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HomeMy WebLinkAboutFinancial Disclosure Statements - Annual - - 1/17/2023PUBLIC OFFICER AND CANDIDATE FINANCIAL DISCLOS~~1lt~l¥'~~kt1TY CLERK Name of Public Officer or Candidate: IIAN HUGH Address: (Please note: this address is public information and not subject to redaction) 8641 N. 48TH DRIVE GLENDALE, AZ 85302 P bl' Off' H Id S ht U IC ice e or oug : GLENDALE CITY COUNCILMEMBER I District/ Division Number (if applicable): I CACTUS ,, I Please check the appropriate box that reflects your service for this filing year: ----- ~ I am a public officer filing this Financial Disclosure Statement covering the 12 months of calendar year 2022. □ I have been appointed to fill a vacancy in a public office within the last 60 days and am filing this Financial Disclosure Statement c , e 12-month period ending with the last full month prior to the date I took office. □ I am a public officer who has served in the last full year of my final term, which expires less than thirty-one days into calendar year 2023. This is my final Financial Disclosure Statement covering the last 12 months plus the final days of my term for the current year. □ I am a candidate for a public office and am filing this Financial Disclosure Statement covering the 12 months preceding the date of this statement, from the month of ______ , to the month of ______ _ VERIFICATION .. ~ .. By signing, I verify under penalty of perjury that the · is Financial Disclosure Statement is true and correct. ISi 6_ 2=-?. 1 Secretary of State Revision November 15, 2022 A. PERSONAL FINANCIAL INTERESTS This section requires disclosure of your financial interests and/or the financial interests of the member{s) of your household.1 1· Identification of Household Members and Business Interests What to disclose: If you are married, is your spouse a member of your household? ii!ilYes □No ON/A (If not married/widowed, select N/A) Are any minor children 2 members of your household? □Yes (If yes, disclose how many_~) ii!ilNo ON/A (If no children, select N/A) For the remaining questions in this Financial Disclosure Statement, the term "member of your household" or "household member" will be defined as the person(s) who correspond to your "yes" answers above. You are not required to disclose the names of your spouse or minor children when answering the questions below. Thus, you may identify your household members as "spouse," "minor child 1 ", "minor child 2," etc. Please note that if you choose to identify your spouse or minor children by name, the Secretary of State's Office or other local filing officer are not expected to redact that information when posting this Financial Disclosure Statement on the internet or providing it in response to a public records request. 1 If additional space is needed to report information on this Financial Disclosure Statement, please attach additional information as numbered exhibits. 2 Minor children include children 18 years old and younger over whom you have joint or sole legal qustody. . 2 Secretary of State Revision November 15, 2022 2. Sources of Personal Compensation What to disclose: In subsection (2)(a), provide the name and address of any employer and/or any other source of compensation who provided you or any member of your household more than $1,000 (other than "Gifts") during the period covered by this report. 3 Describe the nature of each and the type of services for which you or a member of your household were compensated. Subsection (2)(a): PUBLIC OFFICER OR HOUSEHOLD NAME AND ADDRESS OF SOURCE WHO NATURE OF SOURCE OR NATURE OF SERVICES PROVIDED BY PUBLIC OFFICER MEMBER4 BENEFITED PROVIDED COMPENSATION> $1,000 EMPLOYER'S BUSINESS OR HOUSEHOLD MEMBER IAN HUGH CITY OF GLENDALE 30VERNMEN7 COUNCILMEMBER In subsection (2)(b), if applicable, list anything of value that any other person (outside your household) received for your, or a member of your household's, use or benefit. For example, if a person was paid by a third-party to be your personal housekeeper, identify