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| 42737 | 2018/Hopkinson,_Elizabeth_10.9.18_-_CMR_6.02(3).pdf | DISCLOSURE OF ELECTION OR APPOINTMENT TO AN UNCOMPENSATED POSITION RECEIVED AS REQUIRED BY 930 CMR 6.02(3) STATE ETHICS COMMISSION IDENTIFYING INFORMATION 2018 OCT 9 10: Name: Elizabeth M. Hopkinson Your phone: 617-956-1510 (work) 978-505-1634 (cell) Your e-mail: Elizabeth.hopkinson@mass.gov STATE: I already have a job with a state agency or another direct or indirect financial interest in a contract made by a state agency, and I will begin serving in an uncompensated position with the same state agency or another state agency. Write an X COUNTY: I already have a job with a county agency or another direct or indirect beside one financial interest in a contract made by a county agency, and I will begin serving in statement. an uncompensated position with the same county agency or another agency of the same county. MUNICIPAL: I already have a job with a municipal agency or another direct or indirect financial interest in a contract made by a municipal agency, and I will begin serving in an uncompensated position with the same municipal agency or another agency of the same city or town. The uncompensated position will be: Check one. Elected or Non-elected FINANCIAL INTEREST I ALREADY HAVE IN A PUBLIC AGENCY CONTRACT Do you already have I HAVE THE CONTRACT. the contract with a public agency, or I work for a public agency for compensation. does another person or entity have the A contract that I have with a state public agency (e.g., a grant) funds my work; contract? I have a contract for goods, supplies or equipment, etc., with a public agency. Write an I have another type of contract with a public agency. beside the OR appropriate statement. ANOTHER PERSON OR ENTITY HAS THE CONTRACT. I work for a person or entity (e.g., a business, non-profit or organization), and my work is funded by a contract between the person or entity and a public agency. I have an ownership interest in a private entity (e.g, a business or non-profit), and the entity receives funds because of a contract with a public agency. I have an ownership interest in a private entity (e.g., a business or non-profit), and the entity has a contract for goods, supplies or equipment, etc. with a public agency. A public agency has a contract or transaction with a private person or entity, and I have a financial stake in the contract or transaction. CONTRACT BETWEEN A PUBLIC AGENCY AND YOU Fill out this part of the form if the public contract is with you. Name and address of the state, county or municipal agency MA Division of Banks that made the 1000 Washington Street 10th floor contract. Boston, MA 02118 What is the contract E.g., Is it a contract for your services or for goods, supplies or equipment or something else? for? Something else What is your Please include a dollar amount, if possible. financial interest in the public agency Salary of approximately $60,000/year contract? Please include both financial advantages and obligations. CONTRACT BETWEEN A PUBLIC AGENCY AND ANOTHER PERSON OR ENTITY Fill out this part of the form if the contract is with another person or an entity. Name and address of the state, county or municipal agency that made the contract. Please provide the name and address of the person or entity that has the contract. What relationship do E.g., are you an owner, partner or employee of a company that signed the contract? Or of a you have with the subcontractor to such a company? person or entity that has the public contract? What is the contract E.g., Is it a contract for services or for goods, supplies or equipment or something else? for? What is your Please explain the financial interest and include a dollar amount if you know it. financial interest in the public agency contract? Please include both financial advantages and obligations. UNCOMPENSATED PUBLIC POSITION Name and address MA Department of Developmental Services of the public agency Central Middlesex Area Citizens Advisory Board where you will have 35 Nagog Park Suite 2000 an uncompensated Acton, MA 01720 position. What is the uncompensated Member of the Citizens Advisory Board which advocates for issues/policies around position? people living with disabilities Who elected or appointed you to the MA Department of Developmental Services Commissioner position? Employee signature: Elabttt MHopleisen Date: October 3, 2018 Attach additional pages if necessary. IF you already had a compensated public position, file this disclosure with your appointing authority for that position. OTHERWISE, IF you are reporting an uncompensated position with the state or a county, file this disclosure with the State Ethics Commission. If you are reporting an uncompensated position with a city or town, file this disclosure with the city or town clerk. Form revised February, 2012 |