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FORM 1 STATEMENT OF 004 Please print or type your name, mailing address, agency name, and position below: FINANCIAL INTERESTS LAST NAME FIRST NAME MIDDLE NAME : FOR OFFICE. Jackson 'J &(COAL P(Ei2CE

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How to fill out Form 1 Statement of:

01

Be sure to read the instructions carefully before starting the form. It is important to understand what information is required and how to correctly fill out each section.

02

Begin by providing your personal information. This may include your full name, address, contact details, and any other required details such as your Social Security number or tax identification number.

03

Next, carefully review the statement of financial condition. This section typically requires you to provide information about your income, assets, liabilities, and expenses. Make sure to accurately report all relevant financial information.

04

If applicable, include any supporting documents that may be required to verify the information provided in the form. This can include bank statements, tax returns, pay stubs, or any other relevant financial records.

05

Complete any additional sections or schedules that may be included in the form. These sections might include information about your business, investments, or other financial activities.

06

Review the completed form for accuracy and completeness. Double-check all the information provided to ensure there are no errors or missing details.

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Sign and date the form as required. Some forms may also require the signature of a witness or notary public.

08

Make copies of the completed form and any supporting documents for your records before submitting the original to the appropriate authority or organization.

Who needs Form 1 Statement of:

01

Individuals or businesses applying for a loan or credit may need to fill out Form 1 Statement of to provide a comprehensive overview of their financial condition.

02

Those involved in legal proceedings, such as divorce or bankruptcy, may be required to complete this form to disclose their financial situation.

03

Some government agencies or organizations may require individuals or businesses to submit Form 1 Statement of as part of their application process for certain benefits, grants, or licenses.

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