List the name and address of each source of $1,300.00 or more of gross income regardless of whether such income is received solely by you or jointly by you and another individual, such as a spouse. “Income” includes any money or thing of value received or to be received as a claim on future services or in recognition of services rendered in the past, whether in the form of a payment, fee, salary, expense, allowance, forbearance, forgiveness, interest, dividend, royalty, rent, capital gain, reward, severance payment, proceeds from the sale of a financial interest in a corporation, professional corporation, partnership or other entity resulting from termination/withdrawal therefrom upon assumption of public office or employment or any other form of recompense or combination thereof. The term refers to gross income; it includes prize winnings and tax-exempt income but does not include gifts, governmentally mandated payments or benefits, retirement, pension or annuity payments funded totally by contributions of the public official or employee, or miscellaneous, incidental income of minor dependent children. Some examples follow: 1) if you receive monthly pension payments of $1,300.00 or more, where the employer has contributed in whole or in part to your pension, or if you own a 401K account that has generated dividends, distributions or capital gains totaling in the aggregate of $1,300.00 or more, you must list it here; 2) if you sell a property and you have capital gains from that property, and each source is $1,300.00 or more, you must list it here; and 3) If, for example, you are a doctor or lawyer and you receive income from multiple individual clients in an amount of greater than $1,300.00, you should list the name and address of your firm or office, not the individual clients.
An inheritance received from a family member is not considered “income” for purposes of financial disclosure under the Ethics Act unless the inheritance would be expressly designated as a payment for, or in recognition of, services.
An inheritance received from a family member would ordinarily be considered a gift that would not have to be disclosed on the Statement of Financial Interests as per Section 1105(b)(6) of the Ethics Act.
If you do not have ANY reportable source of income, then check the box next to “NONE”.