Filing ID #10032407

f inancial D iScloSure r eport

Clerk of the House of Representatives • Legislative Resource Center • 135 Cannon Building • Washington, DC 20515

filer information
name: Burgess Owens
Status: Congressional Candidate
State/District: UT04

filing information
filing type: Amendment Report
filing year: 2019
filing Date: 01/8/2020

ScheDule a: aSSetS anD "unearneD" income

asset owner Value of asset income income income
type(s) current year to filing preceding year

NFL [PE] Undetermined Pension $5,001 - $15,000 $5,001 - $15,000

Social Security [PE] Undetermined Social Security $15,001 - $50,000 $15,001 - $50,000

* For the complete list of asset type abbreviations, please visit https://fd.house.gov/reference/asset-type-codes.aspx.

ScheDule c: earneD income

Source type amount amount
current year to preceding year
filing

Second Chance 4 Youth Founder & CEO $70,000.00 $70,000.00

Post Hill Publisher Published Books $4,400.00 $14,037.00

BurgessOwens Ent Speaking Engagements $22,500.00 $11,109.00

ScheDule D: liaBilitieS
owner creditor Date incurred type amount of
liability

Nelnet Fall 2001 Student Loan for Duaghter: U of Syrucuse $50,001 -

$100,000

Wells Fargo Dec 2016 Car Loan $15,001 - $50,000

IRS 2018 Taxes oews $6,500.00

ScheDule e: poSitionS
None disclosed.

ScheDule f: agreementS
Date parties to terms of agreement

2019 Second Chance 4 Youth Initiative SecondChance4Youth.org is non-profit organization working to

lower recidivism rate among young men leaving the Juvenile
Correction system. I've resigned day to day involvement as CEO
but will continue compensation of $70,000/year as Founder and
Board Chairman. All official affiliation/compensation will cease
once elected Nov 2020..

ScheDule J: compenSation in exceSS of $5,000 paiD By one Source

Source (name and address) Brief Description of Duties

Second Chance 4 Youth initaitive (Salt Lake City, Founder & CEO
UT, US)

excluSionS of SpouSe, DepenDent, or truSt information

trusts: Details regarding "Qualified Blind Trusts" approved by the Committee on Ethics and certain other "excepted trusts" need not
be disclosed. Have you excluded from this report details of such a trust benefiting you, your spouse, or dependent child?
j Yes n
k
l
m
n i No
j
k
l
m

exemption: Have you excluded from this report any other assets, "unearned" income, transactions, or liabilities of a spouse or
dependent child because they meet all three tests for exemption?
j Yes n
k
l
m
n i No
j
k
l
m

certification anD Signature

b I CERTIFY that the statements I have made on the attached Financial Disclosure Report are true, complete, and correct to the
c
d
e
f
g
best of my knowledge and belief.

Digitally Signed: Burgess Owens , 01/8/2020