that person, describe the nature of that person's services that benefited you, and provide information about the third-party who paid for the services on your behalf. You need not disclose income of a business, including money you· or any member of your household received that constitutes income paid to a business that you or your household member owns or does business as. This type of business income will be disclosed in Question 12. Subsection (2)(b) (if applicable): NAME AND ADDRESS OF PERSON WHO NATURE OF SERVICES PUBLIC OFFICER OR PROVIDED SERVICES VALUED OVER $1,000 PROVIDED BY PERSON FOR NAME AND ADDRESS OF THIRD PARTY WHO PAID HOUSEHOLD MEMBER5 FOR YOUR OR YOUR HOUSEHOLD MEMBER'S YOUR OR YOUR HOUSEHOLD FOR PERSON'S SERVICES ON YOUR OR YOUR BENEFITED HOUSEHOLD MEMBER'S BEHALF USE OR BENEFIT MEMBER'S USE OR BENEFIT 3 Compensation is defined as "anything of value or advantage, present or prospective, including the forgiveness of debt." A.R.S. § 38-541 (2). 4 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc. 5 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc. 3 Secretary of State Revision November 15, 2022 3. Professional, Occupational, and Business Licenses What to disclose: List all professional, occupational or business licenses held by you or any member of your household at any time during the period covered by this Financial Disclosure Statement. This includes licenses in which you or a member of your household had an "interest," which includes (but is not limited to) any business license held by a "controlled" or "dependent" business as defined in Question 12 below. PUBLIC OFFICER OR HOUSEHOLD TYPE OF LICENSE PERSON OR ENTITY HOLDING THE JURISDICTION OR ENTITY THAT ISSUED MEMBER6 LICENSE LICENSE IAN HUGH t_ ~-rA--i L ~~ IAN HUGH ~,A-~ OF~ Uw iF G,.LG~h.~ \ 6 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc. 4 Secretary of State Revision November 15, 2022 4. Personal Creditors What to disclose: The name and address of each creditor to whom you or a member of your household owed a qualifying personal debt over $1,000 during any point during the period covered by this Financial Disclosure Statement. Additionally, if the qualifying personal debt was either incurred for the first time or completely discharged (paid in full) during this period, list the date and check the applicable box to indicate whether it was incurred or discharged. Otherwise, check the box for "N/A" if the debt was not first incurred or fully discharged during the period covered by this Financial Disclosure Statement. You need not disclose the following, which do not qualify as "personal debt": • Debts resulting from the ordinary conduct of a business (these will be disclosed in Section B below); • Debts on any personal residence or recreational property; • Debts on motor vehicles used primarily for personal purposes (not commercial purposes); • Debts secured by cash values on life insurance; • Debts owed to relatives; • Personal credit card transactions or the value of any retail installment contracts you or your household member entered into. PUBLIC OFFICER OR HOUSEHOLD MEMBER7 NAME AND ADDRESS OF CREDITOR (OR PERSON TO IF THE DEBT WAS FIRST INCURRED OR COMPLETELY DISCHARGED DURING THIS REPORTING PERIOD, PROVIDE THE OWING THE DEBT WHOM PAYMENTS ARE MADE) DATE (MM/DD/YYYY) AND CHECK THE APPROPRIATE Box Date: □Incurred □ Discharged ON/A Date: □Incurred □ Discharged ON/A Date: □Incurred □ Discharged ON/A 7 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc. 5 Secretary of State Revision November 15, 2022 5. Personal Debtors What to disclose: The name of each debtor who owed you or a member of your household a debt over $1,000 at any time during the period covered by this Financial Disclosure Statement, along with the approximate value of the debt by financial category. Additionally, if the debt was either incurred for the first time or completely discharged (paid in full) during this period, list the date and check the box to indicate whether it was incurred or discharged. Otherwise, check "N/A" (for "not applicable") after the word "Date" if the debt was not first incurred or fully discharged during the period covered by this Financial Disclosure Statement. PUBLIC OFFICER OR HOUSEHOLD APPROXIMATE VALUE OF IF THE DEBT WAS FIRST INCURRED OR COMPLETELY MEMBER 8 OWED THE DEBT NAME OF DEBTOR DEBT DISCHARGED DURING THIS REPORTING PERIOD, PROVIDE THE DATE (MM/DD/YYYY) AND CHECK THE APPROPRIATE Box □$1000 -$25,000 Date: □$25,001 -$100,000 □Incurred □Discharged ON/A □$100,001 + □$1000 -$25,000 Date: □$25,001 -$100,000 □Incurred □Discharged □NIA □$100,001 + □$1000 -$25,000 Date: D$25,001 -$100,000 □Incurred □ Discharged □ N/A □$100,001 + 8 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc. 6 Secretary of State Revision November 15, 2022 6. Gifts What to disclose: The name of the donor who gave you or a member of your household a single gift or an accumulation of gifts during the preceding calendar year with a cumulative value over $500, subject to the exceptions listed in the below "You need not disclose" paragraph. A "gift" means a gratuity (tip), special discount, favor, hospitality, service, economic opportunity, loan or other benefit received without adequate consideration (reciprocal value) and not provided to members of the public at large (in other words, a personal benefit you or your household member received without providing an equivalent benefit in return). Please note: the concept of a "gift" for purposes of this Financial Disclosure Statement is separate and distinct from the gift restrictions outlined in Arizona's lobbying statutes. Thus, disclosure in a lobbying report does not relieve you or a member of your household's duty to disclose gifts in this Financial Disclosure Statement. You need not disclose the following, which do not qualify as "gifts": • Gifts received by will; • Gift received by intestate succession (in other words, gifts distributed to you or a household member according to Arizona's intestate succession laws, not by will); • Gift distributed from an inter vivas (living) or testamentary (by will) trust established by a spouse or family member; • Gifts received from any other member of the household; • Gifts received by parents, grandparents, siblings, children and grandchildren; or • Political campaign contributions reported on campaign finance reports. PUBLIC OFFICER OR HOUSEHOLD MEMBER9 WHO RECEIVED GIFTS OVER $500 NAME OF GIFT DONOR 9 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc. 7 Secretary of State Revision November 15, 2022 7. Office, Position or Fiduciary Relationship in Businesses, Nonprofit Organizations or Trusts What to disclose: The name and address of each business, organization, trust or nonprofit organization or association in which you or any member of your household held any office, position, or fiduciary relationship during the period covered by this Financial Disclosure Statement, including a description of the office, position or relationship. PUBLIC OFFICER OR HOUSEHOLD MEMBER 10 HAVING NAME AND ADDRESS OF BUSINESS, ORGANIZATION, DESCRIPTION OF OFFICE, POSITION OR FIDUCIARY RELATIONSHIP HELD BY THE PUBLIC THE REPORTABLE RELATIONSHIP TRUST, OR NONPROFIT ORGANIZATION OR ASSOCIATION OFFICER OR HOUSEHOLD MEMBER 10 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc. 8 Secretary of State Revision November 15, 2022 8. Ownership or Financial Interests in Businesses, Trusts or Investment Funds What to disclose: The name and address of each business, trust, or investment fund in which you or any member of your household had an ownership or beneficial interest of over $1,000 during the period covered by this Financial Disclosure Statement. This includes stocks, annuities, mutual funds, or retirement funds. It also includes any financial interest in a limited liability company, partnership, joint venture, or sole proprietorship. Also, check the box to indicate the value of the interest. PUBLIC OFFICER OR HOUSEHOLD MEMBER 11 NAME AND ADDRESS OF BUSINESS, TRUST DESCRIPTION OF THE BUSINESS, TRUST OR APPROXIMATE EQUITY HAVING