search_index: sfi.db/filings, 10055
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| sfi.db/filings | 10055 | Michael F Collins 2016 | 2016-01-01T00:00:00 | 1 | Statement of Financial Interests for 2016 Collins Michael F (508) 856-6507 michael.collins@umassmed.edu You indicated that you did have a spouse residing in your household during 2016. You indicated that you had no dependent child(ren) residing in your household at any time during 2016. 1. You have indicated that you are a candidate for public office. Select the office for which you are a candidate. Page 1 of 16 provide the required information for that position. If you held more than one public position which requires you to file, identify each position. University of Massachusetts President's Office (UMASS) One Beacon Street, Boston, MA, 02108, US Senior Vice President for the Health Sciences 06/01/2007 University of Massachusetts Medical School (UMASS) 55 Lake Avenue North, Office of the Chancellor, Worcester, MA, 01655, US Chancellor 09/26/2008 3. Other than the position(s) identified in Question 2, identify every public position you held, and every public agency to which you provided services, at any time during 2016, whether compensated or not, and whether full- or part-time. services, at any time during 2016, whether compensated or not, and whether full- or part-time. any time during 2016, whether compensated or not, and whether full- or part-time, and provide the required Page 2 of 16 6. Identify any Business from which you were on a leave of absence at any time during 2016, and provide its address. 7. Identify every Business for which your spouse and/or any dependent child(ren) residing in your household worked as an employee, manager, consultant, or independent contractor at any time during 2016, whether compensated or not, and whether full- or part-time, and provide the required information for each. owned more than 1% of any class of the outstanding stock or similar ownership interest, at any time during 2016, and provide the required information for each. during 2016, and provide the required information for each. dependent child(ren) residing in your household during 2016, and provide the required information for each. Page 3 of 16 11. Identify any Business in which you served as an officer, director, or trustee, at any time during 2016, whether Commerce Bank 386 Main St, Worcester, MA, 01608, US Director $20,001 to 40,000 NEHI One Broadway, 15th Floor, Cambridge, MA, 02142, US Trustee UMass Memorial Health Care One Biotech Park, Worcester, MA, 01605 2376, Trustee 333 South Street, Shrewsbury, MA, 01545, US Trustee Gateway Park, 60 Prescott Street, Worcester, MA, 01605, US Trustee 370 Main Street, Suite 650, Worcester, MA, 01608, Trustee 446 MAin Street, Worcester, MA, 01608, US Trustee 3 Dag Hammarskjold Plaza, 8th Floor, New York, NY, 10017 2303, US Trustee One Beacon Street, Boston, MA, 02108, US Trustee 11 Norwich Street, Worcester, MA, 01608, US Trustee UMass Memorial Foundation Massachusetts Biomedical Initiatives Greater Worcester Community Foundation Worcester Regional Chamber of Commerce American University of Beirut University of Massachusetts Foundation Higher Education Consortium of Central Mass Page 4 of 16 an officer, director, or trustee, at any time during 2016, whether compensated or not, and whether full- or part-time, and provide the required information for each. 13. Identify all Real Estate in Massachusetts which you owned directly or through a Business as of December 31, 2016, and which had an assessed value greater than $1,000, and provide the required information for each Real F, S/C Yes Halloran, Jean and John 315 Seapuit River Road, Osterville, MA, 02655, US and/or any dependent child(ren) residing in your household owned directly or through a Business as of December 31, 2016, and which had an assessed value greater than $1,000, and provide the required information for each Real Page 5 of 16 15. Identify any Trust of which you were a beneficiary and which owned Real Estate in Massachusetts as of December 31, 2016, with an assessed value greater than $1,000, and provide the required information for each such Trust and Real Estate holding. 16. Other than the Real Estate identified in Question 15, identify any Trust of which your spouse and/or any dependent child(ren) residing in your household was a beneficiary and which owned Real Estate in Massachusetts as of December 31, 2016, with an assessed value greater than $1,000, and provide the required information for each such Trust and Real Estate holding. 17. Identify any Real Estate in Massachusetts with an assessed value greater than $1,000, that was transferred to another person or entity by you, or by a Trust of which you were a beneficiary, at any time during 2016, and provide the required information for each Real Estate holding. Name of Trust Real Estate Address Transferee Name Transferee Address 34 Gardiner Lane, Osterville, MA, 02655, US F, S/C Realty Trust, Gardiner Lane Nancy B. Samiijan, Trustee, 400 Atlantic Avenue, Boston, MA, 02110, Page 6 of 16 18. Other than the Real Estate identified in Question 17, identify any Real Estate in Massachusetts with an assessed value greater than $1,000, that was transferred to another person or entity by your spouse and/or any dependent child(ren) residing in your household, or by a Trust of which your spouse and/or any dependent child(ren) residing in your household was a beneficiary, at any time during 2016, and provide the required information for each piece of Real Estate transferred. 