Puerto Rico Financial Oversight and Management Board (January 2017) Date of Appointment/Termination: August 31, 2016 Financial Disclosure Report Filer's Information Last Name First Name MI Position Carrion Jose B. Member PROMESA Board Other Commonwealth of Puerto Rico Government Positions Held During the Preceding 12 Months: None Filer's Certification - I certify that the statements I have made in this report are true, complete and correct to the best of my knowledge: Signature: Date: July 12, 2017 (Information in this report is certified as of April 30, 2017) C _ EthicvOfficial's Opinion— On the basis of information contained in this report, I conclude that the tiler's disclosed interests are not so substantial as to be deemed likely to affect the integrity of the services which the FOMB may expect from such member or employee (subject to any comments below) Signature: , 02,--Logasz Date: Comments of Ethics Official:
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Puerto Rico Financial Oversight and Management Board (January 2017)
Date of Appointment/Termination: August 31, 2016
Financial Disclosure Report
Filer's Information
Last Name First Name MI Position
Carrion Jose B. Member PROMESA Board
Other Commonwealth of Puerto Rico Government Positions Held During the Preceding 12 Months:
None
Filer's Certification - I certify that the statements I have made in this report are true, complete and correct to the best of my knowledge:
Signature: Date: July 12, 2017
(Information in this report is certified as of April 30, 2017)C_
EthicvOfficial's Opinion— On the basis of information contained in this report, I conclude that the tiler's disclosed interests are not so substantial as to be deemed likely to affect the
integrity of the services which the FOMB may expect from such member or employee (subject to any comments below)
Signature: ,
02,--LogaszDate:
Comments of Ethics Official:
Puerto Rico Financial Oversight and Management Board (January 2017)Instructions for Part 1
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion 1
Part 1: Positions Held In Last Two Years
# Organization Name City/State Organization Type Position Held From To
1. HUB, CLC Inc. San Juan, PR Insurance Broker President 2012 Present
2. GM Security San Juan, PR Advisory Board Member 2012 Present
3. Advent Morro San Juan, PR Advisory Board Member 2010 Present
4. JBCT-MACPR Trust San Juan, PR Family Trust Trustee 2014 Present
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Puerto Rico Financial Oversight and Management Board (January 2017)Instructions for Part 2
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required information.
Filer's Name Page Number
Jose B. Carrion 1
Part 2: Filer's Employment Assets & Income and Retirement Accounts# Description EIF Value Income Type Income Amount
I. Oriental Carrion, Laffitte & CaseIlas (Retirement Plan - Located in
Oriental)
Y N/A
2. HUB, CLC Inc. N/A Salary
The funds invested by the retirement accounts are the folowing:
3. American Funds AMCAP RET OPT Y N/A
4. American Funds Fundamental Invest Ret 0 Y N/A
5. Columbia Total Return Bond Ret Opt Y N/A
6. Fidelity Advisor Leverag Co Stock Ret Op Y N/A
7. Franklin Growth Series ret Opt Y N/A
8. Prudential Jennison Small Company RET Op Y N/A
9. Transamerica Stable ValueCore Options Y N/A
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Puerto Rico Financial Oversight and Management Board (January 2017)Instructions for Part 3
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required information.
Filer's Name Page Number
Jose B. Carrion 1
Part 3: Filer's Employment Agreements and Arrangements
# Employer or Party City/State Status and Terms Date
i. HUB International San Juan, PR Currently a salaried employee 2012
2. HUB InternationalRetirement Plan
San Juan, PR Currently participate in a defined contribution retirement plan, whose assets were disclosed in Part 2 2012
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Puerto Rico Financial Oversight and Management Board (January 2017)Instructions for Part 4
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required information.
Filer's Name Page Number
Jose B. Carrion 1
Part 4: Filer's Sources of Compensation Exceeding $5,000 in a Year
# Source Name City/State Brief Description of Duties
1, HUB International San Juan, PR President of the local company in San Juan, PR
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Puerto Rico Financial Oversight and Management Board (January 2017)Instructions for Part 5
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required information.
