UTAH HOUSE OF REPRESENTATIVES 2016 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) 1. 2. Name of officeholder: Ken Ivory Employment (2014 Gen. Session, HB 394, pg. 21: An officeholder is required to disclose each of the officeholder's current employers, as well as employers during the preceding year.) Name & address of CURRENT employer(s) Brief description of employment Occupation and/or job title Law Practice Attorney Consulting President Name & address of PRECEDING YEAR'S employer(s) Brief description of employment Occupation and/or job title American Lands Council 859 W South Jordan Pkwy Ste 100 South Jordan UT 84095 Lands Rights President Ivory Law 10808 S Riverfront Pkwy South Jordan UT 84095 Law Practice Attorney Stratton Law Group 1313 East 800 North Orem, UT 84097 LPSG, Inc. 859 West South Jordan Parkway Suite 100 South Jordan, UT 84095 3. Entities in which you are an owner or officer. [2014 Gen. Session, HB 394, pg. 21] CURRENT YEAR: Name of entities Ivory Law, P.C. LPSG, Inc. Where's the Line America Foundation American Lands Council Foundation American Lands Council Type of business or activity conducted by each entity Law Practice (inactive) Consulting Education Education Land rights Page 1 of 4 Your position in each entity President/Owner President/Owner Executive Director Executive Director Executive Committee revised May 30, 2014 PRECEDING YEAR: Name of entities Ivory Law, P.C. LPSG, Inc. Where's the Line America Foundation American Lands Council Foundation American Lands Council 4. Type of business or activity conducted by each entity Law Practice (inactive) Consulting Education Education Land rights Your position in each entity President/Owner President/Owner Executive Director Executive Director Executive Committee 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 American Lands Council Ivory Law P.C. State of Utah Land Rights Law Practice House of Representatives 5. 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. (excludes funds that are managed by a third party, including blind trusts, managed investment accounts, and mutual funds). [2014 Gen. Session, HB 394, pg. 21] Name of entity Type of business or activity conducted by the entity Ivory Law, P.C. Law Practice 6. 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 Type of business or activity conducted by the entity Your position in the entity or organization UPMA Federalism in Action Precious Metals Association Education Board Member Director Page 2 of 4 revised May 30, 2014 7. 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 Description of the type of interest held by the legislator N/A 8. Name of spouse and any other adult residing in your household who is not related by blood or marriage. [see 2014 Gen. Session, HB 394; pg. 22]] Name of SPOUSE: Rebecca J. Ivory Names of OTHER ADULTS residing in home who are not related by blood or marriage: 9. Employment information for your spouse and any other adult residing in your household that is not related to you by blood or marriage - include current employer and employer(s) during the preceding year. [2014 Gen. Session, HB 394, pgs. 20 and 22] SPOUSE's current employer(s): Address of spouse's current employer(s) American Lands Council 859 West South Jordan Pkwy Ste 100 South Jordan, UT 84095 LPSG, Inc 859 West South Jordan Pkwy Ste 100 South Jordan, UT 84095 SPOUSES's employer(s) in the preceding year: Address of spouse's preceding year employer(s) American Lands Council Page 3 of 4 revised May 30, 2014 Information for other adults not related by blood or marriage who are living in the same home as officeholder: Brief description of employment & occupation NAME OF INDIVIDUAL: NAME OF INDIVIDUAL: Brief description of employment & occupation 10. 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 1 /25/16 (Signature of House member) (Date) Received by the Chief Clerk of the House: s/ Sandy D. Tenney 1/25/16 (Signature) (Date) Page 4 of 4 revised May 30, 2014