19. Identify any Real Estate in Massachusetts with an assessed value greater than $1,000, on which, as of December 31, 2016, you, or a Trust of which you were a beneficiary, had a lien, attachment, or mortgage receivable, and provide the required information for each. 20. Other than the Real Estate identified in Question 19, identify any Real Estate in Massachusetts with an assessed value greater than $1,000, on which, as of December 31, 2016, your spouse and/or any dependent child(ren) residing in your household, or a Trust of which your spouse and/or any dependent child(ren) residing in your household, had a lien, attachment, or mortgage receivable, and provide the required information for each. Page 7 of 16 agencies, and authorities, which you owned directly or through a Business, as of December 31, 2016, and which had a fair market value as of that date greater than $1,000, and provide the required information for each such investment. 22. Other than the bonds or other securities identified in Question 21, identify every bond or other security issued by the Commonwealth of Massachusetts or its political subdivisions, agencies, and authorities, which your spouse and/or any dependent child(ren) residing in your household owned directly or through a Business, as of December 31, 2016, and which had a fair market value as of that date greater than $1,000, and provide the required information for each such investment. agencies, and authorities, which was owned as of December 31, 2016, by a Trust of which you were a beneficiary, whether directly or through a Business, and which had a fair market value as of that date greater than $1,000, and provide the required information for each such investment. Page 8 of 16 agencies, and authorities, which was owned as of December 31, 2016, by a Trust of which your spouse and/or any dependent child(ren) residing in your household was a beneficiary, whether directly or through a Business, and which had a fair market value as of that date greater than $1,000, and provide the required information for each such investment. Page 9 of 16 25. Identify every Financial Investment that you owned directly or through a Business as of December 31, 2016, and which had a fair market value as of that date greater than $1,000, and provide the required information for each. Name of Issuer Boston Scientific Corporation Common Stock(BSX) F, S/C Facebook, Inc. Class A Common Stock(FB) F, S/C American International Group, Inc. Warrant expiring January 19, 2021(AIG.W) F, S/C Merck & Company, Inc. Common Stock (new)(MRK) F, S/C Twitter, Inc. Common Stock(TWTR) F, S/C Fidelity Blue Chip Growth Fund(FBGRX) F, S/C Description of Investment Principal Place of Business or State of Incorporation Page 10 of 16 Apple Inc. Common Stock(AAPL) F, S/C Dell Technologies Inc F, S/C Common Stock One Dell Way, Round Rock, TX, 78682, US Texas 26. Other than the Financial Investments identified in Question 25, identify every Financial Investment that your spouse and/or any dependent child(ren) residing in your household owned directly or through a Business as of December 31, 2016, and which had a fair market value as of that date greater than $1,000, and provide the required information for each. For any Financial Investment not included on the drop-down list of publicly traded stock, you must provide the issuer's principal place of business or state of incorporation as well as its address. 27. Identify every Financial Investment that was owned as of December 31, 2016, by a Trust of which you were a beneficiary, and which had a fair market value as of that date greater than $1,000, and provide the required information for each. For any Financial Investment not included on the drop-down list of publicly traded stock, you must provide the issuer's principal place of business or state of incorporation as well as its address. 