6: OFFICER OR DIRECTOR
7: AGENT, & REP. SPOKESPERSON
Non-Commercial Real Estate. List the specific location of Wisconsin real estate in which you or
your family had an interest (except your principal residence and real estate already listed in question
2).
List: real estate you or your family owned directly or through a partnership, corporation, trust or other
enterprise.
Do not list: your principal residence unless it was used to conduct business or for rental purposes, or
real estate for which you provided the location under question 2.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Location of Property
Municipality or town
County
State
Nature of interest
Officers and Directors. List organizations of which you or a family member was an officer or
director (unless already listed in question 2).
List: each business, labor union, association, cooperative, or other organization of which you or a
family member was an officer or director.
Do not list: charitable organizations (entities to which a contribution is tax deductible), political
organizations (entities whose primary purpose is to influence voting), non-profit social or community
service organizations, trusts, or federal/state/local governments or governmental agencies.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Business or Organization
City
State
Position
Agent, Representative or Spokesperson. List each organization that authorized you or a family
member to represent it in its dealings with others as an attorney-at-law, agent, spokesperson, or
representative (unless already listed in question 2, 3, or 6).
List: each business, labor union, association, cooperative, partnership, or other organization
for which you or a family member was an authorized representative or legal agent; in the case of a
lawyer, business clients for which you or a family member was authorized to provide representation
in dealing with other parties or before a tribunal.
Do not list: employers listed in Item 9, businesses you listed in Item 2 as having a 10 percent or
greater interest, individuals, charitable organizations (entities to which a contribution is tax
deductible), political organizations (entities whose primary purpose is to influence voting), non-profit
social or community service organizations, trusts, federal/state/local governments or
governmental agencies, and organizations for which your efforts or those of a family member did not
include representation to third parties (in the case of a lawyer).
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
Statement of Economic Interests — Maria S. Lazar, Calendar Year 2014 (2015)
Personal Finances
Document text (pages 101–112 of 112)
8: CREDITOR
9: EMPLOYERS
10: ADDITIONAL SOURCES OF INCOME
as of 12/31 of the previous calendar year.
#
Business or Organization
City
State
Creditors. List creditors to which you or your family owed $5,000 or more.
Include: each creditor (for personal and business debts) if you or a family member was personally
liable for the debt, and your portion of any partnership debts. Common examples include mortgages,
auto loans, student loans, and credit card debt.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Ceditor
City
State
$5,000 to $50,000
More Than $50,000
1
Honda Financial Services
Torrance
CA
2
Wells Fargo Home Mortgage
Carol Stream
IL
Information covers entire calendar year of 2024
Employers. List your and your family's employers, or other sources of income ($1,000 or more of
income) in the previous calendar year.
List: each employer from which you or a family member received income of $1,000 or more during the
year; the office or department (if a State of Wisconsin employee).
Do not list: an individual (unless the individual was a lobbyist or acting on behalf of an organization).
Please ensure you include your employment with the State of Wisconsin, if you were paid at least
$1,000 from the State of Wisconsin in the previous calendar year
Information in the section must cover the entire previous calendar year.
#
Name of Business
City
State
Nature of Business
1
Photography by Tom Lazar
Brookfield
WI
Photographer
2
State of Wisconsin
Waukesha
Wisconsin
District 2 Court of Appeals
List other sources from which you or your family received income of $1,000 or more in the previous
calendar year.
List: Social Security payments; an entity from which you or your family received retirement
benefits; an entity from which you or your family received directors fees; in the case of a fee or
11: ENTERTAINMENT AND GIFTS
12: HONORARIUM EXPENSES
STATEMENT OF SPOUSAL NON-DISCLOSURE ATTACHMENT
commission, both a third-party payer as well as your customer, client, or tenant; an entity that
purchased real estate from you or your family; an entity that furnished you or your family
honoraria not reported in question 12; any source of income not listed in question 2 or 9
Do not list: the source of dividends or interest; the source of insurance benefits, inheritances,
scholarships (if no teaching or services were required in return); the purchaser of securities unless
you know the purchaser's identity; an individual (unless the individual was a lobbyist or acting on
behalf of a business or organization).
