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Home My WebLink AboutFDR: Karen Thurman! Fort FD -Local r Rev. 3/06 STATE OF GEORGIA FINANCIAL DISCLOSURE SrfAetl',J MIon ❑ Original ❑ Amendment Date of this Statement: 7l�`L, L\ ).00(o Covering Calendar Year: ��G_ (Enter Date of Statement �— Being Amended) Name of Public Officer or Candidate: I� aren 0011 t r15 —Th , r m an First Middle r Last Mailing Address: 110 Am, a rnP t i A - A 1 n1'1Afe-R� CU .}.Gn CA 3=y Street or P.O. Box City County State Zip code Telephone Number: (Office) t4C)'-1.253 -1j S CS Q (Home) -1-1C) - \A4 a - U Ct I Q Name of City or County Office Held or Sought: M �o C\ C oun(a ) 1 b �(kfj Check One: ❑ Elected City or County Officer 216andidate for City or County Office WHO FILES A FINANCIAL DISCLOSURE STATEMENT: Each public officer holding office in Georgia, and each person who qualifies as a candidate for election as a public officer for one of the offices listed below, and all others on the following list. (A) Every constitutional officer; (B) Every elected state official; (C) The executive head of every state department or agency, whether elected or appointed; (D) Each member of the General Assembly; (E) The executive director of each state authority, board or commission and the members thereof, 4041, (F) Every elected county official, every elected county or area school superintendent, and every elected member of a county or area board of education; and (G) Every elected municipal officer. WHEN TO FILE A FINANCIAL DISCLOSURE STATEMENT: Public Officer: A Financial Disclosure Statement is filed not before January 1 and not later than July I of each year that a public officer holds office (except the year of election). The information to be provided shall be that from the preceding calendar year. If the public officer chooses not to run for re-election or for another public office no Financial Disclosure Statement need be filed in the year qualifying to succeed him takes place. A public officer shall not be deemed to hold the office in a year in which the public officer holds office for less than 15 days. Candidate for Public Office: A Financial Disclosure Statement covering the period of the preceding calendar year, shall be filed no later than the fifteenth day following the date of qualifying as a candidate. Candidates for state wide office file not later than seven days after qualifying for office. Only one Financial Disclosure Statement is required per calendar year. Special requirements for State Wide Candidates: Candidates for a public office elected state wide must file their Financial Disclosure Statements not later than seven days after qualifying or filing a notice of candidacy. State wide candidates must disclose more information than other candidates for public office and the additional disclosure sections required of state wide candidates must be completed in the year of election filing. WHERE TO FILE A FINANCIAL DISCLOSURE STATEMENT: Every public officer who is an elected county official and every candidate for election as a county public official will file a Financial Disclosure Statement with the election superintendent of the county of election. Every public officer who is an elected municipal officer and every candidate for election as a municipal public officer will file a Financial Disclosure Statement with the municipal clerk or, if there is no clerk, with the chief executive officer of the municipality of election. SECTION III DIRECT OWNERSHIP INTERESTS IN BUSINESS ENTITY Direct ownership interest is the holding or possession of good legal or rightful title of property or the holding or enjoyment of real or beneficial use of the property by any person and includes any interest owned or held by a spouse of the person if such interest is held jointly or as tenants in common between the person and spouse. Identify the name, address and principal activity of any business entity and the office held by and the duties of the candidate for public office or public officer within a business entity as of December 31 of the covered year in which a direct ownership interest: (A) Is more than 5 percent of the total interest in the business; or (B) Has a net fair market value of more than $10,000. (You may attach additional sheets of paper if necessary.) I held: ❑ No direct ownership interests in any business entity. ❑ Direct ownership interests in the following business entity(ies). IDENTIFY: 1. Name and address of business entity. 2. Principal activity of business entity. 3. The office held by the candidate or the public officer within the business entity. 4. The duties of the candidate or the public officer within such business entity. entity #I pev( M 'k Ownership Interests � t— Check One or Both If Applicable r{ -+nee ❑ Ownership interest is more than 5% p1 Ownership interest has a net fair mar- ket value of more than $10,000.00 Business entity #3 Business entity #4 Business entity #5 ❑ Ownership interest is more than 5% t L Ownership interest has a net fair mar- ket value of more than $10,000.00 ❑ Ownership interest is more than 5% ❑ Ownership interest has a net fair mar- ket value of more than $10,000.00 ❑ Ownership interest is more than 5% ❑ Ownership interest has a net fair mar- ket value of more than $10,000.00 ❑ Ownership interest is more than 5% ❑ Ownership interest has a net fair mar- ket value of more than $10,000.00 SECTION V SPOUSE'S DIRECT OWNERSHIP INTERESTS IN REAL PROPERTY Identify each tract of real property in which the filer's spouse has a direct ownership interest as of December 31 of the covered yearwhen that interest has a fair market value in excess of $10,000.00. (You may attach additional sheets of paper if necessary.) Check one box to show the applicable valuation range for each tract. (You may attach additional sheets of paper if necessary.) My spouse had: ❑ No ownership interests with a fair market value in excess of $10,000.00 Q.Ownership in the following tracts with a fair market value in excess of $10,000 IDENTIFY• 1. County where property is located. 2. State where property is located. 3. General description of property (give street address or location, size of tract, and nature or use of property). Property #2 Property #3 Property #4 Property #5 The Value of this tract is ❑ Between $10,000 and $100,000 ❑ Between $100,000.01 and $200,000 VL More than $200,000 The Value of this tract is ❑ Between $10,000 and $100,000 ❑ Between $100,000.01 and $200,000 ❑ More than $200,000 The Value of this tract is ❑ Between $10,000 and $100,000 ❑. Between $100,000.01 and $200,000 ❑ More than $200,000 The Value of this tract is ❑ Between $10,000 and $100,000 ❑ Between $100,000.01 and $200,000 ❑ More than $200,000 The Value of this tract is ❑ Between $10,000 and $100,000 ❑ Between $100,000.01 and $200,000 0 More than $200,000 SECTION IX ANNUAL PAYMENTS RECEIVED BY THE PUBLIC OFFICER OR BUSINESS ENTITY FROM THE STATE OF GEORGIA (This section to be completed by Public Officers only) Identify all annual payments in excess of $20,000.00 received by the public officer — or by any business entity in which the public officer has an ownership interest of more than 10 percent of the business or has an ownership interest having a net fair market value of more than $20,000.00 — from the State, any agency, department, commission or authority created by the State and authorized and exempted from disclosure under O.C.G.A. § 45-10-25. (You may attach additional sheets of paper if necessary.) I received: TKXo annual payments in excess of $20,000.00 from any State entity. ❑ Annual payments in excess of $20,000.00 from the below named State entity(ies). IDENTIFY: 1. Name and address of State entity making the payments. 2. Amount of annual payment. 3. The general nature of the consideration rendered for the payment(s). State entity source #I State entity source #2 VERIFICATION BY OATH OR AFFIRMATION State of GeorgiefU�.L . O County of I, the undersigned, being duly sworn (affirm), depose and say that the information in this statement is complete, true, and correct. Sworn to and subscribed before me on Kaca, WE111ST 9,20 (-0 C lilt.. --cam. &0Aj!0Xd--&tW;U Signature of Candidate or Public Officer Signature oofNotaary Public PENALTIES: Any person who knowingly fails to comply with or who knowingly violates any of the provisions of the Ethics in Government Act shall be guilty of a My Commission expires�� i , '2 d8 , misdemeanor.