Filer's Name Page Number
Jose B. Carrion 1
Part 5: Spouse's Employment Assets & Income and Retirement Accounts
# Description EIF Value Income Type Income Amount
1. None
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Puerto Rico Financial Oversight and Management Board (January 2017)Instructions for Part 6
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion 1
Part 6: Other Assets and Income
Description EIF Value Income Type Income Amount
1. Fidelity Govt MMKT Capital Reserves CL - Acct #1 Y N/A
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion 2
Part 6: Other Assets and Income# Description EIF Value Income Type Income Amount
1. Johnson and Johnson - Acct #3 Y N/A
2. Microsoft Corp - Acct #3 y N/A
3. Procter & Gamble Co - Acct #3 Y N/A
4. Qualcomm Inc. - Acct 113 Y N/A
5. Tiffany & Co New - Acct #3 Y N/A
6. Union Pacific Corp - Acct #3 Y N/A
7. 3M Corp - Acct #3 Y N/A
8. Blackrock Multi Assets - Acct #3 Y N/A
9. Boston Partners Long - Acct #3 Y N/A
10. 'shares MSCI CDA ETF - Acct #3 Y N/A
11. !shares MSCI Switzerland - Acct #3 Y N/A
12. !shares MSCI Sweden - Acct #3 11 N/A
13. !shares MSCI Pacific - Acct #3 y N/A
14. 'shares lboxx $ Acct - Acct #3 Y N/A
15. !shares Gold TR Acct - Acct #3 Y N/A
16. 'shares Agency Bond - Acct #3 Y N/A
17. !shares JP Morgan Em Bon Acct - #3 Y N/A
18. !shares Core S&P 500 ETF - Acct #3 Y N/A
19. !shares MSCI Eurozone - Acct #3 Y N/A
20. !shares MSCI Japan - Acct #3 Y N/A
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion 3
Part 6: Other Assets and Income# Description ELF Value Income Type Income Amount
11. ML Bank Deposit Program - Acct #8 -JBCT Trust N Interest
12. CD BMO Harris Bank NA - Acct #8 - JBCT Trust N Interest
13. CD Mercantil Commerceban - Acct #8 - JBCT Trust N Interest
14. CD Bank of America NA - Acct #8 - JBCT Trust N Interest
15. CD Bank of China - Acct #8 - JBCT Trust N Interest
16. CD MB Fin! BK NA - Acct #8 - JBCT Trust N Interest
17. Santander UK PLC - Acct #8 - JBCt Trust Y N/A
18. Pfizer Inc - Acct #8 - JBCT Trust Y N/A
19. USD BP Capital PLC - Acct #8 - JBCT Trust Y N/A
20. Oracle Corp - Acct #8 - JBCT Trust Y N/A
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion 4
Part 6: Other Assets and IncomeDescription EIF Value Income Type Income Amount
1 Banco Popular - PMA (Jose) N/A Interest
2. Banco Popular - Saving Account (Jose) N/A Interest
3. BANESCO - Certificate of Deposit N/A Interest
4. Harbour Community Bank N/A Interest
5. Massachusetts Mutual Life lnsurace Co. Y Dividend and Return ofInvestment
6. Fidelity Investment State Of New Hampshire College
Savings
N/A Interest
7. CAE College Savings Account N/A Interest
8. Universal IRA Morningstar Moderate Growth (J.
Carrion)
Y Interest and Dividend
9. Investment in Hockey Parent Holding, L.P. N Interest and Dividend
10. Investment in Ashford Equity Partners, L.P. N Interest and Dividend
11. Junior Investment Corporation N Interest and Dividend
12. Investment in FFI Holding, Inc N Interest and Dividend
13. Investment in Parliament Capital N Interest and Dividend
14. ML Bank Deposit Programs ML - Acct #4 N Interest
15. Altria Group Inc - Acct #4 Y N/A
16. Berkshire Hathaway Inc - Acct #4 Y N/A
17. Blackrock Inc - Acct -#4 Y N/A
18. Block H & R Inc - Acct #4 Y N/A
19. CA Inc - Acct #4 Y N/A
20. Carnival Corp Paired SHS - Acct #4 Y N/A
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion- Spouse 5
Part 6: Other Assets and Income- Spouse# Description EIF Value Income Type Income Amount
1. Chevron Corp -Acct #4 Y N/A
2. Cinn Fincl CRP Ohio - Acct- #4 Y N/A
3. Cisco System Inc Com - Acct #4 Y N/A
4. Coca Cola Com - Acct #4 Y N/A
D. Diageo PLC Spsd ADR New - Acct #4 Y N/A
6. Dominion Res Inc New VA - Acct #4 Y N/A
7. Duke Energy Corp New - Acct #4 Y N/A
8. Eli Lilly & Co - Acct #4 Y N/A
9. General Electric - Acct- #4 Y N/A
10. General Mills - Acct #4 Y N/A