INTEREST OR INVESTMENT FUND INVESTMENT FUND VALUE OF THE INTEREST !AN/SHARON HUGH IAN HUGH TIRE AND AUTO AUTO REPAIR □$1000 -$25,000 5104 W. GLENN DRIVE D$25,001 -$100,000 GLENDALE, AZ 85301 ~$100,001 + □$1000 -$25,000 D$25,001 -$100,000 □$100,001 + □$1000 -$25,000 D$25,001 -$100,000 □$100,001 + 11 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor chi_ld 2," etc. 9 Secretary of State Revision November 15, 2022 9. Ownership of Bonds What to disclose: Bonds issued by a state or local government agency worth more than $1,000 that you or a member of your household held during the period covered by this Financial Disclosure Statement. Also, check the box to indicate the approximate value of the bonds. Additionally, if the bonds were either acquired for the first time or completely divested (sold in full) during this period, list the date and check the box whether the bonds were acquired or divested. Otherwise, check "N/A" (for "not applicable") after the word "Date" if the bonds were not first acquired or fully divested during the period covered by this Financial Disclosure Statement. PUBLIC OFFICER OR IF THE BONDS WERE FIRST ACQUIRED OR COMPLETELY HOUSEHOLD MEMBER 12 ISSUED ISSUING STATE OR LOCAL APPROXIMATE VALUE OF DISCHARGED DURING THIS REPORTING PERIOD, PROVIDETHE BONDS GOVERNMENT AGENCY BONDS DATE (MM/DD/YYYY) AND CHECK THE APPROPRIATE Box □$1000 -$25,000 Date: D$25,001 -$100,000 □Acquired □Divested ON/A □$100,001 + □$1000 -$25,000 Date: D$25,001 -$100,000 □Acquired □Divested ON/A □$100,001 + □$1000 -$25,000 Date: D$25,001 -$100,000 □Acquired □Divested ON/A □$100,001 + 12 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2,''. etc. 10 Secretary of State Revision November 15, 2022 10. Real Property Ownership What to disclose: Arizona real property (land and improvements), which was owned by you or a member of your household during the period covered by this Financial Disclosure Statement, other than your primary residence or property you use for personal recreation. Also describe the property's location (city and state) and approximate size (acreage or square footage) and check the box to indicate the approximate value of the land. Additionally, if the land was either acquired for the first time or completely divested (sold in full) during this period, list the date and check the box to indicate whether the land was acquired or divested. Otherwise, check "N/A" (for "not applicable") if the land was not first acquired or fully divested during the period covered by this Financial Disclosure Statement. You need not disclose: Your primary residence or property you use for personal recreation. PUBLIC OFFICER OR IF THE LAND WAS FIRST ACQUIRED OR COMPLETELY DISCHARGED HOUSEHOLD MEMBER 13 THAT LOCATION AND APPROXIMATE APPROXIMATE VALUE DURING THIS REPORTING PERIOD, PROVIDE THE DATE OWNS LAND SIZE OF LAND (MM/DD/YYYY) AND CHECK THE APPROPRIATE Box IAN/SHARON 5104 W. GLENN DRIVE □$1000 -$25,000 Date: 4/1/2022 HUGH GLENDALE, AZ D$25,001 -$100,000 □Acquired l!ilDivested ON/A ~$100,001 + IAN HUGH 5718 W. MORTEN AVE □$1000 -$25,000 Date: GLENDALE, AZ D$25,001 -$100,000 □Acquired □Divested ~N/A ~$100,001 + □$1000 -$25,000 Date: D$25,001 -$100,000 □Acquired □Divested ON/A □$100,001 + 13 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc .. 11 Secretary of State Revision November 15, 2022 10. Real Property Ownership What to disclose: Arizona real property (land and improvements), which was owned by you or a member of your household during the period covered by this Financial Disclosure Statement, other than your primary residence or property you use for personal recreation. Also describe the property's location (city and state) and approximate size (acreage or square footage) and check the box to indicate the approximate value of the land. Additionally, if the land was either acquired for the first time or completely divested (sold in full) during this period, list the date and check the box to indicate whether the land was acquired or divested. Otherwise, check "N/A" (for "not applicable") if the