Form No. DEC-2016 1 6 OHIO ETHICS COMMISSION FINANCIAL DISCLOSURE STATEMENT This statement is to be filed in 2017 Financial information for calendar year 2016 Please type or print clearly. See instructions for assistance with this page. A. PERSONAL CONTACT INFORMATION Last Name First Name MI TAYLOR MARY --SECTION B. STATUS (Check all that apply) FOR OFFICIAL USE ONLY Candidate CANDIDATES: Please list the date of l. Write-in Candidate the ?rst election (primary, special, or FILED Elected to an Of?ce general) when your name will appear i Appointed to an unexpired on the ballot. term in elective office MAY 1 2 2017 I Public Official Month Day Year Public Employee 2017 OHIO ETHICS COMMISSION Voluntary Filer Other C. PUBLIC POSITION, OFFICE, 0R JOB Position/Title (Example: council member, sheriff, board member, or job title) Seeking LIEUTENANT GOVERNOR VJ Hold El Held Public Entity you serve in 2017', served in 2016, or will serve if elected STATE OF OHIO Public Salary: Start Date: End Date: Uncompensated Month Day Year Month Day Year CI Lessthan$16.000 unu- $16,000 or more 3 3 D. ADDITIONAL PUBLIC POSITION, OFFICE, 0R JOB a: Err. Position/Title (Example: council member, sheriff, board member, or job title) CI Seeking 891 SUPERINTENDENT ?Did Held g3 Public Entity you serve in 2017, served in 2016, or will serve if elected a . OHIO DEPARTMENT OF INSURANCE 5 2 Public Salary: Start Date: End Date: CI Uncompensated Month Day Year Month Day Year El LessthanSISAOO $16,000 or more . OHIO ETHICS COMMISSION USE ONLY- IE Walk-in Filer has answered every required question. Date incomplete form C) Inter Office Filer has not answered these questions: returned to filer: No Check Date completed form Rev'd by: returned to OEC: . Page 1 of 4 1. SOURCES OF INCOME - ALL FILERS MUST ANSWER THIS QUESTION: CI lhave no sources of income that lam required to list. (For help, see instructions page 4) ?f Service Prowdedr-t' cs Stu. x(If reqUIred) (see Addendum with list of additional sources) A Lt. Governor/Superintendent Dept. Oflnsurance Lt. GovernorlSuperintendent Dept. oflnsurance Merrill Dividends/Interest FirstMerit Bank Interest 0 State of Ohio Tax Refund Check instructions to see whether you are required to disclose amounts of income. 2. SOURCES OF GIFTS - ALL FILERS MUST ANSWER THIS QUESTION: I have no sources of gifts that I am required to list. (For help, see instructions page 5) kw: .. Source Of GIft .3 A Global Ties U. i Ballreich Bros PTT Global?C?hemiO?al Bell Inc. (see Addendum for list of additional gifts) 9 3. NAMES OF SPOUSE RESIDING IN HOUSEHOLD AND ANY DEPENDENT CHILDREN - ALL FILERS MUST ANSWER THIS QUESTION: There are no immediate family members whose names I am required to list. . 5.. we: Attics -A-..-- is. . sf --. Donzell S. Taylor 33." 4. NAMES 0F BUSINESSES - ALL FILERS MUST ANSWER THIS QUESTION: (For help, see instructions page S) .25? (For help, see instructions page S) If you or anyone you listed in Question 3 owns or Operates a business, list the name Of the business. There?are no bUSinessF? names that I am required to list. A see Addendum with list of businesses a 5. LAND (REAL ESTATE) IN OHIO - ALL FILERS MUST ANSWER THIS QUESTION: (For help, see instructions page 6) I have no real estate that I am required to list. "1-5 Land (Real Estate): In Ohio ., s. t" . - -. Ir address Or, if: addr?SS' Is plat. nUmber- and county) - .. 1' i it; 2052 South Plaza Drive, Akron OH 44319 You are not required to disclose your personal residence or real property held primarily for personal recreation. Page 2 of 4 6. CREDITORS OVER 51,000 - ALL FILERS MUST ANSWER THIS oussnou: I have no creditors that I am required to list. (For help, see instructions page 6) Creditor Creditor A American Express - Visa First National Bank of Omaha JP Morgan Chase Master Card (United) 7. DEBTORS OVER 51,000 - ALL FILERS MUST ANSWER THIS QUESTION: (For help, see instructions page 5) have no debtors that I am required to list. Oebtor Debtor . A 8. INVESTMENTS OVER $1,000 - ALI. FILERS MUST ANSWER nus QUESTION: I have no investments that I am required to list. (For help, see instructions page 6 and 7) Corporation, TrIIst, Business Trust, Partnership, or Association - A State Farm Life Insurance Merrill Brokerage Account (see Addendum with list of investments) Merrill IRA (see Addendum with list of investments) College Advantage Plan FBO: Joseph R. Taylor Money Market College Advantage Plan FBO: Michael A. Taylor Money Market IF YOU NEED ADDITIONAL SPACE, PLEASE ATTACH A SEPARATE SHEET. 