Information in the section must cover the entire previous calendar year.
#
Source of Income
City
State
List individuals and organizations that provided you with entertainment or gifts (more than $50 in the
aggregate) in the previous calendar year.
Do not list: gifts received by family members if they were not intended for you; gifts from your spouse,
child, parent, brother, sister, grandchild, grandparent, aunt, uncle, niece, nephew, fiancé(e), parent-
in-law, grandparent-in-law, brother-inlaw, or sister-in-law.
Information in the section must cover the entire previous calendar year.
#
Name of Provider
City
State
List, for the previous calendar year, sources of honoraria and payment of expenses related to your
state government duties (more than $50 in the aggregate) not previously reported to the Wisconsin
Ethics Commission.
List: each individual or organization from which you received lodging, transportation, meals,
expenses, or honoraria having a total value of more than $50, for attendance at a
conference, presentation of a talk, participation in a meeting, or for a published work about issues
initiated by or affecting state government or state agencies.
Do not list: information about lodging, transportation, meals, money or any other thing of pecuniary
value: (1) if you returned it within 30 days; (2) if you received it from the agency of which your state
public office is a part; (3) if you received it from a source already listed in question 2, 9, or 10; (4) if
you already reported the payment to the Wisconsin Ethics Commission as a matter of public record.
Information in the section must cover the entire previous calendar year.
You must put a value in both the expenses and honoraria fields. The expenses value covers the
receipt of or reimbursement for actual expenses. The honorarium value is the total amount received,
including the expenses and any other compensation received.
# Payer
Expenses
Value
Honorarium
Amount
Circumstances of receipt
1
National Foundation
for Judicial
Excellence
$500.00
$1,412.22
This was for attendance at the 20th Annual Judicial Symposium in Washington, D.C. The NFJE
reimbursed me for up to $500 of my airfare; it also paid for my hotel stay (est. $ 612.22) and meals
(est. $250-300).
ADDITIONAL DOCUMENTS
Click any documents below to open
Click any documents below to open
(You must check this checkbox and click Submit to file your SEI).
I have read the accompanying instructions and certify:
Due Date: 4/30/2025
Certified Date: 3/26/2025
Amend Date: 1/2/2026
I have read the accompanying instructions and certify that the information contained in this Statement of Economic Interests
is true, complete, and correct to the best of my knowledge, information, and belief. In the event this Statement of Economic
Interests is filed prior to December 31st for the following calendar year, I certify that I will amend it on or before the statutory
filing deadline to accurately reflect my economic interests as of December 31st. If any part has been left blank, I have done
so intentionally because there is nothing to report.
The information sought in this form is required by Wis. Stat. §§ 19.43 and 19.44, or Supreme Court Rule 60.05. Failure to file
a completed form may result in a forfeiture of up to $500. Statements of Economic Interests are open for public inspection.
The Wisconsin Ethics Commission will notify you of the identity of any person who examines your Statement. In accordance
with Wis. Stat. § 15.04(1)(m), the Wisconsin Ethics Commission states that no personally identifiable information is likely to
be used for purposes other than those for which it is collected.
If Filing a paper copy please sign and date:
Signature: __________________________________________
Date : __________________________________________
Statement of Economic Interests
Filed in 2026 for calendar year 2025
Official Name: Lazar, Maria S.
Agency or Office: Court of Appeals
Position Title: Court of Appeals Judge-Candidate - District 02
Agency or Office: Supreme Court
Position Title: Justice-Candidate - Supreme Court Justice
In order to navigate the SEI form, use the green button at the bottom of the page to advance to the next
section. You can also use the green "go to sections" button at the top right to go directly to a particular
section.
If you were appointed or nominated to a new position or a new term of office since 12/31 of the
previous year, this section should be current as of your start date.