land was not first acquired or fully divested during the period covered by this Financial Disclosure Statement. You need not disclose: Your primary residence or property you use for personal recreation. PUBLIC OFFICER OR IF THE LAND WAS FIRST ACQUIRED OR COMPLETELY DISCHARGED HOUSEHOLD MEMBER 13 THAT LOCATION AND APPROXIMATE APPROXIMATE VALUE DURING THIS REPORTING PERIOD, PROVIDE THE DATE OWNS LAND SIZE OF LAND (MM/DD/YYYY) AND CHECK THE APPROPRIATE Box IAN/SHARON 41047 W. BRIDLEWOOD CT □$1000 -$25,000 Date: 4/25/22 HUGH ANTHEM, AZ 1/3 ACRE D$25,001 -$100,000 ~Acquired □Divested DN/A ~$100,001 + IAN/SHARON 10003 W. LANCASTER DR □$1000 -$25,000 Date: 5/18/2022 HUGH . SUN CITY, AZ □$25,001 -$100,000 ~Acquired □Divested DN/A ~$100,001 + IAN/SHARON 2150 W. ALAMEDA #1391 □$1000 -$25,000 Date: 5/31/2022 HUGH PHOENIX, AZ D$25,001 -$100,000 ~Acquired □Divested DN/A ~$100,001 + 13 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc. 11 Secretary of State Revision November 15, 2022 11.TravelExpenses What to disclose: Each meeting, conference or other event during the period covered in this Financial Disclosure Statement where you participated in your official capacity and travel-related expenses of $1,000 or more were paid on your behalf (or for which you were reimbursed) for that meeting, conference, or other event. "Travel-related expenses" include, but are not limited to, the value of transportation, meals, and lodging to attend the meeting, conference, or other event. You need not disclose: Any meeting, conference, or other event where paid or reimbursed travel-related expenses were less than $1,000 or your personal monies were expended related to the travel. NAME OF MEETING, CONFERENCE, OR EVENT ATTENDED LOCATION AMOUNT OR VALUE OF IN OFFICIAL CAPACITY AS PUBLIC OFFICER TRAVEL COSTS □$1000 -$25,000 D$25,001 -$100,000 □$100,001 + □$1000 -$25,000 D$25,001 -$100,000 □$100,001 + □$1000 -$25,000 D$25,001 -$100,000 □$100,001 + 12 Secretary of State Revision November 15, 2022 A. BUSINESS FINANCIAL INTERESTS This section requires disclosure of any financial interests of a business owned by you or a member of your household. 12. Business Names What to disclose: The name of any business under which you or any member of your household owns or did business under (in other words, if you or your household member were self-employed) during the period covered by this Financial Disclosure Statement, which include any corporations, limited liability companies, partnerships, sole proprietorships or any other type of business conducted under a trade name. Also disclose if the named business is controlled or dependent. A business is "controlled" if you or any member of your household (individually or combined) had an ownership interest that amounts to more than 50%. A business is classified as "dependent," on the other hand, if: (1) you or any household member (individually or combined) had an ownership interest that amounts more than 10%; and (2) the business received more than $10,000 from a single source during the period covered by this Financial Disclosure Statement, which amounted to more than 50% of the business' gross income for the period. Please note: If the business was either controlled or dependent, check the box to indicate whether it was controlled or dependent in the last column below. If the business was both controlled and dependent during the period covered by this Financial Disclosure Statement, check both boxes. Otherwise, leave the boxes in the last column below blank. Please note: If a business listed in the foregoing Question 12 was neither "controlled" nor "dependent" during the period covered by this Financial Disclosure Statement, you need not complete the remainder of this Financial Disclosure Statement with respect to that business. If none of the businesses listed in Question 12 were "controlled" or "dependent," you need not complete the remainder of this Financial Disclosure Statement. PUBLIC OFFICER OR HOUSEHOLD MEMBER14 OWNING THE BUSINESS !AN/SHARON HUGH NAME AND ADDRESS OF BUSINESS