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Virginia Conflict of Interest and Ethics Advisory Council

GENERAL ASSEMBLY STATEMENT OF ECONOMIC INTERESTS

NAME: Marcus Simon
OFFICE OR POSITION
HELD OR SOUGHT:
HOUSE OF DELEGATES
DISTRICT NO.
53
ARE YOU FILING THIS FORM AS A CANDIDATE FOR ELECTION TO THIS OFFICE?
[ ] Yes [X] No
BUSINESS ADDRESS: STREET
P.O. Box 958
TELEPHONE:
CITY
FALLS CHURCH
STATE
VA
ZIP
22040
OFFICE
703-821-3556
HOME
REDACTED
EMAIL ADDRESS: REDACTED
FIRST AND LAST NAMES OF MEMBERS OF IMMEDIATE FAMILY: Rachel Simon, Emily Simon, Zachary Simon

I certify that I completed ethics training as required by § 30-129.1. [X] Yes [ ] No

Pursuant to § 30-129.1, although there is no penalty for your failure to attend the full or refresher orientation session, attendance is mandatory under the Code and you must disclose your attendance on this form.

This Statement of Economic Interests will be available to the public via the searchable database on the Virgina Conflict of Interest and Ethics Advisory Council website, as required by § 30-356.

REPORT TO THE BEST OF INFORMATION AND BELIEF Information required on this Statement must be provided on the basis of the best knowledge, information, and belief of the individual filing the Statement as of the date of this report.

AFFIRMATION

In accordance with the rules of the house in which I [shall] serve, if I receive a request that this disclosure statement be corrected, augmented, or revised in any respect, I hereby pledge that I shall respond promptly to the request. I understand that if a determination is made that the statement is insufficient, I will satisfy such request or be subjected to disciplinary action of my house.

I swear or affirm that the information provided on this statement is full, true, and correct to the best of my knowledge.

Marcus Simon (Electronically Signed: 1/15/2017 1:09:01 PM)   1/15/2017 1:09:01 PM
Signature of Member/Member-elect/Candidate   Date
Any legislator who knowingly and intentionally makes a false statement of a material fact on the Statement of Economic Interests is guilty of a Class 5 felony and shall be subject to disciplinary action for such violations by the house in which the legislator sits.

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General Assembly Statement of Economic Interests

SCHEDULE C

SECURITIES

NAME: Marcus Simon

QUESTION:

Do you or a member of your immediate family, separately or together, own securities valued in excess of $5,000 invested in one business or Virginia governmental entity?

INCLUDE securities held in (i) trusts; (ii) individual retirement arrangements (IRAs); (iii) defined contribution plans, including plans established in accordance with sections 401, 403, or 457 of the Internal Revenue Code; and (iv) any other type of investment account.

INCLUDE securities not held in your name or the name of a member of your immediate family if you or a member of your immediate family retains the right to control such securities or the right to receive the income from such securities.

Yes [X]
No [ ]
If yes, complete the table for each such security.

INSTRUCTIONS:

Disclose each business or Virginia governmental entity in which you or a member of your immediate family, separately or together, own securities valued in excess of $5,000.

INCLUDE securities held in (i) trusts; (ii) individual retirement arrangements (IRAs); (iii) defined contribution plans, including plans established in accordance with sections 401, 403, or 457 of the Internal Revenue Code; and (iv) any other type of investment account.

INCLUDE securities not held in your name or the name of a member of your immediate family if you or a member of your immediate family retains the right to control such securities or the right to receive the income from such securities.

“Securities" INCLUDES:
  • Stocks
  • Bonds
  • Mutual funds
  • Limited partnerships
  • Commodity futures contracts
“Securities" EXCLUDES:
  • Defined benefit plans, including pension plans
  • Certificates of deposit
  • Money market funds
  • Annuity contracts
  • Insurance policies
  • Securities issued by the U.S. government or other government securities not issued by the Commonwealth or its political subdivisions.

DRAFT

List the issuer and type of each security. List separately each security held in an IRA, defined contribution plan, or other type of investment account, if such security is valued in excess of $5,000.

