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Power of Attorney for Health Care For Name: Date of Birth: Address: Telephone: This document is on file at Copies of this document have been given to my health care agent(s) and: 1. 2. 3. 4. 5. Courtesy

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What is this document is on?

This document is on financial disclosures.

Who is required to file this document is on?

Government officials and employees are required to file this document.

How to fill out this document is on?

This document can be filled out online or by hand, following the specific instructions provided.

What is the purpose of this document is on?

The purpose of this document is to provide transparency on financial interests of government officials and employees.

What information must be reported on this document is on?

Information such as income, investments, and assets must be reported on this document.