House - Charles Conquest

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WILUAM M, MAGILL, Clerk House of Representatives
Melissa Kuoserik, State House
First Assistant Clerk Montpelier, VT05633-5501
Rebecca Silbemagel, Tel: [phone]
Second Assistant Clerk e-mail: hclerkaleg.state.vLus
Jeremy Weiss,
Journal Clerk
Dierdre Allen
Resolution Clerk VERMONT HOUSE OF REPRESENTATIVES
Chris Ditmeyer,
OFFICE OF THE CLERK
Clerk Assistant
House of Representatives Disclosure Form
Name: I Cciltile574"
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
Nit-1-‘11x)7 ec,1 i. n a -t Xs'

13 c ipt (.,,, il /le iliot Kt I 4thic,r7 X
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My Employer: $e
(Salary disclosure not required)
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Signed this jday of J41 , 2019
CoiZuest
Printed Name, please sign on back