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AG 2012 12 17
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AG 2012 12 17
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Last modified
12/20/2012 9:32:35 AM
Creation date
11/27/2017 11:13:00 AM
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Template:
Meeting Minutes
Doc Type
Agenda
Meeting Minutes - Date
12/17/2012
Board
Board of Commissioners
Meeting Type
Regular
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This entire document and any attachments are public record. <br />Page 3 of 9 <br />Attachment number 4 <br />F -2 Page 79 <br />5(a). Do you, your spouse, or members of your immediate family own interests (generally stock) valued at $10,000 or more in a publicly owned company? <br />❑ Yes ❑ No <br />No-Do not list ownership interests in a widely held investment fund (including mutual funds, regulated investment companies, or pension or deferred <br />compensation plans) if (i) the fund is publicly traded or its assets are widely diversified and (ii) neither you nor an immediate family member are able to <br />control the assets held in the mutual fund, investment company, or pension or deferred compensation plan. <br />Owner of Interest <br />Full Name of Company (Do not use a ticker symbol) <br />5(b). Do you, your spouse, or members of your immediate family hold stock options valued at $10,000 or more in a company or business? <br />❑ Yes ❑ No <br />Owner of Stock Option <br />Full Name of Company (Do not use a ticker symbol) <br />6(a). Do you, your spouse, or members of your immediate family have financial interests valued at $10,000 or more in a non - publicly owned company or <br />business entity (including interests in sole proprietorships, partnerships, limited partnerships, joint ventures, limited liability companies, limited liability <br />partnerships, and closely held corporations)? <br />❑ Yes ❑ No - If "No ", proceed to question 7. <br />Owner of Interest <br />Name of Business Entity <br />6(b). For each of those non - publicly owned companies or business entities identified in question 6(a) (the "primary company "), please list the names of any <br />other companies in which the primary company owns securities or equity interests valued at over $10,000, if known. <br />Non - Publicly Owned Company <br />(the Primary Company) <br />Other Companies in which the Primary Company <br />Owns Security or Equity Interests <br />❑ None or Not Known <br />This entire document and any attachments are public record. <br />Page 3 of 9 <br />Attachment number 4 <br />F -2 Page 79 <br />
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