9. RELATIONSHIPS - Au. FILERS MUST ANSWER THIS outsnon: I have no of?ces or fiduciary relationships that I am required to list. (For help, see instructions page 8) Corporation, Trust,_Business Trust,? Partnership, or Association Of?ce or Nature of Relationship Q. A Mary Taylor Revocable Trust Trustee . College or university trustee - Candidate for a city, township, school district, or ESC position that is paid less than $16,000 a year SKIP QUESTIONS 10 AND 11 IF YOU ARE ONLY REQUIRED TO FILE AS A: - City, township, school district, ESC, or sanitary district official or employee serving in a position that is paid less than $16,000 a year 10. FOOD OR BEVERAGES - ALL FILERS EXCEPT THOSE IN THE Box ABOVE MUST ANSWER THIS QUESTION: have no sources of meals, food, or beverages that I am required to list. (For help, see instructions page 8) Source of Food or Beverag?s Source of Food or Beverages - Page 3 of 4 11. TRAVEL EXPENSES - ALL FILERS EXCEPT THOSE LISTED IN THE BOX on PAGE a MUST ANSWER THIs QUESTION: have no sources of travel expenses that I am required to list. (For help, see instructions page 9) . .. A ODOT 116.95 ODOT 417.00 ODOT 381.12 a ODOT 189.75 ODOT 543.85 I (see Addendum with list of additional travel) 12. NON-DISPUTED INFORMATION - ALL state employees, state of?cials and state board and commission members {except college and university trustees] are REQUIRED to answer Question 12. All other filers should skip this question and go to question 13. I have no information that i am required to list. (For help, see instructions page 9) . . Hault-Jh . . at. ?.NPn*DISPU.ted*Information13. SIGNATURE - ALL FILERS MUST SIGN THE STATEMENT: (For help, see instructions page .10) By signing this statement: 0 I swear or affirm that this statement and any additional attachments have been prepared or carefuily reviewed by me, and constitute my complete, truthful, and correct disclosure of all required information, and that the address listed on page 1 is a correct mailing address. a i acknowledge and understand that, among other potential violations and penalties, knowingly filing a false statement is a criminal misdemeanor of the first degree, in violation of Sections and of the Revised Code, punishable by a fine of not more than $1,000, imprisonment of not more than six months, or both. - I acknowledge and understand that filing a false statement may be grounds for removal from public office or dismissal from public employment pursuant to Sections 304 and 124.34 of the Revised Code. 0 I acknowledge that, in 2016, I served in, or in 2017, lam serving in or a candidate for, the position indicated on page 1 of this statement. if you have any questions before signing this form, please contact the Ohio Ethics Commission at (614) 466-7090. Before signing this statement, please review to make sure that you have answered each question you are required to answer. If you have nothing to list in response to any question, check the box indicating that you have nothing to list. if the response to any required question is omitted, the Commission will return the statement to you as incomplete. Any person who fails to file a complete statement by the appropriate filing deadline will be assessed a late filing fee and may be subject to criminal penalty. Deliver completed statement to: Ohio Ethics Commission, 30 W. Spring St., L3, Columbus, OH 43215 My ?ling fee is: {For help, see instructions page 2) Enclosed (check or money order payable to "Ohio Ethics Commission") Submitted Online included in my attorney registration fees (Judges, Magistrates, and Judicial Candidates Only) My public agency is required or has agreed to pay my filing fee. voue SIGNATURE Is REQUIRED HERE: Date: Rev. 01-2017 Page 4 of 4 MARY TAYLOR OHIO LIEUTENANT GOVERNOR