UTAH HOUSE OF REPRESENTATIVES CONFLICT OF INTEREST & FINANCIAL DISCLOSURE All versions of this document, including amended versions, shall remain on the legislative website and in the House main office(hard copy) for two years from the date the completed form is received by the Chief Clerk. NOTE: "preceding year" means the year immediately preceding the day on which the officeholder files a Conflict of Interest form.UCA: 20A-11-1602(6) Date: January 23, 2017 Name of officeholder: Ken Ivory Employment ( 2014 Gen. Session, HB 394: An officeholder is required to disclose each of the officeholder's current employers, as well as employers during the preceding year.) Current Employer(s) Citizens for Self Governance Convention of States Action 100 Congress Avenue Suite 2000 Austin, TX 78701 Ivory Law 10808 S. Riverfront Parkway, suite 3029 South Jordan, UT 84095 3 Great Rights Institute, Inc. 859 West South Jordan Pkwy, Suite 100 South Jordan, UT 84095 Description of Employment Consulting Occupation and/or job title Senior Legislative Liaison Law Practice Attorney Consulting President Preceding Year's Employer(s) Citizens for Self Governance Convention of States Action 100 Congress Avenue Suite 2000 Austin, TX 78701 Stratton Law Group 1313 East 800 North Orem, UT 84097 3 Great Rights Institute, Inc. 859 West South Jordan Pkwy, Suite 100 South Jordan, UT 84095 Description of Employment Consulting Law Practice Occupation and/or job title Senior Legislative Liaison Attorney Attorney Attorney Consulting President Entities in which you are an owner or officer. [2014 Gen. Session, HB 394, pg.21] Current Year: Entity Name Ivory Law, PC 3 Great Rights Institute, Inc Where's The Line America Foundation Preceding Year: Entity Name Same as above Type of business or activity conducted by each entity Law Practice Consulting Education Your position in each entity Type of business or activity conducted by the entity Your position in each entity President President Executive Director Each individual or entity from whom the regulated officeholder has received $5,000 or more in income currently and during the preceding year. [2014 Gen. Session, HB 394, pg.21] NOTE: UCA 20A-11-1604(5)(b) "in making the disclosure..., a regulated officeholder who provides goods or services to multiple customers or clients as part of a business or a licensed profession is only required to provide the information described in Subsection (4)(e) in relation to the entity or practice through which the regulated officeholder provides the goods or services and is not required to provide the information described in Subsection (4)(e) in relation to the regulated officeholder's customers or clients." Name of individual or entity Type of business or activity conducted by the entity State of Utah House of Representatives Ivory Law, P.C. Law Practice American Lands Council Lands Rights Convention of States Action Education - Constitution, self governance Citizens for Self Government Education - Constitution, Self Governance Federalism In Action Education Each entity in which you currently hold any stocks or bonds having a fair market value of $5,000 or more, including info for the preceding year. [2014 Gen. Session, HB 394, pg.21] (excludes funds that are managed by a third party, including blind trusts, managed investment accounts, and mutual funds) Name of entity Type of business or activity conducted by the entity Ivory Law, P.C. Law Practice Entity or organization for which you serve on the board of directors or in any other type of paid leadership capacity (include current and preceding year). [2014 Gen. Session, HB 394, pg.21] *(only required to list those entities not already listed in responses to questions 3, 4, or 5) Name of entity or organization UPMA Type of business or activity conducted by the entity Precious Metal Association Your position in the entity or organization Board Member Description of any real property in which the legislator holds an ownership or other financial interest that the legislator believes may constitute a conflict of interest. (optional) [2014 Gen. Session, HB 394, pg.22] Description of the real property n/a Description of the type of interest held by the legislator Name of spouse and any other adult residing in your household who is not related by blood or marriage, and their employment information. Include current employer(s) and employer(s) during the preceding year. [2014 Gen. Session, HB 394, pg.22] Name of Spouse: Rebecca Ivory Spouse's current employer Address n/a Spouse's employer in the preceding year American Lands Council Address 859 West South Jordan Pkwy, Ste 100 South Jordan, UT 84095 Information for other adults not related by blood or marriage who are living in the same home as officeholder. Name of Individual Brief description of employment & occupation Any other matter or interest you believe may constitute a conflict of interest. (optional) [2014 Gen. Session, HB 394, pg.22] I certify that I believe the information provided on this form is true and accurate to the best of my knowledge. s/ Ken Ivory (Signature of Legislator) Received by the Chief Clerk of the House: January 23, 2017 (Date) January 23, 2017 (Date)