If you are a continuing official, this section should be current as of 12/31 of the previous year.
If you are leaving office, this section should be current as of your end date.
If you are a candidate, this section should be current as of 12/31 of the year before your election.
(Forms may not be filed before 12/1 of the year before your election.)
The information sought in this form is required by Wis. Stat. §§ 19.43 and 19.44, or Supreme Court Rule
60.05. Failure to file a completed form may result in a forfeiture of up to $500. Statements of Economic
Interests are open for public inspection. The Wisconsin Ethics Commission will notify you of the identity
of any person who examines your Statement. In accordance with Wis. Stat. § 15.04(1)(m), the Wisconsin
Ethics Commission states that no personally identifiable information is likely to be used for purposes
other than those for which it is collected.
Definitions:
"Family” or “family member” means your spouse, and any child, stepchild, parent, or parent-in-law
who receives more than one-half of his or her support from you or from whom you receive more than
one-half of your support.
"Income" means gross income before deductions and depreciation, from whatever source derived,
as defined by the Internal Revenue Code, but excludes dividends and interest.
A "lobbyist" is an individual who attempts to influence legislation or administrative rules in Wisconsin
by communicating with an elected state official, agency official, or legislative employee on another's
behalf for pay. For a list of current lobbyists, go to:
https://lobbying.wi.gov/Who/Lobbyists/2017REG/SearchNames.
If you need further assistance, please contact Ethics Commission Staff at 608-266-8123 or
[email protected].
1A: WISCONSIN DEFERRED COMPENSATION PROGRAM INVESTMENTS
Information current as of December 31, 2025
1B: OTHER INVESTMENTS
b) Other Investments. List stocks, bonds, limited partnerships, and Wisconsin governmental securities
in which you and your family's interest was valued at $5,000 or more. Please list securities by name (e.g.,
ABC Corporation, or Wisconsin Town Municipal Bond, April 2034). Do not just list the type of account or
the institution through which the investments are held (e.g., IRA, Merill Lynch account, etc.).
Include: stocks and stock options, commodity futures contracts, bonds, limited partnerships, securites
issued by the State of Wisconsin or by local government entities within Wisconsin, (include any of the
aforementioned investments held directly, or through a deferred compensation plan, profit-sharing plan,
or pension plan whose investments you or your family directs; in an individual retirement account (IRA);
in a trust you or a family member created or of which you or a family member have beneficial use; or held
for you by a corporation, partnership, or other entity which you or a family member controls).
DO NOT include: mutual funds, money market funds, exchange traded funds or notes, the Wisconsin
retirement system, savings accounts, checking accounts, certificates of deposit, annuities, insurance
contracts, securities issued by the federal goverment or a government outside Wisconsin, securities
issued by an organization that does not do any business in Wisconsin, investments held by you or your
family whose total interest is valued less than $5,000.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current as
of 12/31 of the previous calendar year.
PLEASE NOTE - as of April 17, 2022, the SEI statute has changed. SEI filers no longer have to report
defined benefit retirement plans, annuities, money market funds, mutual funds, exchange-traded funds,
or exchange-traded notes. These options will still be visible on the 2022 SEI form. They have been
removed from the 2023 form, so sections 1A and 1B may look different from what you reported in
previous years. The Mutual Funds option will NOT be visible on the 2023 form.
a)Funds Available in Wisconsin Deferred Compensation Program. These funds are available
to participants in the Wisconsin Deferred Compensation program and many of them are also
available for direct purchase, independent of that program. If you held an investment of $5,000 or
more in any of these funds – either directly or through the program-- please check the appropriate
box. Please report other investments under the next question.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
If you do not hold, through the Wisconsin Deferred Compensation program or otherwise, at least
$5,000 in any of these three securities, this section can be left blank.
PLEASE NOTE - as of April 17, 2022, the SEI statute has changed. SEI filers no longer have to
report defined benefit retirement plans, annuities, money market funds, mutual funds, exchange-
traded funds, or exchange-traded notes. These options will still be visible on the 2022 SEI form.