OHIO ETHICS COMMISSION 2016 FINANCIAL DISCLOSURE STATEMENT ADDENDUM 1. SOURCES OF INCOME: Source of Income Service Provided Amount' (if required) F. IRS Tax Refund G. City of Green Tax Refund H. City of Columbus Tax Refund MARY TAYLOR OHIO LIEUTENANT GOVERNOR OHIO ETHICS COMMISSION 2016 FINANCIAL DISCLOSURE STATEMENT ADDENDUM 2. SOURCES OF GIFTS: Source of Gifts JobsOhio' Onward Ohio Ohio Convention Committee 2016 Rhinegeist Ohio Republican Party Consul General of India Serbian Ambassador The Hunt Institute Council of the Great Lakes Region ozzrxeoxom Champaign County Republican Party 1 Actual or in-kind expenditures for the travel, meals or lodging of the Governor's designees pursuant to RC. provided by JobsOhio in connection with the Governor's performance of of?cial duties related to JobsOhio. MARY TAYLOR OHIO LIEUTENANT GOVERNOR OHIO ETHICS COMMISSION 2016 FINANCIAL DISCLOSURE STATEMENT ADDENDUM 4. NAMES OF BUSINESSES: My husband, Donzell S. Taylor, owns interests in the following entities, which ?do business? as described in the example given in Question 4. Unless otherwise noted, each of these entities is in good standing under the laws of the State of Ohio or the jurisdiction in which they are required to be registered or are currently doing business. The information provided in response to Question 4 may not be considered an acknowledgment that any of these individuals ?do business? other than through their ownership interest in these entities, with all of the rights (including but not limited to limited liability) afforded by applicable law. 123 S. Miller Road, L.L.C. 123 S. Miller Road. L.L.C. irrevocable Trust for the bene?t of Joseph Taylor, Don Taylor, Trustee 123 S. Miller Road, L.L.C. irrevocable Trust for the bene?t of Michael Taylor, Don Taylor, Trustee AIM Investment Holdings, LLC Air Three, LLC Akron Legacy Real Estate Development, LLC Athletic Club Construction, LLC Cleveland Athletic Club, LLC Cleveland Euclid Hotel Associates LLC Cleveland-Massillon Professional Center, LLC Eagle Ford Oil Company, Inc. (rescinded ownership 697/16) Environments 4 Business, LLC Greystone Partners. LLC Hamilton Legacy, LLC Historic Journal News LLC Historic Port Clinton City Hall, LLC Historic Robinson Schwenn, LLC Advisory Group, LLC IWP Bloomington. LLC IWP New Albany, LLC IWP New Albany Investment, LLC IWP Rootstown, LLC IWP Rootstown Investment, LLC Massillon Senior Living, Ltd. Millcraft-Welty Construction Company, LLC (entity dissolved as of 3l9117) MJM Holdings, Inc. North Street, LLC O.A.P.O.. LLC Private Jets, LLC Ridgewood Road Properties. LLC Strategic Thinking Technologies LLC Settler?s Point Associates, LLC Weltleoldt, LLC Weltyfi'ri-C NEOMED. L.L.C. Welly Building Company, LLC of North Carolina Welty Building Company, Ltd. Welty Construction Company, LLC (formerly known as Burn Construction Company, LLC) Welty Energy Infrastructure, LLC (formerly known as Weity Power Services, LLC) Welty PA, LLC Welty Shared Services. LLC Welty-Testa Builders. LLC Whitestone Cleveland LLC White Pond Investments, LLC MARY TAYLOR OHIO LIEUTENANT GOVERNOR OHIO ETHICS COMMISSION 2016 FINANCIAL DISCLOSURE STATEMENT ADDENDUM 8. INVESTMENTS OVER $1,000: Corporation, Etc. Nature of Investment Merrill Brokerage Account Cohen Steers Select Fund Columbia Larke Cap Fund Eaton Vanace Tax Managed Fund EQT Corp Janus Forty Fund Class Victory RS Select Growth Fund Merrill IRA Bank of America Money Market American Growth Fund of America Class American Euro Paci?c Growth Fund Class American Investment Company of America Class Blackrock Global Allocation Fund Class Fidelity Advisor Small Cap Value Class Hartford Equity Income Fund Loomis Sayles Strategic Income Fund Class Pimco Total Return Fund Class RS Select Growth Fund Class MARY TAYLOR OHIO LIEUTENANT GOVERNOR OHIO ETHICS COMMISSION 2016 FINANCIAL DISCLOSURE STATEMENT ADDENDUM 11. TRAVEL EXPENSES: Source of Travel Expenses Amount Ohio Department of Insurance $344.20 Ohio Department of Insurance $58.10 Ohio Department of Insurance $582.20 Ohio Department of Insurance $238.26 Ohio Department of Insurance $201.73 Ohio Department of Insurance $145.45