SCHOOL ETHICS COMMISSION
PERSONAL DISCLOSURE STATEMENT
For Calendar Year 2017
SECTION I. Personal Information
First Name: Tracey
Middle Name: (optional)
Last Name: Severns
School Address: 227 Route 206
City: Flanders
State: NJ
Zip:07836
Position: School Administrator
School District or Charter School: Mount Olive Township School District
County: MORRIS
Spouse Information (if applicable)
First Name: Scott
Middle Name:
Last Name: Severns
Name: Tracey Severns
RELATIVE DISCLOSURE STATEMENT
SECTION II. Relative Information
1. Is any person related to you, or related to you by marriage, employed by the school district or a charter school in which you hold office or are employed? If you are an employee of the NJSBA, is any person so related to you employed by any school district or charter school? If yes, please provide the information requested below. If no so certify.
I answer no to this question.
2. Are you or is any person related to you or related to you by marriage, a party to a contract with your school district or a charter school? If you are an employee of the NJSBA, are you or is any person so related to you, a party to a contract with any school district? If yes, please provide the information requested below. If no so certify.
I answer no to this question.
3. Do you or does any relative receive compensation from or have any interest in any business which is a party to a contract with the school district or charter school in which you hold office or are employed? If you are an employee of the NJSBA, do you or does any relative receive compensation from or hold an interest in any business which is a party to a contract with any district? If yes, provide the name of each business and if applicable, school district. If no so certify.
I answer no to this question.
Name: Tracey Severns
FINANCIAL DISCLOSURE STATEMENT
Based on your financial information for calendar year 2016
This Financial Disclosure Statement is required annually of all school officials in accordance with N.J.S.A. 18A:12-21 et seq., The School Ethics Act. The Act requires that information pertain to the preceding calendar year. The Financial Disclosure Statement must be filed by April 30th of each year or within 30 days of assuming office or position if newly elected or appointed. This statement is a public record. Before completing this statement, read all instructions and definitions.
SECTION III. Financial Information
If the information has changed from the preceding calendar year, it is recommended that the official also provide financial information which is current as of five days prior to the date of this filing.1. List the name and address of each source of income, earned or unearned, from which you or a member of your immediate family received in excess of $2,000. If a publicly traded security is the source of income, the security need not be reported unless you or a member of your immediate family has an interest in the business organization. If you are a district employee, be sure to list the district board or charter school as a source of income. Client fees received through a business need not be separately reported.
| Name of Source | Address of Source | Name of Recipient | Relationship |
|---|---|---|---|
| Pitsgrove Twp BOE | 1076 Almond Rd., Pittsgrove, NJ 08318 | Tracey Severns | self |
| North Plainfield BOE | 33 Mountain Ave., North Plainfield, NJ 07060 | Tracey Severns | self |
| Paramus BOE | 145 Spring Valley Rd., Paramus NJ 07652 | Tracey Severns | self |
| Monmouth County Curriculum Consortium | 70 Conover Rd., Colts Neck, NJ 07722 | Tracey Severns | self |
| Mantua Twp BOE | 684 Main Street, Sewell, NJ 08080 | Tracey Severns | self |
| Mt. Olive Township BOE | 227 Route 46, Flanders, NJ 07836 | Tracey Severns | self |
| Asbury Park BOE | 910 4th Ave., Asbury Park, NJ 07712 | Tracey Severns | self |
| Camden's Promise Charter School | 879 Beidman Avenue, Camden, NJ 08105 | Tracey Severns | self |
| Haddonfield BOE | 1 Lincoln Ave., Haddonfield, NJ 08033 | Tracey Severns | self |
| Clearview Regional High School District | 420 Cedar Rd, Mullia Hill, NJ 08062 | Tracey Severns | self |
| Guttenbeg BOE | 301 69th St., Guttenberg, NJ 07093' | Tracey Severns | self |
| Little Egg Harbor | 307 Frog Pond Rd, Little Egg Harbor, NJ 08087 | Tracey Severns | self |
| Toms River BOE | 1144 Hooper Ave., Toms River, NJ 08753 | Tracey Severns | self |
| LEAP Academy University Charter School | 130 N Broadway, Camden, NJ 08102 | Tracey Severns | self |
| Oak Mountain Custom Woodwork | 59 Far View Rd., Great Meadows, NJ 08738 | Scott Severns | spouse |
| Randolph Township BOE | 25 School House Rd., Randolph, NJ 07869 | Tracey Severns | self |
| Camden County Curriculum Consortium | 500 Rhoads Ave., Westmont, NJ 08108 | Tracey Severns | self |
2. List the name and address of each source of fees/honorariums or gifts/reimbursements or prepaid expenses having an aggregate amount exceeding $250 from any single source, excluding relatives, received by you or an immediate family member. Be sure to list any reimbursement received from the district or charter school for such things as conference attendance, tuition/dues reimbursement, personal appearances, speeches, or writing.