11. Genl Dynamics Corp Com - Acct #4 Y N/A
12. Hasbro Inc Com - Acct #4 Y N/A
13. Intel Corp - Acct #4 Y N/A
14. Kinder Morgan Inc Del - Acct #4 Y N/A
15. Lowes Companies Inc - Acct #4 Y N/A
16. Merck and Co Inc Shs - Acct #4 Y N/A
17. Microsoft Corp - Acct #4 Y N/A
18. Newmarket Corp - Acct #4 Y N/A
19. Norfolk Southern Corp - Acct #4 Y N/A
20. Paychex Inc - Acct #4 Y N/A
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filers Name Page Number
Jose B. Carrion -Spouse 6
Part 6: Other Assets and Income- Spouse# Description EIF Value Income Type Income Amount
1. Pfizer Inc - Acct #4 Y N/A
2. Reynolds American Inc - Acct #4 Y N/A
3. The Mosaic Company (Common Stocks) - Acct #4 y N/A
4. Verizon Communications - Acct #4 Y N/A
5. ML Bank Deposit Programs - Acct #5 N Interest
6. ACS Actividad Cons - Uns Adr - Acct #5 Y N/A
7. Adecco Group Ag - Acct #5 Y N/A
8. Aegon N.V. NY Reg SHS - Acct #5 Y N/A
9. Aercap Holding N.V. SHS - Acct #5 Y N/A
10. Airbus Group - Acct #5 Y N/A
11. Ambev SA SHS ADR - Acct #5 Y N/A
12. Astellas Pharma Inc Shs - Acct #5 Y N/A
13. Axa - Spons ADR - Acct#5 Y N/A
14. Banco Billiton PLC Sp ADR - Acct #5 Y N/A
15. Carlsberg As Sponsored - Acct #5 Y N/A
16. Carrefour SA - Acct #5 Y N/A
17. China Mobile LTD SPN ADR - Acct #5 Y N/A
18. CK Hutchison Holdings - Acct #5 Y N/A
19. DBS Group Hldgs spn ADR - Acct #5 Y N/A
20. Deutsche Post Ag SHS - Acct #5 Y N/A
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion -Spouse 7
Part 6: Other Assets and Income- Spouse
# Description EIF Value Income Type Income Amount
1. Dnb ASA Sp ADR - Acct #5 Y N/A
2. EON SE ADR - Acct #5 Y N/A
3. Engie SHS - Acct #5 Y N/A
4. Fresenius Medical Care - Acct #5 Y N/A
5. Gemalto SHS - Acct #5 Y N/A
6. HSBC Hldg PLC Sp Adr - Acct #5 Y N/A
7. lntesa SanPaolo Spon ADR - Acct #5 Y N/A
8. Julius Baer Group - Acct #5 Y N/A
9. Komatsu New New Spnsdadr - Acct #5 Y N/A
10. Koninkl Phil NV Sh New - Acct #5 Y N/A
11. Mazda Motor Corp - Acct #5 Y N/A
12. Mitsubishi Estate ADR - Acct #5 Y N/A
13. Murata Manufacturing Co - Acct #5 Y N/A
14. Orange Acct - Acct #5 Y N/A
15. Otsuka Holdings CO Ldt - Acct #5 Y N/A
16. Panasonic Corp Shs - Acct #5 Y N/A
17. Roche Hldg Corp Shs - Acct #5 Y N/A
18. Royal DSM NV Spon ADR - Acct #5 Y N/A
19. Royal Dutch Shell PLC - Acct #5 Y N/A
20. Royal Kpn NV SP ADR - Acct #5 Y N/A
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion -Spouse 8
Part 6: Other Assets and Income- Spouse
Description E1F Value Income Type Income Amount
1. Schlumberger LTD - Acct #5 Y N/A
2. Secom CO LTD - Acct #5 Y N/A
3. Secom CO LTD ADR - Acct #5 Y N/A
4. Seiko Epson Corp Unsp ADR - Acct #5 Y N/A
5. Smith -Nphw PLC Spadr New - Acct #5 Y N/A
6. Societe General SPN ADR - Acct #5 Y N/A
7. Suntory Beverage And Food-UADR - Acct #5 Y N/A
8. Total S.A. Sp ADR - Acct #5 Y N/A
9. Vivendi SHS Unsp ADR - Acct #5 Y N/A
10. ML Bank Deposit Programs - Acct #6 N Interest
11. East Washington in Multi - Acct #6 Y N/A
12. Cuyahoga County Ohio - Acct #6 Y N/A
13. Scago EDL FCS CRP SCH DT - Acct #6 Y N/A
14. Adams 12 Five Star Schs - Acct #6 Y N/A
15. Campton TWP III - Acct #6 Y N/A
16. Dallas Fort Worth Tex - Acct #6 Y N/A
17. East Washington in Multi (2021) - Acct #6 Y N/A
18. Rockford ILL - Acct #6 Y N/A
19. Cuyahoga Cnty Ohio - Acct #6 Y N/A
20. Rockford ILL - Acct #6 Y N/A
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion -Spouse 9
Part 6: Other Assets and Income- Spouse# Description EIF , Value Income Type Income Amount
1. Central Greene Pa Sch - Acct #6 Y N/A
2. Kentucky St PPTY & Bldgs - Acct #6 Y N/A
3. East Washington in Multi (2025) - Acct -#6 Y N/A
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion - Spouse 10
Part 6: Other Assets and Income - Spouse# Description EIF Value Income Type Income Amount
5. Banco Popular - CK Account - Gloria Acct #1 N/A Interest
