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| 11277 | Lee Cappola 2018 | Statement of Financial Interests for 2018 Cappola Lee (617) 626-1122 lee.cappola@mass.gov You indicated that you did have a spouse residing in your household during 2018. You indicated that you had no dependent child(ren) residing in your household at any time during 2018. Page 1 of 15 provide the required information for that position. If you held more than one public position which requires you to file, identify each position. Executive Office of Energy and Environmental Affairs (EOEEA) 100 Cambridge St, Boston, MA, 02114, US Secretariat Chief Information Officer 12/24/2017 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 2018, whether compensated or not, and whether full- or part-time. services, at any time during 2018, whether compensated or not, and whether full- or part-time. Public Agency Public Agency Name Consultant / Contractor? Services Provided State MassDOT 10 Park Plaza, Boston, MA, 02116, Consultant þ Information Technology consultancy State MassEOE 75 Pleasant St, Malden, MA, 02148, Consultant þ Information Technology consultancy State UMass Medical School 529 Main St, Charlestown, MA, 02129, US Consultant þ Information Technology consultancy any time during 2018, whether compensated or not, and whether full- or part-time, and provide the required Page 2 of 15 6. Identify any Business from which you were on a leave of absence at any time during 2018, 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 2018, whether compensated or not, and whether full- or part-time, and provide the required information for each. CGI 78 Blanchard Rd, Burlington, MA, 01803, US Consultant owned more than 1% of any class of the outstanding stock or similar ownership interest, at any time during 2018, and provide the required information for each. Percentage of stock Injured Workers Pharmacy 300 Federal St, Andover, MA, 01810, US 0% She Racing, LLC PO Box 708, Fiskdale, MA, 01518, US 49% during 2018, and provide the required information for each. She Racing, LLC PO Box 708, Fiskdale, MA, 01518, US Page 3 of 15 dependent child(ren) residing in your household during 2018, and provide the required information for each. 11. Identify any Business in which you served as an officer, director, or trustee, at any time during 2018, whether She Racing, LLC PO Box 708, Fiskdale, MA, 01518, US Officer an officer, director, or trustee, at any time during 2018, whether compensated or not, and whether full- or part-time, and provide the required information for each. CGI 78 Blanchard Rd, Burlington, MA, 01803, US Director She Racing, LLC PO Box 708, Fiskdale, MA, 01518, Officer Page 4 of 15 13. Identify all Real Estate in Massachusetts which you owned directly or through a Business as of December 31, 2018, and which had an assessed value greater than $1,000, and provide the required information for each Real F, S/C F, S/C and/or any dependent child(ren) residing in your household owned directly or through a Business as of December 31, 2018, and which had an assessed value greater than $1,000, and provide the required information for each Real Page 5 of 15 15. Identify any Trust of which you were a beneficiary, and which owned Real Estate in Massachusetts as of December 31, 2018, 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, 2018, 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 2018, and provide the required information for each Real Estate holding. Page 6 of 15 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 2018, 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, 2018, 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, 2018, 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 15 agencies, and authorities, which you owned directly or through a Business, as of December 31, 2018, 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, 2018, and which had a fair market value as of that date greater than $1,000, and provide the required information for each such investment. Name of Bond/ Other Security Description of Investment Fixed Income Investments Likely in mutual funds owned during this time period agencies, and authorities, which was owned as of December 31, 2018, 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 15 agencies, and authorities, which was owned as of December 31, 2018, 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. 25. Identify every Financial Investment that you owned directly or through a Business as of December 31, 2018, 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 Description of Investment Principal Place of Business or State of Incorporation ACON Equity Partners F, S/C Private Equity Investment Injured Workers Pharmacy (Capital Investment) 300 Federal St, Andover, MA, 01810, US 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, 2018, 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 9 of 15 27. Identify every Financial Investment that was owned as of December 31, 2018, 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, 2018, 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. 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, 2018, where the creditor (person who loaned you the money) is <u>not</u>, 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 Page 10 of 15 30. Did you have a mortgage, including a home equity or reverse mortgage loan, on any property <u>OTHER</u> than your Primary Residence, on which more than $1,000 was owed as of December 31, 2018, which you were obligated to pay and where the creditor (person who loaned you the money) is <u>NOT</u>, 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? 31. Identify all mortgages, including home equity and reverse mortgage loans, <u>other</u> 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, 2018, 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 <u>not</u>, 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. 32. Identify all non-mortgage debts of more than $1,000 that you owed as of December 31, 2018, IF the person to whom you owed the debt is <u>not</u>, 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, 2018, <u>if</u> the person to whom your spouse and/or any dependent child(ren) residing in your household owed the debt is <u>not</u>, 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 11 of 15 34. Identify non-mortgage debts of more than $1,000 which you owed and which were forgiven at any time during 2018, <u>excluding</u> 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. residing in your household and were forgiven at any time during 2018, <u>excluding</u> 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. 36. Identify any Reimbursements for expenses in excess of $100 provided to you at any time during 2018 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 2018 from any person having a direct interest in legislation, legislative action, or a matter before a governmental body. Page 12 of 15 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 2018 by any legislative agent or executive agent (lobbyist). 37.a Identify any Reimbursements for expenses in excess of $100, other than those identified in response to Question 37, provided to your spouse and/or dependent child(ren) residing in your household at any time during 2018 by any person having a direct interest in legislation, legislative action, or a matter before a governmental body. 38. Identify any Gifts and/or Honoraria worth more than $100 provided to you at any time during 2018 by any person having a direct interest in legislation, legislative action, or a matter before a governmental body. 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 2018 by any person having a direct interest in legislation, legislative action, or a matter before a governmental body. Page 13 of 15 40. Did you, your spouse and/or any dependent child(ren) residing in your household during 2018, own anything that you have not reported on this Statement of Financial Interests because it was held in a Blind Trust during 2018? Page 14 of 15 I, Lee Cappola, certify under the pains and penalties of perjury that: Submitted: 04/19/2019 If you were required to amend your Statement of Financial Interests last year, we encourage you to carefully review your 2018 Page 15 of 15 |