Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

12
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 PERSONAL FINANCIAL STATEMENT FORM PFS COVER SHEET Filed in accordance with chapter 572 of the Government Code. For filings required in 2009, covering calendar year ending December 31 , 2008. Use FORM PFS--INSTRUCT1ON GUIDE when completing this form. 1 NAME 2 ADDRESS 3 TELEPHONE NUMBER 4 REASON FOR FILING STATEMENT TITLE FIRST: Ml . , _ Mr lAMU*w P NICKNAME; LAST; SUFFIX "Ml 1 ' UA/ AA ADDRESS POBOX; APT/ SUITE *. CITY; STATE; ZIPCODE . boo U/, SHiv ^-. #70 & AVST/^TX nen*z | | (CHECK IF FILER'S HOME ADDRESS) AREA CODE PHONE NUMBER; EXTENSION (£f£) <f|5- Wf TOTAL NUMBER OF PAGES FILED; ACCOUNT # I P? 1 OFFICE USE ^LY^ ^ Date Received ^T) CO CT s 35 ° p| o 2 ^ ^^ ^0 ?\J -J" ! ~~ Z^ m Rece.pt » CO i^ ^ HD / PM Amount Date Processed Date Imaged n HANinmATF [INDICATE OFFICE) [DELECTED OFFICER rriA-\fO' (INDICATE OFFICE> G APpni(MTFn nFFIHFR [INDICATE AGENCY) D FXFCUTIVF HFAD (INDICATE AGENCY) D FORMER OR RETIRED JUDGE SITTING BY ASSIGNMENT i~1 STATF PARTY HHAIR (INDICATE PAHTYl I I DTHFR (INDICATE POSITION) Family members whose financial activity you are reporting (filer must report information about the financial activity of the filer's spouse or dependent children if the filer had actual control over that activity): SPDIISF DFPFNnFNT HUH D 1 ? 3. In Parts 1 through 18, you will disclose your financial activity during the preceding calendar year. In Parts 1 through 14, you are roqwirod to diccloco not only your own financial aoti'.'ity, but ctloo that of your opouoo or a dependent child if you had aotual i^Qntiol over that person s financial activity. COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

description

Mayor of Austin Will Wynn's Personal Financial Statement, filed April 2009, indicating hisreal property and investments, family, work, and other financial relationships. Posted by Texas Watchdog. Online at www.texaswatchdog.org.

Transcript of Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Page 1: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506

PERSONAL FINANCIAL STATEMENT FORM PFSCOVER SHEET

Filed in accordance with chapter 572 of the Government Code.For filings required in 2009, covering calendar year ending December 31 , 2008.

Use FORM PFS--INSTRUCT1ON GUIDE when completing this form.

1 NAME

2 ADDRESS

3 TELEPHONENUMBER

4 REASONFOR FILINGSTATEMENT

TITLE FIRST: Ml . , _

Mr lAMU*w PNICKNAME; LAST; SUFFIX

"Ml1' UA/AA

ADDRESS PO BOX; APT / SUITE *. CITY; STATE; ZIP CODE .

boo U/, SHiv -. #70 &

AVST/^TX nen*z| | (CHECK IF FILER'S HOME ADDRESS)

AREA CODE PHONE NUMBER; EXTENSION

(£f£) <f|5- Wf

TOTAL NUMBER OF PAGES FILED;

ACCOUNT #

I P? 1OFFICE USE LY^ ^

Date Received ^T) CO CT

s 35° p|o 2^ ^^

^0?\J -J" !~~Z^ mRece.pt » CO i

HD / PM Amount

Date Processed

Date Imaged

n HANinmATF [INDICATE OFFICE)

[DELECTED OFFICER rriA-\fO' (INDICATE OFFICE>

G APpni(MTFn nFFIHFR [INDICATE AGENCY)

D FXFCUTIVF HFAD (INDICATE AGENCY)

D FORMER OR RETIRED JUDGE SITTING BY ASSIGNMENT

i~1 STATF PARTY HHAIR (INDICATE PAHTYl

I I DTHFR (INDICATE POSITION)

Family members whose financial activity you are reporting (filer must report information about the financial activity of the filer's spouse ordependent children if the filer had actual control over that activity):

SPDIISF

DFPFNnFNT HUH D 1

?

3.

In Parts 1 through 18, you will disclose your financial activity during the preceding calendar year. In Parts 1 through 14, you areroqwirod to diccloco not only your own financial aoti'.'ity, but ctloo that of your opouoo or a dependent child if you had aotual i^Qntiol

over that person s financial activity.•

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Page 2: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506

STOCK

| | NOT APPLICABLE

PART 2

List each business entity in which you, your spouse, or a dependent child held or acquired stock during the calendar yearand indicate the category of the number of shares held or acquired. If some or all of the stock was sold, also indicate thecategory of the amount of the net gain or loss realized from the sale. For more information, see FORM PFS--INSTRUCTION GUIDE.

When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.

