disclosures: 041160025cc144bf0c5ab7fa2403c5d1924f8745cf8d133bf05b9f6beaf3e1f3
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| 041160025cc144bf0c5ab7fa2403c5d1924f8745cf8d133bf05b9f6beaf3e1f3 | 2018/Kohn,_Amanda_5.7.18_-_7(d).pdf | 2018 | Amanda Kohn | DISCLOSURE BY SPECIAL STATE EMPLOYEE OF FINANCIAL INTEREST IN A STATE CONTRACT RECEIVED AS REQUIRED BY G. L. c. 268A, ยง 7(d) STATE ETHICS COMMISSION SPECIAL STATE EMPLOYEE INFORMATION 2018 MAY 7 AM11:33 Name of special state employee: Amanda Kohn I am a special state employee because: Put an X beside one I serve in a state position for which no compensation is provided. statement. I am not an elected official, and I earned compensation for fewer than 800 hours in the preceding 365-day period. By the classification of my position by my state agency or by the terms of a contract or my conditions of employment, I am permitted to have personal or private employment during normal business hours. I work for a company or organization which has a contract with a state agency, and I am a "key employee" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular, and the contract states that I am a special state employee or indicates that I meet one of the three requirements listed above. Title/ Position Intern If you are a special state employee because a state agency has contracted with your company or Fill in this box organization, please provide the name and address of the company or organization. if it applies to you. Tuffs University, 136 Harrison Ave, Boston MA 02111 State Agency/ This is "my State Agency." Department: Office of Senator Jason Lewis Agency Address: State House, Room 511B Boston, MA 02133 Office phone: 617-722-1206 Office e-mail: Check one: Elected or Non-elected Starting date as a special state 4/11/2018 employee. BOX # 1 ELECTED SPECIAL STATE EMPLOYEE I am an elected special state employee. Select either STATEMENT #1 or STATEMENT #1: I had a financial interest in a contract made by a state agency before 1 was STATEMENT #2. elected to a compensated special state employee position. I will continue to have this financial interest in a state contract. STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: Write an X A compensated, non-elected position with a state agency. by your financial interest. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a "key employee" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. BOX #2 NON-ELECTED SPECIAL STATE EMPLOYEE I am a non-elected special state employee (compensated or uncompensated). STATEMENT #1: I had a financial interest in a contract made by a state agency, other than an Select either employment contract, before I took a non-elected, compensated special state employee STATEMENT #1 or position. I will continue to have this financial interest in a state contract. STATEMENT #2. My financial interest in a contract made by a state agency is: A contract between a state agency and myself, but not an employment contract. Write an X by your financial A financial benefit or obligation because of a contract that a state agency has with another interest. person or with a company or organization. OR STATEMENT #2: I will have a new financial interest in a contract made by a state agency. My financial interest in a contract made by a state agency is: A compensated, non-elected position with a state agency. A contract between a state agency and myself. A financial benefit or obligation because of a contract that a state agency has with another person or with a company or organization. Other work because a state agency has a contract with my company or organization and I am a "key employee" because the contract identifies me by name or it is otherwise clear that the state is contracting for my services in particular. FINANCIAL INTEREST IN A STATE CONTRACT This is the "contracting agency." Name and address of state agency that Children's Family Trust made the contract Write an X to confirm In my work as a special state employee for my State Agency, I do not participate in or have this statement. official responsibility for any of the activities of the contracting agency. ANSWER THE QUESTION IN THIS BOX FILL IN IF THE CONTRACT IS BETWEEN THE STATE AGENCY AND YOU. THIS BOX OR - Please explain what the contract is for, THE NEXT BOX ANSWER THE QUESTIONS IN THIS BOX IF THE CONTRACT IS BETWEEN THE STATE AGENCY AND ANOTHER PERSON OR ENTITY - Please identify the person or entity that has the contract with the state agency. - What is your relationship to the person or entity? - What is the contract for? Tufts University, Rebecca Fauth and Thomas Stopka are the leads I am employed as a research assistant by Tufts University and my supervisor is Thomas Stopka. The contract is to do research on child maltreatment rates in MA and services provided by Children's Trust Family Centers What is your | 2018/Kohn,_Amanda_5.7.18_-_7(d).pdf |