HELD OR SOUGHT: Manager, Office of Air Quality Assessments
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.
I swear or affirm that the information provided on this statement is full, true, and correct to the best of my knowledge.
Michael Kiss (Electronically Signed: 1/8/2018 10:30:43 AM) | 1/8/2018 10:30:43 AM | |
Signature of Officer or Employee | Date |
DRAFT
1. Do you or a member of your immediate family receive remuneration, benefits, or compensation for service as an officer or director of a business?
2. Do you or a member of your immediate family receive salary or wages in excess of $5,000 annually from any employer? DO NOT INCLUDE salary received from a state or local governmental or advisory agency.
NAME OF BUSINESS OR EMPLOYER | LOCATION OF BUSINESS OR EMPLOYER (CITY OR COUNTY, AND STATE) | POSITION HELD | BY WHOM | OFFICE OR DIRECTORSHIP OR EMPLOYMENT |
Dominion Energy | Glen Allen, VA | Environmental Manager | Rebekah Kiss | EMPLOYMENT |
1. Do you owe more than $5,000 to any one creditor, including any contingent debt to any one creditor?
2. Does a member of your immediate family owe more than $5,000 to any one creditor, including any contingent debt to any one creditor?
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?
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?
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?
Do you or a member of your immediate family, separately or together, hold an interest valued at more than $5,000 in real property? DO NOT INCLUDE your principal residence or any real estate disclosed on Schedule D. INCLUDE real estate held in trust.
Did you receive in your capacity as an officer or employee of your agency any lodging, transportation, money, or other thing of value with a combined value exceeding $100 during the prior calendar year for: your presentation of a talk or series of talks at the same event, or participation in a meeting
OR
your attendance at a meeting, conference, or event where your attendance at the meeting, conference, or event was designed to educate you on issues relevant to your duties as an officer or employee of your agency, or to enhance your knowledge and skills relative to your duties as an officer or employee of your agency?
Did you or a member of your immediate family receive from any (i) lobbyist; (ii) lobbyist’s principal; or (iii) contractor any gift or combination of gifts with a value exceeding $50 during the prior calendar year?Did you or a member of your immediate family receive from any (i) lobbyist; (ii) lobbyist’s principal; or (iii) contractor any gift or combination of gifts with a value exceeding $50 during the prior calendar year?
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?
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?
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 you or a member of your immediate family, separately or together, hold an interest valued in excess of $5,000 in real estate that is the subject of a contract with a governmental agency?