Statement of Economic Interests

STATEMENT OF ECONOMIC INTERESTS
      
Staff Name: Janice
Date Received:04/30/14

Filing Year: 2012    Submit Date: 4/30/2014 12:56:57 PM

Candidate
   CANDIDATE:   No   FOR OFFICE IN  CITY     COUNTY     AL  STATE
 FOR OFFICE OF 

Law Enforcement
 
Law Enforcement:   Judge - Any Level:   District Attorney/Assistant or Deputy DA/DA Investigator:
 
Attorney General/AG Attorney, Special Agent/Investigator:   Post Certified Law Enforcement Officers:

01.   Full Name, Home Address, and Telephone Number(s) of Filing Person:
First Name: Clyde Business Phone:
205-391-2461
Middle Name: Michael
  Last Name: Fields   Suffix:
  Nickname: Mike


PLEASE FILL IN THE BLANKS OR CHECK ON THE CORRECT WORD(S) OR NUMBER(S) AS APPROPRIATE
              
02. Last year, I was an ()  ()  () with the
()  () () and the name and address of my
()  ()  ()  ()  ()  () ()  () was

Name:     Shelton State Community College-Alabama State Port Authority
Address: 9500 Old Greensboro Road Tuscaloosa,AL35405-POBox 1588 Mobile,AL 36633
02.1 As an / / last year, my job title/position was  Job Placement Officer Director
02.2 Last year, the name(s) of the ()  ()  ()   
 , , ,  ,  , of which I was a Member was(were)  Alabama State Port Authority-West Alabama Regional Commission
02.3 Last year in the above public position(s) in 02. thru 02.2 I earned:  (More than $10,000)
03. Other than any public position(s) listed in 02. thru 02.2, list any occupation, employment or business
(including self-employment) where you or your spouse spent at least 1/3 of your or your spouse's working time:
Not Applicable
03.1 The name and address of my employer, listed in 03. above, was
Name:      Not Applicable
Address: Not Applicable
03.2 I was SELF-EMPLOYED last year and the NAME and ADDRESS of my business was
Name:      na
Address: na
03.3 From the occupations or businesses listed in 03., I, My Spouse and/or Dependents earned last year an aggregate of:
  Not Applicable
03.4 Last year, (  ()  () owned 5% or more of the stock in the firm(s) listed in (03.1 and/or 03.2)
Not Applicable
03.5 Last year, (  () () was a consultant and earned more than $1,000 from each firm listed in (03.1 and/or 03.2)
Not Applicable
03.6  Last year, (  () () served as an () () () of the firm(s) listed in (03.1
and/or 03.2)
Not Applicable
04. Information on Family Members:
Spouse Information:
Spouse Name Business or Employer
N.A. N.A.

  
Names Only of LIVING ADULT CHILDREN: Matt Fields
  
Names Only of LIVING PARENTS:
(No Maiden Names) 		na
  
Names Only of LIVING SISTERS/BROTHERS:
(No Maiden Names) 		Joan Boyles
  
Names Only of LIVING PARENTS OF SPOUSE:
(No Maiden Names) 		na

05. OTHER INCOME INFORMATION ON YOU, YOUR SPOUSE AND DEPENDENT CHILDREN
List total combined household income, in addition to what is listed in 02.3 thru 03.5, the names of each business income is derived from, and the income from each business.

Applicable
OTHER HOUSEHOLD INCOME: not reported in 03.-03.6. Provide the name(s) of each SOURCE(s) of incomeTYPE OF INCOME RECEIVED: Salary, Fees, Dividends, Profits, Commissions, Bank Interest, Other CompensationSelect Appropriate Income Amount
Alabama Power Co.retainer$10,000 - $50,000

05.1 Last year did you earn more than $5,000 as an: (Select the applicable one)
Not Applicable
05.2 Last year did you earn more than $1,000 but less than $5,000 as an:
(Select the applicable one)
Not Applicable
05.3 Last year, did YOU, YOUR SPOUSE or DEPENDENTS serve as:
(Select the applicable one)
Not Applicable


05.4 Name any business or subsidiary thereof in which YOU, YOUR SPOUSE, or DEPENDENTS, jointly or severally, owned 5% or
more of the stock or in which YOU, YOUR SPOUSE or DEPENDENTS served as an OFFICER, DIRECTOR, TRUSTEE, or CONSULTANT where the service provides income of at least $1,000 and less than $5,000; or at least $5,000 or more for the reporting period.
 Not Applicable
06. REAL ESTATE HOLDINGS (Exclude your Homestead) (TO BE COMPLETED ONLY BY ELECTED OFFICIALS,
APPOINTED OFFICIALS or CANDIDATES for State, County or Municipal Offices.)

