant or deny a land development permit; chief
bodies, but including judicial nominating commission members; Directors of of police;fire chief;municipal clerk;appointed district school superintendent;
Enterprise Florida,Scripps Florida Funding Corporation,and Career Source community college president; district medical examiner; purchasing agent
Florida;and members of the Council on the Social Status of Black Men and (regardless of title) having the authority to make any purchase exceeding
Boys; the Executive Director, Governors, and senior managers of Citizens $20,000 for the local governmental unit.
Property Insurance Corporation; Governors and senior managers of Florida 8) Officers and employees of entities serving as chief administrative
Workers' Compensation Joint Underwriting Association; board members of officer of a political subdivision.
the Northeast Fla. Regional Transportation Commission; board members of 9) Members of governing boards of charter schools operated by a city
Triumph Gulf Coast, Inc;board members of Florida Is For Veterans, Inc.;and or other public entity.
members of the Technology Advisory Council within the Agency for State 10) Employees in the office of the Governor or of a Cabinet member
Technology. who are exempt from the Career Service System, excluding secretarial,
3) The Commissioner of Education, members of the State Board clerical, and similar positions.
of Education, the Board of Governors, the local Boards of Trustees and 11) The following positions in each state department, commission,
Presidents of state universities,and the Florida Prepaid College Board. board, or council: Secretary, Assistant or Deputy Secretary, Executive
4) Persons elected to office in any political subdivision (such as Director, Assistant or Deputy Executive Director, and anyone having the
municipalities, counties, and special districts)and any person appointed to power normally conferred upon such persons, regardless of title.
fill a vacancy in such office, unless required to file Form 6. 12) The following positions in each state department or division:
5) Appointed members of the following boards,councils,commissions, Director,Assistant or Deputy Director, Bureau Chief,Assistant Bureau Chief,
authorities, or other bodies of county, municipality, school district, and any person having the power normally conferred upon such persons,
independent special district, or other political subdivision: the governing regardless of title.
body of the subdivision;community college orjunior college district boards of 13) Assistant State Attorneys, Assistant Public Defenders, criminal
trustees; boards having the power to enforce local code provisions; boards conflict and civil regional counsel, and assistant criminal conflict and civil
of adjustment; community redevelopment agencies; planning or zoning regional counsel, Public Counsel, full-time state employees serving as
boards having the power to recommend, create, or modify land planning or counsel or assistant counsel to a state agency, administrative law judges,
zoning within a political subdivision, except for citizen advisory committees, and hearing officers.
technical coordinating committees, and similar groups who only have the 14) The Superintendent or Director of a state mental health institute
power to make recommendations to planning or zoning boards, and except established for training and research in the mental health field,or any major
for representatives of a military installation acting on behalf of all military state institution or facility established for corrections,training, treatment, or
installations within that jurisdiction; pension or retirement boards empowered rehabilitation.
to invest pension or retirement funds or determine entitlement to or amount of 15) State agency Business Managers, Finance and Accounting
pensions or other retirement benefits, and the Pinellas County Construction Directors, Personnel Officers, Grant Coordinators, and purchasing agents
Licensing Board. (regardless of title)with power to make a purchase exceeding$20,000.
6) Any appointed member of a local government board who is 16) The following positions in legislative branch agencies: each
required to file a statement of financial interests by the appointing authority employee (other than those employed in maintenance, clerical, secretarial,
or the enabling legislation, ordinance, or resolution creating the board. or similar positions and legislative assistants exempted by the presiding
7) Persons holding any of these positions in local government: mayor; officer of their house); and each employee of the Commission on Ethics.
county or city manager; chief administrative employee or finance director
INSTRUCTIONS FOR COMPLETING FORM IF:
INTRODUCTORY INFORMATION (Top of Form): a period covering the entire 2019 calendar year, nor should
this form be used to report your financial interests for a
NAME OF AGENCY: The name of the governmental unit which period beyond 2019.
you served or by which you were employed. PUBLIC RECORD: The disclosure form and everything
OFFICE OR POSITION HELD OR SOUGHT: The title of the attached to it is a public record. Your Social Security
office or position you held during the disclosure period. Number is not required and you should redact it from any
DISCLOSURE PERIOD: This statement reflects your documents you file. If you are an active or former officer
financial interests for the period between January 1 and the or employee listed in Section 119.071, F.S., whose home
last day of your public office or employment in 2019. Please address is exempt from disclosure, the Commission will
write the last day of your office or employment in this part of maintain that confidentiality if you submit a written request.
the form. This date should be prior to December 31, 2019.