These options are NOT visible on the 2023 form. All but 3 options have been removed from section
1A, so your 2023 SEI may look different from the form you filed in previous years.
Name of Security
None
$5,000 to $50,000
More Than $50,000
Stable Value
FDIC Bank Option
Name of Security
None
$5,000 to $50,000
More Than $50,000
Schwab PCRA
FIXED RETURNS FOR THE QUARTER
BROKERAGE FUNDS
WISCONSIN GOVERNMENTAL SECURITY
2: BUSINESS ACTIVITIES
Name of Security
None
$5,000 to $50,000
More Than $50,000
STOCK
Name of Security
None
$5,000 to $50,000
More Than $50,000
Home Depot (HD)
LIMITED PARTNERSHIP
Name of Security
None
$5,000 to $50,000
More Than $50,000
BOND
Name of Security
None
$5,000 to $50,000
More Than $50,000
OTHER
Name of Security
None
$5,000 to $50,000
More Than $50,000
List businesses, farms, rental, commercial, and income-producing real estate; and business activities
in which you or your family had at least a 10% or greater interest.
a) Enterprises operating under a business or trade name:
List the name of each business; farm; and rental, commercial and income-producing real estate that
operated under a business name.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Name of Business
Nature of Business
City
County
State
1
Photography by Tom Lazar
Artist/photographer
Brookfield
Waukesha
WI
List businesses, farms, rental, commercial, and income-producing real estate; and business activities
in which you or your family had at least a 10% or greater interest.
b) Enterprises not operating under a business or trade name: If no business or trade name, list
the address or fire number where the enterprise is located.
If you or a family member owned rental or other income-producing real estate, but did not
operate under a business name, list the street address or fire number, municipality or town,
county, and state of the real estate, and describe the nature of the business.
If you or a family member was self-employed, but did not operate under a business name, list
the street address or fire number, municipality or town, county, and state of the real estate, and
describe the nature of the business.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Name of Business
Nature of Business
City
County
State
3: BUSINESS PARTNERS
4: COMMERCIAL CUSTOMERS,CLIENTS,AND TENANTS
5: NON-COMMERCIAL REAL ESTATE
Business Partners. For each enterprise reported under question 2, list its co-owners, partners,
officers, and directors (other than yourself), unless the information is already registered with the
Wisconsin Department of Financial Institutions.
If you need to edit the name of the business, make changes in question 2.
List separately for each business the names and locations:
for a general partnership, its partners
for a corporation not registered to do business in Wisconsin, its officers and directors
for a limited partnership not registered to do business in Wisconsin, its general partners
Do not list:
information for a limited partnership created or registered in Wisconsin
information for a corporation created or registered in Wisconsin
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Name of Business
Partners,or Officers and Directors
City
State
Commercial Customers, Clients, and Tenants. For each unincorporated business, subchapter S
corporation, service corporation (SC), limited liability company (LLC), partnership, or income-
producing real estate reported in question 2 from which the filer or a member of the filer's immediate
family received $10,000 or more in the previous calendar year, list businesses, organizations, and
lobbyists that paid the enterprise $10,000 or more in the previous calendar year.
Please also indicate if an organization listed authorized you to represent it in its dealings with others
as an attorney-at-law, agent, spokesperson, or representative.
List: both a third-party payer as well as the customer, client, or tenant if the business received income
from a third-party payer (such as a fee, commission, or insurance payment received by a realtor,
travel agent, or medical practice)
Do not list: an individual (unless the individual was a lobbyist or acting on behalf of a business or
organization), or a decedent's estate
Information in the section must cover the entire previous calendar year.
#
Name of Customers
City
State
Spokesperson
Non-Commercial Real Estate. List the specific location of Wisconsin real estate in which you or
your family had an interest (except your principal residence and real estate already listed in question
2).
List: real estate you or your family owned directly or through a partnership, corporation, trust or other
enterprise.
