Form No. COMMISSION FINANCIAL DISCLOSURE STATEMENT This statement is to be filed in 2018 Financial information for calendar year 2017 Piease type or print ciearly. See instructions for assistance with this page. A. PERSONAL CONTACT INFORMATION Last Name First Name I Ml_ Randazzo Samuel B. STATUS (Check all that apply) i30R USE ONLY [3 Candidate CANDIDATES: Please list the date of Write-in Candidate the first eiection (primary, special, or to an Of?ce general) when your name wili appear onlme Appointed to an unexpired on the banot term in elective office 8 Public Otficiai Month Dav Year 1:44 PM Public Em lo ee Voluntarypm; Other 2018 Confirrn 1302182744196 -- C. PUBLIC OFFICE, OR JOB Position/Titie (Example: councii merriber, sheriff, board member, or job title) Ci Seeking Board Member HOid Held Public Entity you serve in 2018, served in 2017, or serve it eiected Public Utilities Commission of Ohio Nominating Council Public Saiary: Start Date: End Date: El Uncompensated Month Day Year Month Day Year Less than $16,000 $16,000 or more D. ADDITIONAL PUBLIC OFFICE, 0R JOB Position/Titie (Example: councii member, sheriff, board member, orjob title) Ci Seeking Ci Hoid Ci Held Public Entity you serve in 2018, served in 2017, or serve it eiected Public Saiary: Start Date: End Date: Uncompensated Month Day Year Month Day Year Less than $16,000 [3 $16,000 or more SOR COMMISSION USE ONLY Walkwin Filer has answered every required question. Date incompiete torrn El Inter Office Filer has not answered these questions: returned to ?ler; El No Check Date completed form Rev'd by: returned to OEC: Page 1 of 4 I. SOURCES Oi: INCOME - MUST ANSWER THIS QUESTION: (For heip, see instructions page 5i) I have no sources of income that I am required to iist. Source of income Service Provided ($323322) A Waliace Nuriok LLC legal services/management Administration Company management Sustainability Funding Alliance of Ohio management Chase Bank] Huntington interest Check instructions to see whether you are required to disclose amounts of income. 2. SOURCES Oi: GIFTS - ALL FILERS MUST ANSWER THIS oursnon: (For heip, see instructions page 5) I have no sources of gifts that i am required to list. Source of Gift Source of Gift A 3. NAMES OF SPOUSE IN HOUSEHOLD AND ANY DEPENDENT CHILDREN - ALL MUST ANSWER QUESTION: There are no immediate famiiy members whose names I am required to list. (For heir), see instructions range S) Spouse Residing in Household Dependent Children Carol D. Farmer Dependent Children 4. OF BUSINESSES - MUST ANSWIER THIS (For heip, see instructions gage S) if you or anyone you listed in Question 3 owns or operates a business, iist the name of the business. There are no business names that I am required to list. Business Name Business Name A MoNees Waliace Nurick Sustainability Funding Alliance of Ohio Administration Company 5. LAND (REAL ESTATE) iN - ALL MUST ANSWER QUESTION: (For heip, see instructions ridge 6) I have no reai estate that I am required to list. Land (Real Estate) in Ohio (List address or, if address is unavailabie, plat number and county) A 1725 Gerrard Avenue, Coiurnbus, OH 43212 1788 W. Third, Columbus, OH 43212 465 S. Grant Avenue, Columbus, OH 43206 You are not required to disciose your personai residence or real property held primarily for personal recreation. Page 2 of 4 6. CREDITORS OVER $1,000 - FitERs MUST ANSWER THIS QUESTION: (For heig, see instructions page g) I have no creditors that I am required to iist. Creditor Creditor A 7. DEBTORS OVER $1,000 - MUST ANSWER THIS QUESTION: (For heip, see instructions tinge 6) have no debtors that I am required to list. Debtor Debtor A 8. INVESTMENTS OVER $1,000 - AEL FILERS ANSWER ?nits (For help, see instructions page a and l:l I have no investments that I am required to list. Corporation, Trust, Business Trust, Partnership, or Association Nature of investment A iEU?Ohio Administration Company Owner Sustainability Funding Alliance of Ohio Owner Moniees Waliace Nurici< LLC Senior Counsel E. iF YOU NEED SPACE, A SEPARATE SHEET. 9. FIDUCIARY RELATIONSHIPS - ALL MUST ANSWER THIS QUESTION: (For heip, see instructions page 8) l] I have no offices or fiduciary relationships that I am required to list. Corporation, Trust, Business Trust, Partnership, or Association Office or Nature of Relationship A industrial Energy Users-Ohio General Counsei SKIP QUESTIONS 30 AND 11 iF YOU ARE ONLY REQUIRED TO FELE AS A: - Coliege or university trustee 0 Candidate for a city, township, school district, or ESC position that is paid less than $16,000 a year - City, township, school district, ESC, or sanitary district official or employee serving in a position that is paid iess than $16,000 a year FOOD OR BEVERAGES - ALL EXCEPT THOSE LISTED IN THE BOX ABOVE MUST ANSWER QUESTION: I have no sources Of meais, 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 Page 3 of 4 11. TRAVEL EXPENSES - ALL FILERS EXCEPT THOSE LISTED IN THE BOX ON PAGE 3 MUST ANSWER Ti-liS QUESTION: I have no sources of travel expenses that I am required to list. (For heip, see instructions gage a) Source of Travel Expenses Amount A 12. NON-DISPUTED INFORMATION - 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 gage s) Non-Disputed Information 13. SIGNATURE - MUST SIGN (For heip, see instructions gage 10) By signing this statement: 0 i 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 ali 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 penaities, knowingly filing a false statement is a criminal misdemeanor of the first degree, in vioiation of Sections 1.0202(0) 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 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 2017, 3 served in, or in 2018, 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 apnronriate deadiine be assessed a iate filing fee and may be subject to criminal penaky. Deliver compietecl statement to: Ohio Ethics Commission, 30 W. Spring St., L3, Columbus, Oi-i 43215 My filing fee is: (For heip, see instructions gage 2) C) Enciosed (check or rnoney order payable to "Ohio Ethics Commission") Cl Submitted Online E) Included in my attorney registration fees (Judges, Magistrates, and iudicial Candidates Only) My public agency is required or has agreed to pay my filing fee. YOUR SIGNATURE Is REQUIRED HERE: SW 0' Date: 2/19/20i8 1:44 PM Confirmation Number: 1302182744196 Rev_ 1-2018 Page 4 of 4