For defined contribution plans administered by the Commonwealth or its political subdivisions, list the administering agency as the issuer of the security, unless the security is held in a self-directed brokerage account, in which case list the issuer of the security.

NAME OF ISSUER OF SECURITY TYPE OF SECURITY (STOCKS, BONDS, MUTUAL FUNDS, IRA, ETC.) VALUE OF SECURITY
US Government Securities Fund AMUSX Mutual Fund $5,001 to $50,000
Washington Mutual Investors Fund AWSHX Mutual Fund $5,001 to $50,000
AMCAP Fund (CAFEX) Mutual Fund $5,001 to $50,000
American Mutual Fund - CMLEX Mutual Fund $5,001 to $50,000
Bond Fund of America (CAFEX) Mutual Fund $5,001 to $50,000
Europacific Growth Fund - CEUEX Mutual Fund $5,001 to $50,000
Growth Fund of America - CGFEX Mutual Fund $5,001 to $50,000
Bank Fund of America - ABNDX Bond Fund $5,001 to $50,000
Europacific Growth Fund - AEPGX Mutual Fund $5,001 to $50,000
Growth Fund of America - AGTHX Mutual Fund $5,001 to $50,000
Investment Company of America AIVSX Mutual Fund $5,001 to $50,000
The Income Fund of America (CIMEX) Mutual Fund $5,001 to $50,000
Washington Mutual Investors Fund - CWMEX Mutual Fund $5,001 to $50,000
Putnam Investor Fund A Mutual Fund $5,001 to $50,000
Putnam Mulitcap Growth FUnd Mutual Fund $5,001 to $50,000
Paychex Stock Stock $5,001 to $50,000
Van Eck Constant Maturity CMCYX $5,001 to $50,000
I Shares LQD ETP $5,001 to $50,000
I Shares IJH ETP $5,001 to $50,000
SPDR S&P ETF ETF $50,001 to $250,000
Vanguard BSV Mutual Fund $5,001 to $50,000
Vanguard BND Mutual Fund $5,001 to $50,000
Vanguard VWO Mutual Fund $5,001 to $50,000
Vanguard VNQ MUTUAL FUND $5,001 to $50,000
Van Eck Constant Maturity CMCYX Mutual Fund $5,001 to $50,000
TSHARES LQD Mutual Fund $5,001 to $50,000
TSHARES IJH Mutual Fund $5,001 to $50,000
TSHARES IJR Mutual Fund $5,001 to $50,000

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General Assembly Statement of Economic Interests

SCHEDULE D

BUSINESS INTERESTS AND RENTAL PROPERTY

NAME: Marcus Simon

QUESTIONS:

1. Do you or a member of your immediate family own, separately or together, a business that has a value in excess of $5,000?

OR

Do you or a member of your immediate family, separately or together, have an interest in a business and the interest owned by you or a member of your immediate family has a value in excess of $5,000? DO NOT INCLUDE any securities disclosed on Schedule C.

Yes [X]
No [ ]
If yes, complete Table 1.

2. Do you or a member of your immediate family own, separately or together, a rental property that has a value in excess of $5,000?

OR

Do you or a member of your immediate family, separately or together, have an interest in a rental property and the interest owned by you or a member of your immediate family has a value in excess of $5,000?

Yes [X]
No [ ]
If yes, complete Table 2.

Table 1: Business Interests

INSTRUCTIONS:

Disclose each business owned by you or a member of your immediate family with a value in excess of $5,000 and each interest in a business owned by you or a member of your immediate family with a value in excess of $5,000. DO NOT REPORT any securities disclosed on Schedule C.

If the business is owned or operated under a trade, partnership, or corporate name, list that name. If the business is not owned or operated under a trade, partnership, or corporate name, describe the nature of the business.