Do not list: your principal residence unless it was used to conduct business or for rental purposes, or
6: OFFICER OR DIRECTOR
7: AGENT, & REP. SPOKESPERSON
real estate for which you provided the location under question 2.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Location of Property
Municipality or town
County
State
Nature of interest
Officers and Directors. List organizations of which you or a family member was an officer or
director (unless already listed in question 2).
List: each business, labor union, association, cooperative, or other organization of which you or a
family member was an officer or director.
Do not list: charitable organizations (entities to which a contribution is tax deductible), political
organizations (entities whose primary purpose is to influence voting), non-profit social or community
service organizations, trusts, or federal/state/local governments or governmental agencies.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Business or Organization
City
State
Position
Agent, Representative or Spokesperson. List each organization that authorized you or a family
member to represent it in its dealings with others as an attorney-at-law, agent, spokesperson, or
representative (unless already listed in question 2, 3, or 6).
List: each business, labor union, association, cooperative, partnership, or other organization
for which you or a family member was an authorized representative or legal agent; in the case of a
lawyer, business clients for which you or a family member was authorized to provide representation
in dealing with other parties or before a tribunal.
Do not list: employers listed in Item 9, businesses you listed in Item 2 as having a 10 percent or
greater interest, individuals, charitable organizations (entities to which a contribution is tax
deductible), political organizations (entities whose primary purpose is to influence voting), non-profit
social or community service organizations, trusts, federal/state/local governments or
governmental agencies, and organizations for which your efforts or those of a family member did not
include representation to third parties (in the case of a lawyer).
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Business or Organization
City
State
8: CREDITOR
9: EMPLOYERS
10: ADDITIONAL SOURCES OF INCOME
Creditors. List creditors to which you or your family owed $5,000 or more.
Include: each creditor (for personal and business debts) if you or a family member was personally
liable for the debt, and your portion of any partnership debts. Common examples include mortgages,
auto loans, student loans, and credit card debt.
For new officials, information in this section must be current as of the new official's start date
or nomination date. For officials who are leaving state service, this section must be current as of the
date the official left office. For candidates, or officials filing an annual SEI, the section must be current
as of 12/31 of the previous calendar year.
#
Ceditor
City
State
$5,000 to $50,000
More Than $50,000
1
Carmax Auto Finance
Kennesaw
GA
2
Wells Fargo Home Mortgage
Carol Stream
IL
Information covers entire calendar year of 2025
Employers. List your and your family's employers, or other sources of income ($1,000 or more of
income) in the previous calendar year.
List: each employer from which you or a family member received income of $1,000 or more during the
year; the office or department (if a State of Wisconsin employee).
Do not list: an individual (unless the individual was a lobbyist or acting on behalf of an organization).
Please ensure you include your employment with the State of Wisconsin, if you were paid at least
$1,000 from the State of Wisconsin in the previous calendar year
Information in the section must cover the entire previous calendar year.
#
Name of Business
City
State
Nature of Business
1
Matthew Bender
New York
New York
Editing Wisconsin Criminal Law Text
2
Photography by Tom Lazar
Brookfield
WI
Photographer
3
State of Wisconsin
Madison
WI
District 2 Court of Appeals
List other sources from which you or your family received income of $1,000 or more in the previous
calendar year.
List: Social Security payments; an entity from which you or your family received retirement
benefits; an entity from which you or your family received directors fees; in the case of a fee or
commission, both a third-party payer as well as your customer, client, or tenant; an entity that
purchased real estate from you or your family; an entity that furnished you or your family
honoraria not reported in question 12; any source of income not listed in question 2 or 9
Do not list: the source of dividends or interest; the source of insurance benefits, inheritances,
scholarships (if no teaching or services were required in return); the purchaser of securities unless
you know the purchaser's identity; an individual (unless the individual was a lobbyist or acting on
behalf of a business or organization).