CHECK THE APPROPRIATE Box IF THE BUSINESS IS "CONTROLLED" BY OR "DEPENDENT" ON You OR A HOUSEHOLD MEMBER ~ Controlled □ Dependent □ Controlled □ Dependent □ Controlled □ Dependent 14 You are not required to disclose the names of your spouse or minor children. Thus, you may identify your household members as "spouse," "minor child 1," "minor child 2," etc. 13 Secretary of State Revision November 15, 2022 13. Controlled Business Information What to disclose: The name of each controlled business listed in Question 12 above, and the goods or services provided by the business. If a single client or customer (whether a person or business) accounts for more than $10,000 and 25% of the business' gross income during the period covered by this Financial Disclosure Statement, the client or customer is deemed a "major client" and therefore you must describe what your business provided to this major client in the third column below. Also, if the major client is a business, please describe the client's type of business activities in the final column below (but if the major client is an individual, write "N/A" for "not applicable" in the final column below). If the business does not have a major client, write "N/A" for "not applicable" in the last two columns below. You need not disclose: The name of any major client, or the activities of any major client that is an individual. If you or your household member does not own a business, or if your or your household member's business is not a controlled business, you may leave this question blank. NAME OF YOUR OR YOUR HOUSEHOLD GOODS OR SERVICES PROVIDED DESCRIBE WHAT YOUR BUSINESS TYPE OF BUSINESS ACTIVITIES OF THE MEMBER'S CONTROLLED BUSINESS BY THE CONTROLLED BUSINESS PROVIDES TO ITS MAJOR CLIENT MAJOR CLIENT (IF A BUSINESS) .I~ ~\U ~!) .. --r'i,JE" AUTO REPAIR AUTO REPAIR AUTO REPAIR -..!--tf\' ,sci) 14 Secretary of State Revision November 15, 2022 14. Dependent Business Information What to disclose: The name of each dependent business listed in Question 12 above, and the goods or services provided by the business. You must describe what your business provided to its major "source of compensation"* in the third column below. Also, if the "source of compensation" is a business, please describe the type of business activities it performs in the final column below (but if the "source of compensation" is an individual, write "N/A" for "not applicable" in the final column below). · If the dependent business is also a controlled business, disclose the business only in Question 13 above and leave this question blank. You need not disclose: The name of any "source of compensation," or the activities of any "source of compensation" that is an individual. If you or your household member does not own a business, or if your or your household member's business is not a dependent business, you may leave this question blank. * For this section, "source of compensation" is defined as a person or a business that accounts for more than $10,000 and 50% of the dependent business' gross income during the reporting period. NAME OF YOUR OR YOUR GOODS OR SERVICES PROVIDED DESCRIBE WHAT YOUR BUSINESS TYPE OF BUSINESS ACTIVITIES OF HOUSEHOLD MEMBER'S DEPENDENT BY THE DEPENDENT BUSINESS PROVIDES TO SOURCE OF THE SOURCE OF COMPENSATION (IF A BUSINESS COMPENSATION BUSINESS) 15 Secretary of State Revision November 15, 2022 15. Real Property Owned by a Controlled or Dependent Business What to disclose: Arizona real property (land and improvements), which was owned by a controlled or dependent business during the period covered by this Financial Disclosure Statement. Also describe the property's location (city and state) and approximate size (acreage or square footage) and check the box to indicate the approximate value of the land. If the business is one that deals in real property and improvements, check the box that corresponds to the aggregate value of all parcels held by the business during the period covered by this Financial Disclosure Statement. Additionally, if the land was