Business Interests

Full Name

Email

Are You An Owner, Or Partial Owner, In Any Businesses? *

Yes

No

How Many Business Interests?

1

2

3

4

5

6

7

8

9

10

Business Interest #1 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

Business Interest #2 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

Business Interest #3 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

Business Interest #4 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

Business Interest #5 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

Business Interest #6 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

Business Interest #7 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

Business Interest #8 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

Business Interest #9 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

Business Interest #10 Details

Who Holds the Interest *

Ownership Interest % *

Estimated Value *

$

By checking this box, I confirm I have no further Business Interests to Submit. *

Yes

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