1 BUSINESS ENTITY

2 STOCK HELD OR ACQUIRED BY

3 NUMBER OF SHARES

4 IF SOLD D NET GAIN

D NET LOSS

BUSINESS ENTITY

STOCK HELD OR ACQUIRED BY

NUMBER OF SHARES

IF SOLD D NET GAIN

D NET LOSS

BUSINESS ENTITY

STOCK HELD OR ACQUIRED BY

NUMBER OF SHARES

IF SOLD D NET GAIN

D NET LOSS

BUSINESS ENTITY

STOCK HELD OR ACQUIRED BY

NUMBER OF SHARES

IF SOLD D NET GAIN

D NET LOSS

BUSINESS ENTITY

STOCK HELD OR ACQUIRED BY

NUMBER OF SHARES

IF SOLD D NET GAIN

D NET LOSS

<P»>/4*s l/n/^r/>x£^ , //u~Q?f FILER

D LESS THAN 100

D 5,000 TO 9,999

D LESS THAN $5,000

D SPOUSE D DEPENDENT CHILD

D 1 00 TO 499 D 500 TO 999 D

D 10,000 OR MORE

D $5,000-$9,999 D $10,000-$24,999 D

1,000 TO 4, 999

$25,000-OR MORE

NAME

D FILER

D LESS THAN 100

D 5,000 TO 9,999

D LESS THAN $5,000

D FILER

D LESS THAN 100

D 5,000 TO 9,999

D LESS THAN $5,000

D SPOUSE D DEPENDENT CHILD

D 1 00 TO 499 D 500 TO 999 Q

D 10,000 OR MORE

D $5,000-$9,999 D SlO,000-$24,999 D

NAME

D SPOUSE D DEPENDENT CHILD

D 100 TO 499 D 500 TO 999 D

D 10,000 OR MORE

D $5,000-49,999 D $10,000-$24,999 Q

1 .000 TO 4,999

$25,000-OR MORE

1,000 TO 4,999

$25,000-OR MORE

NAME

D FILER

D LESS THAN 100

D 5,000 TO 9,999

D LESS THAN $5,000

D SPOUSE D DEPENDENT CHILD

D 1 00 TO 499 D 500 TO 999 D

D 10,000 OR MORE

D $5,000-$9.999 D S10,000-$24,999 D

1 ,000 TO 4,999

$25,000-OR MORE

NAME

D FILER

D LESS THAN 100

CH 5,000 TO 9,999

D LESS THAN $5,000

D SPOUSE D DEPENDENT CHILD

D 100 TO 499 D 500 TO 999 D

CH 10,000 OR MORE

D $5,000-$9,999 D $10,000-S24,999 D

1 ,000 TO 4,999

$25,000-OR MORE

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Page 3: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506

BONDS, NOTES & OTHER COMMERCIAL PAPER PARTS

0 NOTAPPLICABLE

List all bonds, notes, and other commercial paper held or acquired by you, your spouse, or a dependent child during thecalendar year. If sold, indicate the category of the amount of the net gain or loss realized from the sale. For moreinformation, see FORM PFS--INSTRUCTION GUIDE.

When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.

DESCRIPTIONOF INSTRUMENT

HELD OR ACQUIRED BYFILER DSPOUSE DEPENDENT CHILD

IF SOLD

D NET GAIN

U NET LOSS

DESCRIPTIONOF INSTRUMENT

D LESS THAN $5,000 D $5,000--$9,999 D $10,000--$24,999 D $25,000-OR MORE

HELD OR ACQUIRED BYFILER D SPOUSE D DEPENDENT CHILD

IF SOLD

D NET GAIN

D NET LOSS

DESCRIPTIONOF INSTRUMENT

D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE

HELD OR ACQUIRED BYD FILER SPOUSE DEPENDENT CHILD

IF SOLD

D NET GAIN

D NET LOSS

D LESS THAN $5,000 D $5,000-$9.999 D $10,000-$24,999 D S25.000--OR MORE

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Revised 12/01/2008

Page 4: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506

INCOME FROM INTEREST, DIVIDENDS, ROYALTIES & RENTS PART 5

NOT APPLICABLE

List each source of income you, your spouse, or a dependent child received in excess of $500 that was derived frominterest, dividends, royalties, and rents during the calendar year and indicate the category of the amount of the income. Formore information, see FORM PFS--INSTRUCTION GUIDE.

When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.

SOURCE OF INCOMENAME AND ADDRESS

RECEIVED BYD FILER SPOUSE D DEPENDENT CHILD

AMOUNT

SOURCE OF INCOME

$500-$4,999 $5,000-39,999 D $10,000-$24,999 D $25,000--OR MORE

NAME AND ADDRESS

RECEIVED BYD FILER SPOUSE D DEPENDENT CHILD

AMOUNT

SOURCE OF INCOME

$500-$4,999 D $5,000--S9,999 D $10,000-$24,999 D S25.000-OR MORE

NAME AND ADDRESS

RECEIVED BYD FILER D SPOUSE D DEPENDENT CHILD

AMOIJMTD SbUO~$4.999 D 5ib,UUU-$9,999 D $10,000-524,999 D 325,000-OR MORE

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Revised 12/01/2008

Page 5: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506

INTERESTS IN REAL PROPERTY PART 7A

NOTAPPLICABLE

Describe all beneficial interests in real property held or acquired by you, your spouse, or a dependent child during thecalendar year. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale.For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM PFS--INSTRUCTION GUIDE.