11: ENTERTAINMENT AND GIFTS
12: HONORARIUM EXPENSES
STATEMENT OF SPOUSAL NON-DISCLOSURE ATTACHMENT
Information in the section must cover the entire previous calendar year.
#
Source of Income
City
State
List individuals and organizations that provided you with entertainment or gifts (more than $50 in the
aggregate) in the previous calendar year.
Do not list: gifts received by family members if they were not intended for you; gifts from your spouse,
child, parent, brother, sister, grandchild, grandparent, aunt, uncle, niece, nephew, fiancé(e), parent-
in-law, grandparent-in-law, brother-inlaw, or sister-in-law.
Information in the section must cover the entire previous calendar year.
#
Name of Provider
City
State
List, for the previous calendar year, sources of honoraria and payment of expenses related to your
state government duties (more than $50 in the aggregate) not previously reported to the Wisconsin
Ethics Commission.
List: each individual or organization from which you received lodging, transportation, meals,
expenses, or honoraria having a total value of more than $50, for attendance at a
conference, presentation of a talk, participation in a meeting, or for a published work about issues
initiated by or affecting state government or state agencies.
Do not list: information about lodging, transportation, meals, money or any other thing of pecuniary
value: (1) if you returned it within 30 days; (2) if you received it from the agency of which your state
public office is a part; (3) if you received it from a source already listed in question 2, 9, or 10; (4) if
you already reported the payment to the Wisconsin Ethics Commission as a matter of public record.
Information in the section must cover the entire previous calendar year.
You must put a value in both the expenses and honoraria fields. The expenses value covers the
receipt of or reimbursement for actual expenses. The honorarium value is the total amount received,
including the expenses and any other compensation received.
# Payer
Expenses
Value
Honorarium
Amount
Circumstances of receipt
1 Federalist
Society
$494.00
$609.00
I received reimbursement for actual travel expenses of $494. The $609 honorarium amount includes those
travel expenses and also includes the hotel and food charges that were paid by the organization. I was a
presenter on Wisconsin State Supreme Court opinions and constitutional issues at the Midwestern State
Court Roundup Presentation at the Midwestern Conference in Detroit, MI on June 20, 2025. I was reimbursed
for my travel expenses only.
2
National
Civil
Justice
Institute
$522.00
$1,827.00
I received reimbursement for actual travel expenses of $522. The $1,827 honorarium amount includes those
travel expenses and also includes the hotel and food charges that were paid by the organization. Attendance
at the 2025 Judges Forum for State Appellate Court Judges: Judicial Interpretation and Precedent: The Vital
Role of State Courts in San Francisco, CA put on by the National Civil Justice Institute July 18-20, 2025. I was
reimbursed for my travel expenses; the NCJI paid for the hotel room at the conference facility, food and
beverages, and estimated a $200 expense for the educational program.
ADDITIONAL DOCUMENTS
Click any documents below to open
Click any documents below to open
(You must check this checkbox and click Submit to file your SEI).
I have read the accompanying instructions and certify:
Due Date: 1/9/2026
Certified Date: 1/2/2026
I have read the accompanying instructions and certify that the information contained in this Statement of Economic Interests
is true, complete, and correct to the best of my knowledge, information, and belief. In the event this Statement of Economic
Interests is filed prior to December 31st for the following calendar year, I certify that I will amend it on or before the statutory
filing deadline to accurately reflect my economic interests as of December 31st. If any part has been left blank, I have done
so intentionally because there is nothing to report.
The information sought in this form is required by Wis. Stat. §§ 19.43 and 19.44, or Supreme Court Rule 60.05. Failure to file
a completed form may result in a forfeiture of up to $500. Statements of Economic Interests are open for public inspection.
The Wisconsin Ethics Commission will notify you of the identity of any person who examines your Statement. In accordance
with Wis. Stat. § 15.04(1)(m), the Wisconsin Ethics Commission states that no personally identifiable information is likely to
be used for purposes other than those for which it is collected.
If Filing a paper copy please sign and date:
Signature: __________________________________________
Date : __________________________________________