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Home My WebLink About6/23/2021 - Form 1 - Statement of Financial InterestsFORM 1 STATEMENT OF 2020 Please print or type your name, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address, agency name, and position below: LAST NAME -- FIRST NAME -- MIDDLE NAME: BOLTON MARLON DWAYNE MAILING ADDRESS 6 ANN LEE LANE CITY: ZIP: COUNTY: TAMARAC 33319 BROWARD NAME OF AGENCY: CITY OF TAMARAC / BROWARD COUNTY GOVERNMENT NAME OF OFFICE OR POSITION HELD OR SOUGHT: COMMISSIONER / BOARD MEMBER (ACTION AGENCY) CHECK ONLY IF ❑ CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2020. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR El DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (If you have nothing to report, write "none" or "n/a") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY CITY OF TAMARAC 7525 NW 88TH AVE, TAMARAC FL 333 GOVERNEMENT BROWARD COUNTY GOV. 115 S. ANDREWS AVE, FL 33301 GOVERNMENT PRAISE EXPERIENCE WOC 1625 S. STATE ROAD 7, NORTH LAUDS NON PROFIT FORECAST HOLDINGS LLC 1PO BOX 451711, FORT LAUDERDALE, I ADVERTISING/CONSULTANC PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions] (If you have nothing to report, write "none" or 'Wa") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE ONE NONE NONE PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] You are not limited to the space on the (If you have nothing to report, write "none" or 'Wa") lines on this form. Attach additional ONE sheets, if necessary. FILING INSTRUCTIONS for when ONE and where to file this form are located at the bottom of page 2. NONE INSTRUCTIONS on who must file this form and how to fill it out NONE begin on page 3. cE FURM 1 - Ettecuve: January 1, 2021 (Continued on reverse side) PAGE 1 Incorporated by reference in Rule 34-8.202(1), F.A.C. PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] (If you have nothing to report, write "none" or "n/a") TYPE OF INTANGIBLE ] BUSINESS ENTITY TO WHICH THE PROPERTY RELATES (STOCKS I CARNIVAL CRUISE LINES, GROUPON, MMNFF, TOPS TD AMERITRADE PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or "n/a") NAME OF CREDITOR I ADDRESS OF CREDITOR GREAT LAKES EDUCATION LOAN Sl PO Box 7860. Madison, WI 53707 I CITIBANK, NA 15825 N University Dr, Tamarac. FL 33321 PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions] (If you have nothing to report, write "none" or "n/a') �f / ,BUSINESS ENTITY # 1 ( BUSINESS ENTITY 2 NAME OF BUSINESS ENTITY 1 w��S'� �O\� A3 ��L I� J0;, -- Y\ (I' ff� ADDRESS OF BUSINESS ENTITY IPO BOX 451711, FT LATJDERDAI76 PLEASANT HILL LN PRINCIPAL BUSINESS ACTIVITY ADV. & CONSULTANCY CONSULTANCY POSITION HELD WITH ENTITY AUTH. MEMBER MANAGER I OWN MORE THAN A 5% INTEREST IN THE BUSINESS YES YES NATURE OF MY OWNERSHIP INTEREST SOLE PROPRIETOR MANAGER/DIRECTOR PART G — TRAINING For elected municipal officers, appointed school superintendents, and commissioners of a community redevelopment agency created under Part III, Chapter 163 required to complete annual ethics training pursuant to section 112.3142, F.S. ❑ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: Signatu . Date Signed: 06/23/2021 FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics, it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForml@leg.state.fl.us and retain a copy for your records. Do not file by both mail and email. Choose only one filing method. Form 6s will not be accepted via email. CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: I, , prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPA/Attorney Signature: Date Signed: Candidates file this form together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local officer/employee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1 F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2020. u ruKm i - trtecove: January i, zuzi. PAGE 2 Incorporated by reference in Rule 34-8.202(1), F.A.C.