Form No. OEC-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 . for assistance with this page. SECTION A. PERSONAL CONTACT INFORMATION Last Name First Name MI Whaley Nannette SECTION B. STATUS (Check all that apply) FOR OFFICIAL USE ONLY If] Candidate CANDIDATES: Please list the date of Write-in Candidate the first election (primary, special, or FILE Elected to an office general) when your name will appear Online Appointed to an unexpired on the ballot. term in elective office 5/1 3/201 7 Ll Public Official Month Dav Year 10:02 AM i i Public 2?17 Confirm 1005174402132 Voluntary Filer Other SECTION C. PUBLIC POSITION, OFFICE, OR JOB Position/Title (Example: council member, sheriff, board member, orjob title) i Seeking Mayor ?Old Held Public Entity you serve in 2017, served in 2016, or will serve if elected Dayton Public Salary: Start Date: End Date: i i Uncompensated Month Day Year Month Day Year ULessthan$16,000 01062014 01082018 i?i $16,000 or more SECTION 0. ADDITIONAL PUBLIC POSITION, OFFICE, OR JOB Position/Title (Example: council member, sheriff, board member, orjob title) Seeking 7 Hold T. Held Public Entity you serve in 2017, served in 2016, or will serve if elected Public Salary: Start Date: End Date: Li Uncompensated Month Day Year Month Day Year Less than $16,000 l:l $16,000 or more FOR OHIO ETHICS COMMISSION USE ONLY Walk-in Filer has answered every required question. Date incomplete form Inter Office Filer has not answered these questions: returned to filer: Ci No Check Date completed form Rev'd by: returned to OEC: Page 1 of 4 I. SOURCES OF INCOME - ALL MUST ANSWER rHis QUESTION: have no sources of income that I am required to list. (For heir), see instructions page 5i) Source of income Amount* Service Provided (if required) City of Dayton Commissioner A EUE-CWA Veba Trustee Check instructions to see whether you are required to disclose amounts of income. 2. SOURCES OF GEFTS - ALL FILERS MUST ANSWER THIS have no sources of gifts that I am required to list. (For heEp, see instructions page 5) Source of Gift Source of Gift A Virginia and Dan Genres Russ and Katie Joseph Jon and Diana Sebaly 3. NAMES 0F SPOUSE RESIDING IN HOUSEHOLD AND ANY DEPENDENT CHILDREN - ALL FILERS MUST ANSWER TI-rls QUESTION: There are no immediate family members whose names I am required to list. Spouse Residing in Househoid Sam Braun Dependent Children 4. NAMES OF BUSINESSES - ALI. FILERS MUST ANSWER THES (For heir), see instructions page E3) Dependent Chitdren (For heirs, see instructions page if you or anyone you listed in Question 3 owns or operates a business, Eist the name of the business. There are no business names that I am required to list. Business Name Business Name 5. LAND (REAL ESTATE) IN OHIO - ALL FILERS MUST ANSWER QUESTEON: have no reai estate that I am required to list. (For heir), see instructions page Land (Real Estate) in Ohio (List address or, if address is unavailabie, plat number and county) You are not required to disciose your personai residence or real property held primariiy for personal recreation. Page 2 of4 6. CREDITORS OVER $1,000 - ALL FILERS MUST ANSWER THIS QUESTION: (For heip, see instructions page 6) I have no creditors that I am required to list. Creditor Creditor A CODE Credit Union Macy's Saliie Mae Servicing Universal Credit Card 7. DEBTORS OVER $1,000 - ALE. FILERS MUST ANSWER THIS QUESTION: (For hein, see instructions page a) I have no debtors that I am required to list. Debtor Debtor A 8. ENVESTMENTS OVER 51,000 - ALI. FELERS MUST ANSWER THIS QUESTION: (For help, see instructions page and I have no investments that I am required to list. Corporation, Trust, Business Trust, Partnership, or Association Nature of investment A Ohio Deferred Compensation 401 Account Ohio PERS Pension IF YOU NEED SPACE, PLEASE ATTACH A SEPARATE 9. RELATIONSHIPS - ALL FILERS MUST ANSWER Ti?ils (For heip, see instructions page a) I have no offices or fiduciary relationships that i am required to list. Corporation, Trust, Business Trost, Partnership, or Association Office or Nature of Relationship A IUE-CWA VEBA Trustee SKIP QUESTIONS CEO AN9 11 IF YOU ARE ONLY REQUIRED TO FILE AS A: - Coliege or university trustee - City, township, school district, ESC, or sanitary district 0 Candidate for a city, township, school district, or ESC official or employee serving in a position that is paid position that is paid less than $16,000 a year iess than $16,000 a year 10. FOOD OR BEVERAGES - ALL FILERS EXCEPT THOSE LISTED IN THE BOX ABOVE MUST ANSWER THIS QUESTION: I have no sources of meals, food, or beverages that I am required to list. (For heip, see instructions page 8) Source of Food or Beverages Source of Food or Beverages A City of Dayton, Ohio Page 3 of4 11. TRAVEL EXPENSES - ALL FILERS EXCEPT THOSE LISTED rN THE BOX 0N PAGE 3 MUST ANSWER Ti-iiS QUESTION: I have no sources of travel expenses that I am required to list. (For heip, see instructions page a) Source of Travel Expenses Amount A Atlantic $470.70 City of Dayton $434.17 City of Dayton $270.18 City of Dayton $1,763.20 City of Dayton $79.50 American lnstutute of Architects $550.64 12. NON-DISPUTED INFORMATEON - ALL state empioyees, state officials and state board and commission members (except college and university trustees) are REQUERED to answer Question 12. Ali other fiiers should skip this question and go to question 13. have no information that I am required to list. (For heip, see instructions page a) Non-Disputed Information t3. SIGNATURE - ALL FILERS MUST SIGN ?rt?it (For heip, see instructions page 1.0) By signing this statement: 0 swear or affirm that this statement and any additional attachments have been prepared or carefuliy reviewed by me, and constitute my complete, truthfui, and correct disclosure of all required information, and that the address listed on page 1 is a correct address. 0 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. - acknowledge and understand that a faise statement may be grounds for removal from public office or dismissal from public employment pursuant to Sections 3.04 and 124.34 of the Revised Code. 0 i acknowledge that, in 2016, 3 served in, or in 2017, i am 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 iist 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 faiis to file a complete statement by the appropriate fiting deadline wilt be assessed a iate filing fee and may be subject to criminal penany. Deliver compieted statement to: Ohio Ethics Commission, 30 W. Spring St., L3, Columbus, OH 43215 My filing fee is: (For heip, see instructions page 2) Enciosed (check or money order payable to ?Ohio Ethics Commission") Submitted Online included in my attorney registration fees (iudges, Magistrates, and judicial Candidates Only) My public agency is required or has agreed to pay my filing fee. YOUR SEGNATURE Is REQUIRED HERE: NW WW Date: 5/13/2017 10:02 AM Confirmation Number: 1005174402132 Rev, 01-2017 Page 4 of 4