The Form 1 F cannot be used to report financial interests for
CE Form 1F Effective:January 1,2019 PAGE 3
Incorporated by reference in Rule 34-8.208(2),F.A.C.
MANNER OF CALCULATING REPORTABLE INTEREST
As noted on the form,filers have the option of reporting based on either thresholds that are comparative (usually, based on percentage
values)or thresholds that are based on absolute dollar values. The instructions on the following pages specifically describe the different
thresholds. Check the box that reflects the choice you have made.You must use the type of threshold you have chosen for each part
of the form. In other words, if you choose to report based on absolute dollar value thresholds, you cannot use a percentage threshold
on any part of the form.
PART A— PRIMARY SOURCES OF INCOME partnership, LLC, limited partnership, proprietorship, joint venture,
[Required by s. 112.3145(3)(b)1, F.S.] trust,firm, etc., doing business in Florida); and,
(2) You received more than $5,000 of your gross income during the
Part A is intended to require the disclosure of your principal sources disclosure period from that business entity.
of income during the disclosure period. You do not have to disclose the
amount of income received, and you need not list your public salary from If your interests and gross income exceeded these thresholds,then for that
serving in the position(s)which requires you to file this form. The income business entity you must list every source of income to the business entity
of your spouse need not be disclosed; however, if there is joint income to which exceeded 10% of the business entity's gross income (computed on
you and your spouse from property you own jointly (such as interest or the basis of the business entity's most recently completed fiscal year), the
dividends from a bank account or stocks), you should disclose the source source's address, and the source's principal business activity.
of that income if it exceeded the threshold. Examples:
Please list in this part of the form the name, address, and principal — You are the sole proprietor of a dry cleaning business,from which
business activity of each source of your income which exceeded$2,500 of you received more than$5,000. If only one customer, a uniform rental
gross income received by you in your own name or by any other person company, provided more than 10%of your dry cleaning business,you
for your use or benefit. must list the name of the uniform rental company, its address, and its
"Gross income" means the same as it does for income tax purposes, principal business activity(uniform rentals).
even if the income is not actually taxable,such as interest on tax-free bonds. — You are a 20% partner in a partnership that owns a shopping
Examples include: compensation for services, income from business, mall and your partnership income exceeded the above thresholds.
gains from property dealings, interest, rents, dividends, pensions, IRA List each tenant of the mall that provided more than 10% of the
distributions,social security,distributive share of partnership gross income, partnership's gross income and the tenant's address and principal
and alimony, but not child support. business activity.
Examples: PART C— REAL PROPERTY
— If you were employed by a company that manufactures computers
and received more than $2,500, list the name of the company, its [Required by s. 112.3145(3)(b)3, F.S.]
address, and its principal business activity(computer manufacturing). In this part, list the location or description of all real property in Florida
— If you were a partner in a law firm and your distributive share of in which you owned directly or indirectly at any time during the disclosure
partnership gross income exceeded$2,500, list the name of the firm, period in excess of 5%of the property's value.You are not required to list
its address, and its principal business activity(practice of law). your residences.You should list any vacation homes if you derive income
from them.
— If you were the sole proprietor of a retail gift business and your
gross income from the business exceeded $2,500, list the name of Indirect ownership includes situations where you are a beneficiary of
a trust that owns the property, as well as situations where you own more
the business, its address, and its principal business activity(retail gift than 5% of a partnership or corporation that owns the property. The value
sales). of the property may be determined by the most recently assessed value for
— If you received income from investments in stocks and bonds, list tax purposes, in the absence of a more current appraisal.
each individual company from which you derived more than $2,500. The location or description of the property should be sufficient to
Do not aggregate all of your investment income. enable anyone who looks at the form to identify the property. A street
— If more than $2,500 of your gross income was gain from the sale address should be used, if one exists.
of property (not just the selling price), list as a source of income the
purchaser's name, address, and principal business activity. If the PART D—INTANGIBLE PERSONAL PROPERTY
purchaser's identity is unknown, such as where securities listed on [Required by s. 112.3145(3)(b)3, F.S.]