NAME OF BUSINESS OR NATURE OF BUSINESS LOCATION OF BUSINESS (CITY OR COUNTY, STATE, AND COUNTRY) GROSS INCOME
Independent Settlement Group, LLC DBA Ekko Title Fairfax County, VA USA MORE THAN $250,000
Leggett, Simon, Freemyers & Lyon, PLC Fairfax County, VA USA $50,001 to $250,000

Table 2: Rental Property

INSTRUCTIONS:

Disclose each rental property owned by you or a member of your immediate family with a value in excess of $5,000 and each interest in rental property owned by you or a member of your immediate family with a value in excess of $5,000.

List each rental property individually.

If the rental property is owned or recorded under a trade, partnership, or corporate name, list that name. DO NOT LIST the street address for any rental property. No address will be redacted from this table.

NAME IN WHICH RENTAL PROPERTY IS OWNED OR RECORDED LOCATION OF RENTAL PROPERTY (CITY OR COUNTY, STATE, AND COUNTRY) TYPE OF RENTAL PROPERTY (RESIDENTIAL, COMMERCIAL, ETC.) GROSS INCOME
Simon Family Living Trust Arlington, Virginia Residential $50,000 or LESS

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General Assembly Statement of Economic Interests

SCHEDULE G

GIFTS

NAME: Marcus Simon

QUESTION:

Did you or a member of your immediate family receive from any lobbyist or lobbyist’s principal any gift or combination of gifts with a value exceeding $50 during the prior calendar year?

DO NOT INCLUDE gifts with a value of less than $20. Such items are exempted from the definition of a gift and should not be aggregated together or reported.

Yes [X]
No [ ]
If yes, complete the table below.

INSTRUCTIONS:

Disclose each lobbyist or lobbyist principal that, during the prior calendar year, gave you or a member of your immediate family any gift or combination of gifts with a value exceeding $50.

Identify the recipient and donor of each such gift. Disclose the exact gift or event, the date on which you accepted it, and the value of the gift. If an exemption from the $100 gift cap established in § 30-103.1 applies, mark the applicable exemption.

NAME OF RECIPIENT NAME OF DONOR EXACT GIFT OR EVENT DATE ACCEPTED VALUE GIFT CAP EXEMPTION
Marcus Simon Virginia Municipal League VML Day at the Capitol 1/28/2016 22.72
Marcus Simon Williamsburg Foundation Commemorative Session January 30, 2016 165.00 Widely attended event
Rachel Simon Williamsburg Foundation Commemorative Session January 30, 2016 165.00 Widely attended event
Marcus Simon Inova / Aetna Dinner in Richmond 2/17/2016 62
Marcus Simon Northern Virginia Chamber of Commerce Viva Virginia 1/14/2016 34 Widely attended event
Marcus Simon Agribusiness Council Dinner 1/14/2016 75 Widely attended event
Marcus Simon Falls Church News Press Dinner and Tickets to Chamber Gala 4/2/2016 100 Widely attended event
Marcus Simon Washington Gas & Light Va Chamber Fabulous 50 4/28/2016 50 Widely attended event
Marcus Simon Virginia AFL CIO Reception 2/1/2016 32 Widely attended event
Marcus Simon ARC of Northern Virginia ANNUAL GALA 10/22/2016 275 Widely attended event
Marcus Simon Insight Memory Care Center Gala Tickets 10/27/16 125 Widely attended event

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General Assembly Statement of Economic Interests

SCHEDULE H

PAYMENTS FOR REPRESENTATIONS AND OTHER SERVICES GENERALLY

NAME: Marcus Simon

PAYMENTS FOR REPRESENTATIONS BY YOU

QUESTION 1:

Did you represent any business before any state governmental agency during the prior calendar year for which you received compensation in excess of $5,000 for such representation?

DO NOT INCLUDE compensation for the performance of other services unrelated to the representation before the state governmental agency when calculating the amount of compensation received from a business. If you have job responsibilities other than those involving such representation, you should prorate your salary to determine the portion attributable to your representation.

DO NOT REPORT any business that you represented before a court or judicial officer, or where the representation consisted solely of the filing of mandatory papers and any subsequent representation regarding the mandatory papers.

Yes []
No [X]
If yes, complete Table 1.