either acquired for the first time or completely divested (sold in full) during this period, list the date and check whether the land was acquired or divested. Otherwise, check "N/A" (for "not applicable") if the land was not first acquired or fully divested during the period covered by this Financial Disclosure Statement. You need not disclose: If you or your household member does not own a business, or if your or your household member's business is not a dependent business, you may leave this question blank. NAME OF CONTROLLED OR LOCATION AND APPROXIMATE APPROXIMATE VALUE OF IF THE LAND WAS FIRST ACQUIRED OR COMPLETELY DEPENDENT BUSINESS THAT OWNS SIZE LAND DISCHARGED DURING THIS REPORTING PERIOD, PROVIDE THE LAND DATE (MM/DDNYYY) AND CHECK THE APPROPRIATE Box 0$1000 -$25,000 Date: 0$25,001 -$100,000 □Acquired □Divested ON/A 0$100,001 + □$1000 -$25,000 Date: 0$25,001 -$100,000 □Acquired □Divested ON/A □$100,001 + 0$1000 -$25,000 Date: 0$25,001 -$100,000 □Acquired □Divested ON/A 0$100,001 + 16 Secretary of State Revision November 15, 2022 16. Controlled or Dependent Business' Creditors What to disclose: The name and address of each creditor to which a controlled or dependent business owed more than $10,000, if that amount was also more than 30% of the business' total indebtedness at any time during the period covered by this Financial Disclosure Statement ("qualifying business debt"). Additionally, if the qualifying business debt was either incurred for the first time or completely discharged (paid in full) during this period, list the date and check the box to indicate whether it was incurred or discharged. Otherwise, check "NIA" (for "not applicable") after the word "Date" if the business debt was not first incurred or fully discharged during the period covered by this Financial Disclosure Statement. You need not disclose: If you or your household member does not own a business, or if your or your household member's business is not a controlled or dependent business, you may leave this question blank. NAME OF CONTROLLED OR DEPENDENT NAME AND ADDRESS OF CREDITOR (OR IF THE DEBT WAS FIRST INCURRED OR COMPLETELY DISCHARGED DURING THIS REPORTING PERIOD, PROVIDE THE DATE BUSINESS OWING THE QUALIFYING DEBT PERSON TO WHOM PAYMENTS ARE MADE) (MM/DD/YYYY) AND CHECK THE APPROPRIATE Box Date: □Incurred □ Discharged □NIA Date: □Incurred □ Discharged □NIA Date: □Incurred □ Discharged □NIA 17 Secretary of State Revision November 15, 2022 17.Controlled or Dependent Business' Debtors What to disclose: The name of each debtor who owed more than $10,000 to a controlled or dependent business, if that amount was also more than 30% of the total indebtedness owed to the controlled or dependent business at any time during the period covered by this Financial Disclosure Statement ("qualifying business debt"). Also check the box to indicate the approximate value of the debt by financial category. Additionally, if the qualifying business debt was either incurred for the first time or completely discharged (paid in full) during this period, list the date and check the box to indicate whether it was incurred or discharged. Otherwise, check "N/A" (for "not applicable") if the business debt was not first incurred or fully discharged during the period covered by this Financial Disclosure Statement. You need not disclose: If you or your household member does not own a business, or if your or your household member's business is not a controlled or dependent business, you may leave this question blank. NAME OF CONTROLLED OR APPROXIMATE VALUE IF THE DEBT WAS FIRST INCURRED OR COMPLETELY DEPENDENT BUSINESS OWED THE NAME OF DEBTOR OF DEBT DISCHARGED DURING THIS REPORTING PERIOD, PROVIDE THE DEBT DATE (MM/DD/YYYY) AND CHECK THE APPROPRIATE Box □$1000 -$25,000 Date: D$25,001 -$100,000 □Incurred □Discharged ON/A □$100,001 + □$1000 -$25,000 Date: D$25,001 -$100,000 □Incurred □Discharged ON/A □$100,001 + □$1000 -$25,000 Date: D$25,001 -$100,000 □Incurred □Discharged ON/A □$100,001 + 18 Secretary of State Revision November 15, 2022