an exchange are sold through a brokerage firm,the source of income Describe any intangible personal property that, at any time during the
should be listed as"sale of(name of company)stock,"for example. disclosure period, was worth more than $10,000 and state the business
— If more than $2,500 of your gross income was in the form of entity to which the property related. Intangible personal property includes
interest from one particular financial institution (aggregating interest things such as cash on hand,stocks, bonds,certificates of deposit,vehicle
from all CD's, accounts, etc., at that institution), list the name of the leases, interests in businesses, beneficial interests in trusts, money owed
institution, its address, and its principal business activity. you, Deferred Retirement Option Program (DROP) accounts, the Florida
Prepaid College Plan, and bank accounts. Intangible personal property
PART B—SECONDARY SOURCES OF INCOME also includes investment products held in IRAs, brokerage accounts, and
[Required by s. 112.3145(3)(b)2, F.S.] the Florida College Investment Plan. Note that the product contained in
a brokerage account, IRA, or the Florida College Investment Plan is your
This part is intended to require the disclosure of major customers, asset—not the account or plan itself. Things like automobiles and houses
clients, and other sources of income to businesses in which you own an you own, jewelry, and paintings are not intangible property. Intangibles
interest. It is not for reporting income from second jobs.That kind of income relating to the same business entity may be aggregated;for example, CDs
should be reported in Part A"Primary Sources of Income," if it meets the and savings accounts with the same bank. Property owned as tenants by
reporting threshold.You will not have anything to report unless, during the the entirety or as joint tenants with right of survivorship should be valued at
disclosure period: 100%. The value of a leased vehicle is the vehicle's present value minus
the lease residual (a number found on the lease document).
(1) You owned(either directly or indirectly in the form of an equitable
or beneficial interest) during the disclosure period more than 5% of
the total assets or capital stock of a business entity(a corporation,
CE Form 1F Effective:January 1,2019 PAGE 4
Incorporated by reference in Rule 34-8.208(2),F.A.C.
PART E—LIABILITIES
[Required by s. 112.3145(3)(b)4, F.S.] Disclose in this part of the form the fact that you owned during the
List the name and address of each creditor to whom you owed disclosure period an interest in, or held any of certain positions with,the
more than $10,000 at any time during the disclosure period. The types of businesses listed above. You must to make this disclosure if
amount of the liability of a vehicle lease is the sum of any past-due you own or owned(either directly or indirectly in the form of an equitable
payments and all unpaid prospective lease payments. You are not or beneficial interest)at any time during the disclosure period more than
required to list the amount of any debt. You do not have to disclose 5% of the total assets or capital stock of one of the types of business
credit card and retail installment accounts,taxes owed(unless reduced entities listed above. You also must complete this part of the form for
to a judgment), indebtedness on a life insurance policy owed to the each of these types of businesses for which you are, or were at any
company of issuance, or contingent liabilities.A"contingent liability" is time during the disclosure period, an officer, director, partner, proprietor,
one that will become an actual liability only when one or more future or agent(other than a resident agent solely for service of process).
events occur or fail to occur, such as where you are liable only as If you have or held such a position or ownership interest in one of
a guarantor, surety, or endorser on a promissory note. If you area
nnota contingent these types of businesses, list the name of the business, its address
makeri and are jointly liable or jointly and severally liable, then it is and principal business activity, and the position held with the business
not ngent liability. (if any). If you own(ed)more than a 5%interest in the business, indicate
PART F—INTERESTS IN SPECIFIED BUSINESSES that fact and describe the nature of your interest.
[Required by s. 112.3145(6), F.S.]
The types of businesses covered in this disclosure include: state (End of Dollar Value Thresholds Instructions.)
and federally chartered banks; state and federal savings and loan
associations; cemetery companies; insurance companies, mortgage
companies, credit unions; small loan companies; alcoholic beverage
licensees; pari-mutuel wagering companies, utility companies, entities
controlled by the Public Service Commission; and entities granted a
franchise to operate by either a city or a county government.
® r r
PART A— PRIMARY SOURCES OF INCOME — If more than 5% of your gross income was gain from the sale
[Required by s. 112.3145(3)(a)1, F.S.] of property (not just the selling price), list as a source of income
the purchaser's name, address, and principal business activity. If
Part is intended to require the disclosure of your principal sources the purchaser's identity is unknown, such as where securities listed
of income during the disclosure period. You do not have to disclose the on an exchange are sold through a brokerage firm, the source of
amount of income received, and you need not list your public salary income should be listed as "sale of (name of company) stock," for
received from serving in the position(s) which requires you to file this example.
form, but this amount should be included when calculating your gross — If more than 5%of your gross income was in the form of interest
income for the disclosure period. The income of your spouse need not from one particular financial institution (aggregating interest from
be disclosed; however, if there is joint income to you and your spouse all CD's, accounts, etc., at that institution), list the name of the
from property you own jointly(such as interest or dividends from a bank institution, its address, and its principal business activity.
account or stocks),you should include all of that income when calculating
your gross income and disclose the source of that income if it exceeded PART B—SECONDARY SOURCES OF INCOME
the threshold.
