The Law Requires:
Disclose each bank account, savings account, and insurance policy in which a direct financial interest was held that exceeds $24,000 at any time during the reporting period; each other item of intangible personal property in which a direct financial interest was held that exceeds $2,400 during the reporting period; the name, address, and nature of the entity; and the nature and highest value of each direct financial interest during the reporting period, RCW 42.17A.710(1)(b).
Explanation:
Bank Account Details (>$24,000)
In this section, report the name and address of each bank, savings and loan, credit union or other financial institution in which you or a qualified family member had an account over $24,000 at any time during the reporting period.
- Under "Held by," indicate whether the bank account is held by you, your spouse or registered domestic partner. If it is a joint account, you may check more than one box.
- Identify the type of account [savings, checking, sharedraft, certificate of deposit, individual retirement account (IRA) or KEOGH if managed by the bank], etc.;
- Use the range of values that reflects the account's highest value during the reporting period;
- Use the range of values to disclose how much income was generated by the account, if at least $2,400 in income was produced. If under $2,400 in income was generated, leave that field as "None."
Insurance Policy Details(>$24,000)
Give the name and address of each insurance company where you or a family member had a policy with a cash or loan value of over $24,000 during the reporting period. Do not report an insurance policy that had no cash or loan value in this section.
Identify
- Under "Held by," indicate whether the policy is held by you, your spouse or registered domestic partner. If it is a joint account, you may check more than one box.
- Identify the type of policy (life, disability, annuity, etc.);
- Indicate the highest value of the policy during the reporting period using the pop up list of value ranges and
- Use the value ranges to disclose how much income was produced, if at least $2,400 in income was generated by the policy. If under $2,400 in income, leave the word "None" under "Income from policy."
Investment Account Details(>$2,400)
Show the name of each company, partnership, corporation, association, government agency, etc., in which you or a family member had a financial interest worth over $2,400, including investments that were only held during a portion of the reporting period. Provide an address for investment holdings that are not listed on a major stock exchange.
This is the section in which you will show:
- Employer retirement system account (if you or a family member paid into an employer-sponsored retirement system, that retirement account is a reportable asset)
- IRA, if managed by an agent. List name of manager or management company that decides how IRA money is invested. If investor managed, list each holding worth over $2,400 in the Publicly Traded Stocks or the Self-directed Investment sections, which are after this one
- Money market accounts; if managed by an agent, list name of manager or management company that decides how money is invested. If investor managed, list each holding worth over $2,400 in the Publicly Traded Stocks or the Self directed investment sections, which are after this one.
Publicly Traded Stocks (>$2,400)
Use this section to report all publicly held stocks owned by you or a qualified family member at any time during the reporting period, if they were worth more than $2,400 at any time during the reporting period of your F-1. Report the stocks in a self-directed account here, but not the stocks in an account directed by an account manager - stocks in an investment account that is not self-directed are reported in the previous section, Investment Account Details.
Report:
- Held By - You, the filer, spouse or registered domestic partner, or dependent(s). Check more than one box if the stocks were jointly owned.
- Nature of holdings (retirement, personal or other)
- Ticker symbol, stock name, highest value during the reporting period, and income, if any, during the reporting period. Use the ranges of value given in the pop-up lists.
Self directed investments (> $2,400)
Use this section to report investments owned by you or a qualified family member at any time during the reporting period, if they were worth more than $2,400 at any time during the reporting period of your F-1. Report the investments in a self-directed account here, but not the investments in an account directed by an account manager - investments in an investment account that is not self-directed are reported in the previous section, Investment Account Details. Report publicly traded stocks on the previous screen.
- Non-publicly traded stocks, bonds, securities, commodities (list each holding separately if worth over $2,400 at any time during the reporting period; it's insufficient simply to identify the brokerage house)
- Stock options held or exercised during the reporting period -- report the value at grant date and if you exercised the option, the value exercised.
- Stock appreciation rights,
- Businesses in which you or your family had less than a 10% ownership interest (if 10% or more, these are reported in a later section, business interests)
For each item listed, you are requested to report:
- Under "Held by," indicate whether the policy is held by you, your spouse or registered domestic partner, or dependent(s). If it is owned jointly, you may check more than one box.
- Identify the investment name and address,
- Identify the investment type
- Indicate the highest value of the investment during the reporting period using the value ranges; and use the value ranges to disclose how much income was produced, if any.
Note: Each stock (if not publicly traded), bond and other intangible asset holding worth over $2,400 at any time during the reporting period, whether held for the entire reporting period or just a portion of it, must be reported in this section. If you sold an intangible asset during the period, simply select the range of amounts that reflects the sale price plus any other interest or dividend income generated by the asset and select it from the pop-up list in the section for income or value of stock option exercised.
Other Less common assets (>$2,400)
This is a section for reporting other assets not reported in other sections, such as:
- Loans owed you or a qualified family member by individuals, candidates, political committees, businesses, associations, churches, etc. (Do not include accounts receivable due in the normal course of business)
- Legal judgments due you or your family
- Educational investment accounts such as Washington Guaranteed Education Tuition accounts. Do not report scholarships or grants that may only be used for educational purposes.
For each asset
- Under "Held by," indicate whether the policy is held by you, your spouse or registered domestic partner, or dependent(s). If it is owned jointly, you may check more than one box.
- Identify the investment name and address,
- Identify the nature of the asset
- Indicate the highest value of the investment during the reporting period using the value ranges; and
- Use the value ranges to disclose how much income was drawn from the asset, if any.