search_index_fts: 43681
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| 43681 | 2020/Szivos,_John_1.21.2020_-_6.pdf | DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY AS REQUIRED BY G. L. c. 268A, § 6 STATE EMPLOYEE INFORMATION Name: John Szivos Title or Position: Adjunct Professor State Agency: Higher Education - Mount Wachusett Community College Agency Address: 444 Green St Gardner MA 01440 Office Phone: 978-632-6600 Office E-mail: J_szivos@mwcc.ma.edu My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular malter. E.g., a judicial or other proceeding. application, I will be teaching a course and want to use a textbook that 1 wrote. I may see a small financial gain submission, request from the sale of the book. for a ruling or other determination, contract. claim, controversy, charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: I am the course instructor and the book is congruous with the course content and how I E.g., approval, deliver the course. disapproval, decision, recommendation, rendering advice, investigation, other. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. __x_ t have a financial Interest in the matter. - 2020 JAN 21 PM 13 RECEIVED My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial Interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter I would estimate it would be less than $75.00 Employee signature: Date: John Lynna 1/8/20 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Laurie Occhipinti Title or Position: Dean Agency/Department: Mount Wachusett Community College Agency Address: 444 Green St Gardner MA 01440 Office Phone: 978-630-9350 Office E-mail locchipinti@mwcc.mass.edu DETERMINATION Determination by As appointing official, as required by G.L. c. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. Write an X I am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: lamin alpmn Date: Comment: 1/15/2020 Attach additional pages if necessary. File copy with: |