6. Banco Popular - CK Account - Gloria Acct #2 N/A Interest
7. Banco Popular - PMA - Gloria N/A Interest
8. Universal IRA Morningstar Moderate Growth Y N/A
9. Apartment I - San Juan, Puerto Rico N/A Rent Income
10. Apartment 11 - San Juan, Puerto Rico N/A Rent Income
11. Apartment 111 - San Juan, Puerto Rico N/A Rent Income
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Puerto Rico Financial Oversight and Management Board (January 2017)Instructions for Part 7
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion & Spouse 1Part 7: Transactions# Description Type Date Amount
I. Alaska ST HSG Fin Corp ST Proj Ser A - Redemption sale 12-05-2016
2. Astrazeneca PLC SPND ADR sale 12-05-2016
3. Atos Orign SA Unsup ADR sale 09-30-2016
4. Addeco Group AG sale 12-22-2016
5, BPH Billinton PLC SP sale 12-22-2016
6. Ericsson American SEK 10 new sale 10-14-2016
7. lnfineon Tech AG Spdadr sale 09-01-2016
8. Novartis ADR sale 10-31-2016
9. National Grid PLC SP ADR sale 10-31-2016
10. National Grid PLC SP ADR sale 10-14-2016
11. National Grid PLC SP ADR sale 10-17-2016
12. Unbail - Rodamco SE UNSP ADR sale 10-11-2016
13. Vodafone GroupPLC SHS ADR sale 9-30-2016
14. Vodafone GroupPLC SHS ADR sale 10-11-2016
15. Vodafone GroupPLC SHS ADR sale 10-12-2016
16. Astrazeneca PLC SPND ADR sale 12-02-2016
17. Astrazeneca PLC SPND ADR sale 12-05-2016
18. Atos Orign SA Unsup ADR sale 12-19-2016
19. Atos Orign SA Unsup ADR sale 12-20-2016
20. Atos Orign SA Unsup ADR sale 12-22-2016
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or far- ly member names. See instructions for required
information.
Filer's Name Page Number
Jose B. Carrion & Spouse 2
Part 7: Transactions# Description Type Date Amount
I. IHS Markit LTD SHS sale 11-29-2016
2. IHS Markit LTD SHS sale 12-08-2016
3, IHS Markit LTD SHS sale 12-09-2016
4. Konin Phil NV SH New sale 11-12-2016
5. Societe General SPN ADR sale 12-05-2016
6. Seiko Epson Corp UNSP ADR sale 12-05-2016
7. Corrections Corp of Amer sale 09-26-2016
8. Corrections Corp of Amer sale 9-27-2016
9. Corrections Corp of Amer sale 9-28-2016
10. Corrections Corp of Amer sale 9-29-2016
11. Corrections Corp of Amer sale 9-30-2016
12. Corrections Corp of Amer sale 10-03-2016
13. Corrections Corp of Amer sale 10-04-2016
14. Corrections Corp of Amer sale 10-05-2016
15. Corrections Corp of Amer sale 10-06-2016
16. Corrections Corp of Amer sale 10-07-2016
17. Corrections Corp of Amer sale 10-10-2016
18. Corrections Corp of Amer sale 10-11-2016
19. Corrections Corp of Amer sale 10-12-2016
20. CA Inc. sale 10-14-2016
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required
information.Filer's Name Page Number
Jose B. Carrion & Spouse 3
Part 7: Transactions# Description Type Date Amount
1. Intel Corp. sale 10-14-2016
2. Kinder Morgan Inc. Del sale 10-14-2016
3. The Southern Company Series 2015 Sub sale 10-18-2016
4. The Southern Company Series 2015 Sub sale 10-19-2016
5. The Southern Company Series 2015 Sub sale 10-25-2016
6. The Southern Company Series 2015 Sub sale 10-26-2016
7. Alaska ST 1--IGS Fin Corp ST Cap Proj Ser A - Redemption sale 12-01-2016
8. Wal-Mart Stores, Inc. sale 09-30-2016
9, Popular Inc. - Common Stocks sale 10-30-2016
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Puerto Rico Financial Oversight and Management Board (January 2017)Instructions for Part 8
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required information.
Filer's Name Page Number
Jose B. Carrion
Part 8: Liabilities
# Creditor Name Type Amount Year Incurred Rate Term
1. None
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Puerto Rico Financial Oversight and Management Board (January 2017)Instructions for Part 9
Note: This form is subject to public disclosure. Do not include account numbers, street addresses, or family member names. See instructions for required information.