Please list in this part of the form the name, address, and principal
[Required by s. 112.3145(3)(a)2, F.S.]
business activity of each source of your income which exceeded 5% of This part is intended to require the disclosure of major customers,
the gross income received by you in your own name or by any other clients, and other sources of income to businesses in which you own
person for your benefit or use during the disclosure period. an interest. It is not for reporting income from second jobs. That kind of
"Gross income" means the same as it does for income tax income should be reported in Part A, "Primary Sources of Income," if it
meets the reporting threshold.You will not have anything to report unless
purposes, even if the income is not actually taxable, such as interest
on tax-free bonds. Examples include: compensation for services, during the disclosure period:
income from business, gains from property dealings, interest, rents, (1) You owned(either directly or indirectly in the form of an equitable
dividends, pensions, IRA distributions, social security, distributive share or beneficial interest) more than 5% of the total assets or capital
of partnership gross income, and alimony, but not child support. stock of a business entity (a corporation, partnership, LLC, limited
partnership, proprietorship, joint venture, trust, firm, etc., doing
Examples: business in Florida); and,
— If you were employed by a company that manufactures computers (2) You received more than 10% of your gross income from that
and received more than 5%of your gross income from the company, business entity; and,
list the name of the company, its address, and its principal business (3) You received more than $1,500 in gross income from that
activity(computer manufacturing).
business entity.
— If you were a partner in a law firm and your distributive share of If your interests and gross income exceeded these thresholds, then for
partnership gross income exceeded 5% of your gross income, list that business entity you must list every source of income to the business
the name of the firm, its address, and its principal business activity entity which exceeded 10% of the business entity's gross income
(practice of law). (computed on the basis of the business entity's most recently completed
— If you were the sole proprietor of a retail gift business and your fiscal year), the source's address, and the source's principal business
gross income from the business exceeded 5% of your total gross activity.
income, list the name of the business, its address, and its principal
business activity(retail gift sales).
— If you received income from investments in stocks and bonds,
you list each individual company from which you derived more than
5% of your gross income. Do not aggregate all of your investment
income.
CE Form 1F Effective:January 1,2019 PAGE 5
Incorporated by reference in Rule 34-8.208(2),F.A.C.
Examples: PART E— LIABILITIES
— You are the sole proprietor of a dry cleaning business, from [Required by s. 112.3145(3)(b)4, F.S.]
which you received more than 10% of your gross income—an List the name and address of each creditor to whom you owed
amount that was more than $1,500. If only once customer, a any amount that, at any time during the disclosure period, exceeded
uniform rental company, provided more than 10% of your dry your net worth. You are not required to list the amount of any debt
cleaning business, you must list the name of the uniform rental or your net worth. You do not have to disclose: credit card and retail
company, its address, and its principal business activity (uniform installment accounts, taxes owed (unless reduced to a judgment),
rentals). indebtedness on a life insurance policy owed to the company of
— You are a 20% partner in a partnership that owns a shopping issuance, or contingent liabilities. A "contingent liability" is one
mall and your partnership income exceeded the thresholds listed that will become an actual liability only when one or more future
above. You should list each tenant of the mall that provided more events occur or fail to occur, such as where you are liable only as
than 10% of the partnership's gross income, and the tenant's a guarantor, surety, or endorser on a promissory note. If you are a
address and principal business activity. "co-maker" and are jointly liable or jointly and severally liable, it is not
a contingent liability.
PART C — REAL PROPERTY Calculations: To determine whether the debt exceeds your
[Required by s. 112.3145(3)(a)3, F.S.] net worth, total all of your liabilities (including promissory notes,
In this part, list the location or description of all real property in mortgages, credit card debts, judgments against you, etc.). The
Florida in which you owned directly or indirectly at any time during amount of the liability of a vehicle lease is the sum of any past-due
the disclosure period in excess of 5% of the property's value. You payments and all unpaid prospective lease payments. Subtract
are not required to list your residences. You should list any vacation the sum total of your liabilities from the value of all your assets
homes, if you derive income from them. as calculated above for Part D. This is your "net worth." List each
creditor to whom your debt exceeded this amount unless it is one of
Indirect ownership includes situations where you are a the types of indebtedness listed in the paragraph above (credit card
beneficiary of a trust that owns the property, as well as situations and retail installment accounts, etc.). Joint liabilities with others for
where you own more than 5% of a partnership or corporation that which you are "jointly and severally liable," meaning that you may
owns the property. The value of the property may be determined by be liable for either your part or the whole of the obligation, should be
the most recently assessed value for tax purposes, in the absence included in your calculations at 100%of the amount owed.
of a more current appraisal.