28. Other than the Financial Investments identified in Question 27, identify every Financial Investment that was owned as of December 31, 2016, by a Trust of which your spouse and/or any dependent child(ren) residing in your household was a beneficiary, and which had a fair market value as of that date greater than $1,000, and provide the required information for each. For any Financial Investment not included on the drop-down list of publicly traded stock, you must provide the issuer's principal place of business or state of incorporation as well as its address. Page 11 of 16 29. Identify all mortgages, including home equity and reverse mortgage loans, on your Primary Residence, on which more than $1,000 was owed as of December 31, 2016, where the creditor (person who loaned you the money) is NOT, by blood or marriage, your parent, grandparent, great grandparent, child, grandchild, great grandchild, aunt, uncle, sister, brother, niece, nephew, or the spouse of any such relative, and provide the required information for each. The Cooperative Bank of Cape Cod 25 Benjamin Franklin Way, Hyannis, MA, 02601, 15 2.75 2031 Primary Residence, on which more than $1,000 was owed as of December 31, 2016, which you were obligated to pay and where the creditor (person who loaned you the money) is NOT, by blood or marriage, your parent, grandparent, great grandparent, child, grandchild, great grandchild, aunt, uncle, sister, brother, niece, nephew, or the spouse of any such relative? Obligor Amount Outstanding Amount Mortgage Term Interest Rate (%) Termination Year 11030 Turtle Beach Road, TH 2, North Palm Beach, FL, 33408, F, S/C $100,001 or more $100,001 or more 10 Years 4 2022 Creditor Finemark National Bank and Trust Creditor 12681 Creeksid e Lane, Fort Myers, FL, 33919, Page 12 of 16 31. Identify all mortgages, including home equity and reverse mortgage loans, OTHER than any mortgage on your Primary Residence or any mortgage identified in response to Question 30, on which more than $1,000 was owed as of December 31, 2016, and which your spouse and/or any dependent child(ren) residing in your household were obligated to pay and where the creditor (person who loaned the money to your spouse and/or dependent child(ren) residing in your household) is NOT, by blood or marriage, your parent, grandparent, great grandparent, child, grandchild, great grandchild, aunt, uncle, sister, brother, niece, nephew, or the spouse of any such relative, and 32. Identify all non-mortgage debts of more than $1,000 that you owed as of December 31, 2016, IF the person to whom you owed the debt is NOT, by blood or marriage, your parent, grandparent, great grandparent, child, grandchild, great grandchild, aunt, uncle, sister, brother, niece, nephew, or the spouse of any such relative, and 33. Identify all non-mortgage debts of more than $1,000 that your spouse and/or any dependent child(ren) residing in your household owed as of December 31, 2016, IF the person to whom your spouse and/or any dependent child(ren) residing in your household owed the debt is NOT, by blood or marriage, your parent, grandparent, great grandparent, child, grandchild, great grandchild, aunt, uncle, sister, brother, niece, nephew, or the spouse of any such relative, and 34. Identify non-mortgage debts of more than $1,000 which you owed and which were forgiven at any time during 2016, EXCLUDING debts forgiven by a person who is, by blood or marriage, your parent, grandparent, great grandparent, child, grandchild, great grandchild, aunt, uncle, sister, brother, niece, nephew, or the spouse of any such relative, and provide the required information for each. Page 13 of 16 residing in your household and were forgiven at any time during 2016, EXCLUDING debts forgiven by a person who is, by blood or marriage, your parent, grandparent, great grandparent, child, grandchild, great grandchild, aunt, uncle, 36. Identify any Reimbursements for expenses in excess of $100 provided to you at any time during 2016 by any legislative agent or executive agent (lobbyist). 36.a Identify any Reimbursements for expenses in excess of $100, other than those identified in response to Question 36, you received at any time during 2016 from any person having a direct interest in a matter before the 37. Identify any Reimbursements for expenses in excess of $100 provided to your spouse and/or any dependent child(ren) residing in your household at any time during 2016 by any legislative agent or executive agent (lobbyist). Page 14 of 16 37.a Identify any Reimbursements for expenses in excess of $100, other than those identified in response to Question 36, provided to your spouse and/or dependent child(ren) residing in your household at any time during 2016 by any person having a direct interest in a matter before the governmental body by which you were or are now employed. 38. Identify any Gifts and/or Honoraria worth more than $100 provided to you at any time during 2016 by any person having a direct interest in a matter before a governmental body by which you were or are now employed. 39. Identify any Gifts and/or Honoraria worth more than $100 provided to your spouse and/or any dependent child(ren) residing in your household at any time during 2016 by any person having a direct interest in a matter before the governmental body by which you were or are now employed. 40. Did you, your spouse and/or any dependent child(ren) residing in your household during 2016, own anything that you have not reported on this Statement of Financial Interests because it was held in a Blind Trust during 2016? Page 15 of 16 I, Michael F Collins, certify under the pains and penalties of perjury that: Submitted: 04/19/2017 If you were required to amend your Statement of Financial Interests last year, we encourage you to carefully review your 2016 Page 16 of 16 |