| Name of Source | Address of Source | Name of Recipient | Relationship |
|---|---|---|---|
| Pine Hill BOE | 1003 Turnerville Rd., Pine Hill, NJ 08021 | Tracey Severns | self |
| Pitman BOE | 420 Hudson Ave., Pitman, NJ 08071 | Tracey Severns | self |
| Rancocas Valley Regional High School | 520 Jacksonville Rd., Mt. Holly, NJ 08060 | Tracey Severms | self |
| Springfield Township BOE | 2146 Jacksonville, Jobstown, NJ 08041 | Tracey Severns | self |
| Deptford Township Board of Education | 2022 Good Intent Rd, Deptford, NJ 08096 | Tracey Severns | self |
| Kingsway Regional School District | 201 Kings Highway, Woolrich Twp, NJ 08085 | Tracey Severns | self |
| Camden City Board of Education | 201 North Front Street, Camden NJ 08102 | Tracey Severns | Self |
| Chesterfield Board of Education | 30 Saddle Way, Chesterfield, NJ 08515 | Tracey Severns | self |
| Clementon Board of Education | 4 Audubon Ave., Clementon, NJ 08021 | Tracey Severns | self |
| Edgewater Park BOE | 25 Washington Ave., Edgewater Park, NJ 08010 | Tracey Severns | self |
| Middletown Township BOE | PO Box 4170, Middletown, NJ 07748 | Tracey Severns | self |
| Min Hill BOE | 42 Canfield Ave., Mine Hill, NJ 07803 | Tracey Severns | self |
| Morris School District | 31 Hazel St., Morristown, NJ 07960 | Tracey Severns | self |
| North Hanover Board of Education | 331 Monmouth Rd., Wrightstown, NJ 08562 | Tracey Severns | self |
| Mt. Olive Township BOE | 227 Route 206, Flanders, NJ 07836 | Tracey Severns | self |
3. List the name and address of all business organizations in which you or a member of your immediate family held an interest during the preceding calendar year.
| Name of Busn. Organization | Address of Busn. Organization | Name of Interest Holder | Relationship |
|---|---|---|---|
| Teach4Results | 59 Far View Rd., Great Meadows, NJ 07838 | Tracey Severns | self |
| Oak Mountain Custom Woodwork | 59 Far View Rd, Great Meadows, NJ 07838 | Scott Severns | spouse |
SECTION IV. Certification
I understand that this certification constitutes my representation of the accuracy of its contents. I hereby certify that these disclosure statements contain no willful misstatement or omission of material fact and constitute a full disclosure with respect to all matters required by N.J.S.A. 18A:12-21 et seq. I am aware that if I fail to file a statement or if I file a statement containing information that I know to be false, I shall be subject to disciplinary action up to and including removal pursuant to N.J.S.A. 18A:12-29.
Certified by:
Tracey Severns
Date:04/28/2017