Example: You owe $15,000 to a bank for student loans, $5,000
The location or description of the property should be sufficient for credit card debts, and $60,000 (with spouse) to a savings
to enable anyone who looks at the form to identify the property. A and loan for a home mortgage. Your home (owned by you and
street address should be used, if one exists. your spouse) is worth $80,000 and your other property is worth
PART D—INTANGIBLE PERSONAL PROPERTY $20,000. Since your net worth is $20,000 ($100,000 minus
[Required by s. 112.3145(3)(a)3, F.S.] $80,000), you must report only the name and address of the
savings and loan.
Describe any intangible personal property that, at any time
during the disclosure period, was worth more than 10% of your total PART F—INTERESTS IN SPECIFIED BUSINESSES
assets, and state the business entity to which the property related. [Required by s. 112.3145, F.S.]
Intangible personal property includes things such as cash on hand,
stocks, bonds, certificates of deposit, vehicle leases, interests in The types of businesses covered in this disclosure include: state
businesses, beneficial interests in trusts, money owed you, Deferred and federally chartered banks; state and federal savings and loan
Retirement Option Program (DROP) accounts, the Florida Prepaid associations; cemetery companies; insurance companies; mortgage
College Plan, and bank accounts. Intangible personal property also companies; credit unions; small loan companies; alcoholic beverage
includes investment products held in IRAs, brokerage accounts, and licensees; pari-mutuel wagering companies, utility companies,entities
the Florida College Investment Plan. Note that the product contained controlled by the Public Service Commission; and entities granted a
in a brokerage account, IRA, or the Florida College Investment Plan franchise to operate by either a city or a county government.
is your asset—not the account or plan itself. Things like automobiles Disclose in this part the fact that you owned during the
and houses you own, jewelry, and paintings are not intangible disclosure period an interest in, or held any of certain positions with,
property. Intangibles relating to the same business entity may be the types of businesses listed above. You must make this disclosure
aggregated; for example, CD's and savings accounts with the same if you own or owned (either directly or indirectly in the form of an
bank. equitable or beneficial interest) at any time during the disclosure
Calculations: To determine whether the intangible property period more than 5% of the total assets or capital stock of one of
exceeds 10% of your total assets, total the fair market value of all of the types of business entities listed above. You also must complete
your assets (including real property, intangible property, and tangible this part of the form for each of these types of businesses for which
personal property such as jewelry, furniture, etc.). When making this you are, or were at anytime during the disclosure period, an officer,
calculation, do not subtract any liabilities(debts)that may relate to the director, partner, proprietor, or agent (other than a resident agent
property. Multiply the total figure by 10% to arrive at the disclosure solely for service of process).
threshold. List only the intangibles that exceed this threshold amount. If you have or held such a position or ownership interest in
The value of a leased vehicle is the vehicle's present value minus the one of these types of businesses, list the name of the business, its
lease residual(a number which can be found on the lease document). address and principal business activity, and the position held with
Property that is only jointly owned property should be valued the business (if any). If you own(ed) more than a 5% interest in the
according to the percentage of your joint ownership. Property owned business, indicate that fact and describe the nature of your interest.
as tenants by the entirety or as joint tenants with right of survivorship
should be valued at 100%. None of your calculations or the value of
the property have to be disclosed on the form. (End of Percentage Thresholds Instructions.)
Example: You own 50% of the stock of a small corporation that
is worth $100,000, the estimated fair market value of your home
and other property (bank accounts, automobile, furniture, etc.)
is$200,000.As your total assets are worth $250,000, you must
disclose intangibles worth over $25,000. Since the value of the
stock exceeds this threshold, you should list "stock" and the
name of the corporation. If your accounts with a particular bank
exceed $25,000, you should list "bank accounts" and bank's
name.
CE Form 1F Effective:January 1,2019 PAGE 6
Incorporated by reference in Rule 34-8.208(2),F.A.C.