House - Ben Jickling

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WILLIAM ic MADILL, Clerk House of Representatives
Melissa Kucserik, State House
First Assistant Clerk Montpelier, VT05633-5501
Rebecca Silbemagel, Tel: [phone]
Second Assistant Clerk e-mail: hcierkeleg.statemLus
Jeremy Weiss,
Journal Clerk
Dlerdre Allen,
Resolution Clerk VERMONT HOUSE OF REPRESENTATIVES
Chris Ditmeyer,
OFFICE OF THE CLERK
Clerk Assistant
House of Representatives Disclosure Form
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Name: Prt
I serve on, or am a member of, the following Boards, Commissions, or Entities that are
regulated by law or that receive funding from the State:
Remuneration
Board, Entity, or Commission Name, No Yes- Yes
and Position (e.g. Board Member, Only
Board Chair) Expenses
e.g.
mileage
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Of
My Employer: Mon tx--
-(Salary disclosure not required)
Signed this IL day of 30vv-i'r ,(cid:9) 2019
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Printed Name, please sign on back