Are you an ELECTED OFFICIAL, APPOINTED OFFICIAL or a CANDIDATE for State, County or Municipal Offices ?
 Yes
06.1 Did YOU, YOUR SPOUSE or DEPENDENTS own real estate for investment or revenue production last year?
No
  
If yes, list each piece of real estate wherever situated separately below and provide the requested information. 
06.2 Did YOU, YOUR SPOUSE OR DEPENDENTS or A BUSINESS WITH WHICH YOU ARE ASSOCIATED receive any rent or
lease income from any governmental agency in Alabama last year?
 No

If yes, specific details of the lease or rent agreement shall be filed with the Ethics Commission.


07. INDEBTEDNESS INFORMATION: Report debts owed to all businesses operating in Alabama**as of December 31, of the reporting year. Include debts for YOU, YOUR SPOUSE and DEPENDENT CHILDREN.
(**Doing business in Alabama, regardless of where their home office is located or where you mail your payment.) DO NOT INCLUDE indebtedness associated with HOMESTEAD - home in which you live.
Provide ACTUAL Number of Debts and Check Corresponding COMBINED Dollar Amount.
DO NOT list Debtor's Names or Accounts Numbers.
TYPE How many do you OWE? How much do you OWE?
(Select one that relates to the combined total in each category) 
07.1 BANKS (include Credit Cards)  1   Less than $25,000
07.2 CREDIT UNIONS and SAVINGS and LOAN ASSOCIATIONS (include Credit Cards)  2   $25,000 - $50,000
07.3 INSURANCE COMPANIES  0   Not Applicable
07.4 MORTGAGE FIRMS  0   Not Applicable
07.5 STOCKBROKERS or BOND FIRMS  0   Not Applicable
07.6 INDIVIDUALS or OTHER BUSINESS(ES) (include store cards)  0   Not Applicable
07.7 STUDENT LOANS  0   Not Applicable


08. PROFESSIONAL OR CONSULTING SERVICES: Complete tis Section ONLY if YOU or YOUR SPOUSE received income last year in return for professional or consulting activities.
State the NUMBER of CLIENTS and CHECK Corresponding Income and/or Retainer Income.)
 
Categories of ClientsNumber of ClientsAnnual Gross Income During Reporting YearAnticipated Annual Retainer Income
08.1 UTILITIES0Not ApplicableNot Applicable
Electric1$10,000 - $25,000Not Applicable
Gas0Not ApplicableNot Applicable
Telephone0Not ApplicableNot Applicable
Water0Not ApplicableNot Applicable
Cable Television0Not ApplicableNot Applicable
08.2 TRANSPORTATION0Not ApplicableNot Applicable
Intrastate Companies0Not ApplicableNot Applicable
Pipeline Companies0Not ApplicableNot Applicable
Oil Exploration0Not ApplicableNot Applicable
Gas Exploration0Not ApplicableNot Applicable
Oil and Gas Retailers0Not ApplicableNot Applicable
08.3 FINANCE and INSURANCE0Not ApplicableNot Applicable
Banks0Not ApplicableNot Applicable
Savings & Loan Associations0Not ApplicableNot Applicable
Loan and/or Finance Companies0Not ApplicableNot Applicable
Manufacturing Firms0Not ApplicableNot Applicable
Mining Companies0Not ApplicableNot Applicable
Life Insurance Companies0Not ApplicableNot Applicable
Casualty Insurance Companies0Not ApplicableNot Applicable
Other Insurance Companies0Not ApplicableNot Applicable
Retail Companies0Not ApplicableNot Applicable
Beer Companies0Not ApplicableNot Applicable
Wine Companies0Not ApplicableNot Applicable
Liquor Companies0Not ApplicableNot Applicable
Beverage Distributors0Not ApplicableNot Applicable
08.4 ASSOCIATIONS0Not ApplicableNot Applicable
Trade0Not ApplicableNot Applicable
Professional0Not ApplicableNot Applicable
Governmental0Not ApplicableNot Applicable
Public Employee0Not ApplicableNot Applicable
Public Official0Not ApplicableNot Applicable
08.5 GOVERNMENT0Not ApplicableNot Applicable
State0Not ApplicableNot Applicable
County0Not ApplicableNot Applicable
Municipal0Not ApplicableNot Applicable
Other Government Corp. Or Authorities0Not ApplicableNot Applicable
08.6 MISCELLANEOUS0Not ApplicableNot Applicable

09.  DECLARATION OF REPORTING PERSON
I have read and completed this Statement of Economic Interests Form and do swear (or affirm) that the information contained in said Statement of Economic Interests is true and correct. I fully understand that anyone who violates the disclosure provision of this Act shall be subject to a fine of $10.00 a day not to exceed $1,000 annually. I also understand that any attachments that I place with this form become a part of this public record.
PLEASE PRINT/TYPE NAME OF PERSON SIGNING FORM:
Fields, Clyde


    

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