disclosures: 05bd0bd8e673e6092e06eefd213a49006b3b9d575399b502d46cfc52540c47da
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| 05bd0bd8e673e6092e06eefd213a49006b3b9d575399b502d46cfc52540c47da | 2018/Alexandre,_Judith_-_CMR_6.05(2)(b)_-_8.6.pdf | 2018 | Judith Alexandre | DISCLOSURE BY STATE EMPLOYEE OF A FINANCIAL INTEREST IN A CONTRACT WITH THE DEPARTMENT OF CHILDREN AND FAMILIES AS REQUIRED BY 930 CMR 6.05(2)(b) STATE EMPLOYEE INFORMATION Name of state employee: Judith Alexandre Title/ Position Domestic Violence Supervisor Agency: 2018 AUG-6 AUG AM 11:56 AN STATE ETHICS COMMISSION RECEIVED Department of Children and Families Bill Pay unit Agency address: 600 Washington Sf Boston 600 Washington St. Boston, MA 02111 I am a state employee, and I also have agreed to serve as a foster parent, guardian, or pre-adoptive or adoptive parent, or to serve in a comparable status. The Department of Children and Families ("DCF") has a contract or agreement with me or with another person or organization relating to the service I am providing. I am disclosing that I receive financial benefits and/ or have financial obligations because of the contract or agreement made by DCF. FINANCIAL INTEREST IN A DCF CONTRACT I have an agreement to serve as: Foster parent; Guardian; Please write an X beside your answer. Pre-adoptive parent; Adoptive parent; Other. Please explain. . My agreement is with: Please write an X DCF directly; beside your answer, and provide any A person or organization that has a contract with DCF. requested information. - Please provide the name and address of the person or organization. MSPCC- Kid's Net Boston Region 3815 Washington St. 2nd Floor Jamaica Plain, MA 02130 Phone #: 857-728-2157 or 617-983-5850 Fax: 617-983-5854 PLEASE DO NOT PROVIDE INFORMATION BELOW ABOUT THE IDENTITY OF THE CHILD. Please refer to the child as "the child" or "the foster child," etc. In the answers below, please provide a dollar amount, if possible. Please identify any Do you receive, e.g., a subsidy or benefits, compensation, reimbursement of expenses, or a financial benefit you clothing allowance? receive because of your service. Reimbursement at a daily rate based on the age of a child to cover a child's living expenses; Clothing allowances and supplements for holidays or birthdays; Reimbursement for certain out-of-pocket expenses; Who provides these Department of Children and Families financial benefits to 600 Washington Street 6th Floor you? Include the Boston, MA 02111 name and address. Please identify any Did you agree to accept any financial obligation, e.g., to maintain homeowner's insurance? financial obligation you have accepted in connection with this service. Employee signature: Judith My Meburr Date: 7/12/18 Attach additional pages if necessary. File copy with: State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised February, 2012 | 2018/Alexandre,_Judith_-_CMR_6.05(2)(b)_-_8.6.pdf |