PAYMENTS FOR REPRESENTATIONS BY ASSOCIATES

QUESTION 2:

Did persons with whom you have a close financial association represent any business before any state governmental agency during the prior calendar year for which compensation was received in excess of $5,000 for such representation?

DO NOT INCLUDE members of your immediate family when determining with which individuals you have a close financial association, unless you and your immediate family member are employed by or work for the same business or organization. 

DO NOT INCLUDE compensation for the performance of other services unrelated to the representation when calculating the amount of compensation received from a business.  If your associate has job responsibilities other than those involving such representation, you should prorate his salary to determine the portion attributable to his representation.

DO NOT REPORT any business that such persons represented before a court or judicial officer, or where the representation consisted solely of the filing of mandatory papers and any subsequent representation regarding the mandatory papers.

Yes []
No [X]
If yes, complete Table 2.

PAYMENTS FOR OTHER SERVICES GENERALLY

QUESTION 3:

Did you or persons with whom you have a close financial association furnish services to any business operating in Virginia during the prior calendar year for which compensation was received in excess of $5,000 for such services?

DO NOT INCLUDE members of your immediate family when determining with which individuals you have a close financial association, unless you and your immediate family member are employed by or work for the same business or organization.

DO NOT INCLUDE compensation reported on Table 1 or Table 2 of this schedule.

Yes [X]
No [ ]
If yes, complete Table 3.

TABLE 1

PAYMENTS FOR REPRESENTATIONS BY YOU

INSTRUCTIONS:

Disclose each business that you represented before any state governmental agency during the prior calendar year for which you received compensation in excess of $5,000 for such representation.

For each business, list the type of business, the name of the state governmental agency before which you appeared on behalf of the business, and the purpose of the representation.

DO NOT INCLUDE compensation for the performance of other services unrelated to the representation before the state governmental agency when calculating the amount of compensation received from a business.

DO NOT REPORT:

TYPE OF BUSINESS NAME OF AGENCY PURPOSE OF REPRESENTATION AMOUNT OF COMPENSATION RECEIVED

TABLE 2

PAYMENTS FOR REPRESENTATIONS BY ASSOCIATES

INSTRUCTIONS:

Disclose each business that persons with whom you have a close financial association represented before any state governmental agency during the prior calendar year for which compensation was received in excess of $5,000 for such representation.

For each business, list the type of business, the name of the state governmental agency before which such persons appeared on behalf of the business, and the purpose of the representation.

DO NOT INCLUDE compensation for the performance of other services unrelated to the representation when calculating the amount of compensation received from a business.

DO NOT REPORT:

TYPE OF BUSINESS NAME OF AGENCY PURPOSE OF REPRESENTATION AMOUNT OF COMPENSATION RECEIVED

TABLE 3

PAYMENTS FOR OTHER SERVICES GENERALLY

INSTRUCTIONS:

Disclose each business operating in Virginia to which you or persons with whom you have a close financial association furnished services during the prior calendar year for which compensation was received in excess of $5,000 for such services.

Identify the businesses, by category, for which services were furnished and the type of service rendered to such businesses. To calculate the amount of compensation to report for each business category, include compensation received from all businesses within each category.

DO NOT INCLUDE compensation reported on Table 1 or Table 2 of this schedule.

BUSINESS CATEGORY TYPE OF SERVICE RENDERED AMOUNT OF COMPENSATION RECEIVED
Banking Legal Representation $5,001 to $50,000
Real Estate Legal Representation $5,001 to $50,000

General Assembly Statement of Economic Interests

ADDITIONAL INFORMATION

You may provide any additional information you wish to be included with your Statement of Economic Interests on this page. Please note any information you provide on this page will become part of your Statement of Economic Interests and will be open to the public. You MAY NOT add attachments as a substitute for properly filling out any part of this form.


Marcus & Rachel Simon received a $3200 Neighborhood Assistance Act Tax Credit as a result of a $5000 Charitable Contribution to the Falls Church-McLean Children's Center on June 29, 2016



Virginia Conflict of Interest and Ethics Advisory Council