When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.

HELD OR ACQUIRED BY FILER SPOUSE D DEPENDENT CHILD

2 STREETADDRESSfj NOT AVAILABLE

[g^CHECK IF FILER'S HOME ADDRESS

&GO W-STREET ADDRESS, INCLUDING CITY, COUNTY AND STATE

3 DESCRIPTIONG LOTS

G ACRES

NUMBER OF LOTS OH ACRES AND NAME OF COUNTY WHERE LOCATED

C0f\d-0 I

NAMES OF PERSONSRETAINING AN INTEREST

G NOTAPPLICABLE(SEVERED MINERAL INTEREST)

IF SOLDG NET GAIN

G NET LOSS

G LESS THAN $5,000 Q $5,000--$9,999 Q $10,000-524,999 G $25,000-OR MORE

HELD OR ACQUIRED BY FILER SPOUSE G DEPENDENT CHILD

STREETADDRESSI ! NOTAVAILABLE

| | CHECK IF FILER'S HOME ADDRESS

STREET ADDRESS, INCLUDING CITY COUNTY. AND STATE

i 6.

tx -78-70 /DESCRIPTIONG LOTS

G ACRES

NUMBER OF LOTS OR ACRES AND NAME OF COUNTY WHERE LOCATED

NAMES OF PERSONSRETAINING AN INTEREST

G NOTAPPLICABLE(SEVERED MINERAL INTEREST)

IF SOLDG NET GAIN

Q NET LOSS

G LESS THAN $5,000 G S5,000--$9,999 G $10,000--$24,999 G S25.000--OR MORE

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Revised 12/01:200

Page 6: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (51 2) 463-5800 1 -800-325-8506

GIFTS PARTS

NOT APPLICABLE

Identify any person or organization that has given a gift worth more than $250 to you, your spouse, or a dependent child, anddescribe the gift. The description of a gift of cash or a cash equivalent, such as a negotiable instrument or gift certificate, mustinclude a statement of the value of the gift. Do not include: 1) expenditures required to be reported by a person required to beregistered as a lobbyist under chapter 305 of the Government Code; 2) political contributions reported as required by law; or3) gifts given by a person related to the recipient within the second degree by consanguinity or affinity. For more information,see FORM PFS--INSTRUCTION GUIDE.

When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.

DONORNAME AND ADDRESS

RECIPIENT D FILER D SPOUSE D DEPENDENT CHILD

DESCRIPTION OF GIFT

DONORNAME AND ADDRESS

RECIPIENT D FILER D SPOUSE DEPENDENT CHILD

DESCRIPTION OF GIFT

DONORNAME AND ADDRESS

RECIPIENT D FILER D SPOUSE D DEPENDENT CHILD

DESCRIPTION OF GIFT

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Revised 12/01/2008

Page 7: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 1 2070 Austin, Texas 7871 1 -2070 (512) 463-5800 1 -800-325-8506

BLIND TRUSTS PART 10A

[T/NOT APPLICABLE

Identify each blind trust that complies with section 572.023(c) of the Government Code. See FORM PFS--INSTRUCTIONGUIDE.

When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.

1 NAM EOF TRUST

2 TRUSTEE

3 BENEFICIARY

4 FAIR MARKET VALUE

' DATE CREATED

NAME OF TRUST

TRUSTEE

BENEFICIARY

FAIR MARKET VALUE

DATE CREATED

NAME OF TRUST

TRUSTEE

BENEFICIARY

FAIR MARKET VALUE

DATE CREATED

NAME AND ADDRESS

fj FILER D SPOUSE D DEPFNinFNT r.HII D

D LESS THAN $5,000 D S5,000--$9,999 D $10,000-324,999 D $25,000-OR MORE

NAME AND ADDRESS

n Fll FR D SPOUSE D DEPENDENT CHILD

D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D S25,000-OR MORE

NAME AND ADDRESS

D FILER D SPOUSE D DEPENDENT CHILD

D LESS THAN $5,000 D $5,000--$9,999 D $10,000-$24,999 Q 525,000-OR MORE

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Revised 12/01.'2008

Page 8: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506

ASSETS OF BUSINESS ASSOCIATIONS PART 11A

NOTAPPLICABLE

Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS--INSTRUCTION GUIDE.

When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.

BUSINESSASSOCIATION

NAME AND AD DRESS(Check If Filer's Home Address)

2 BUSINESS TYPE

3 HELD, ACQUIRED,OR SOLD BY

FILER D SPOUSE D DEPENDENT CHILD

ASSETSDESCRIPTION CATEGORY

D LESS THAN $5,000 D $5,000-$9,999

D $10,000--S24,999 H/$25, -OR MORE

D LESS THAN $5.000 D $5,000-$9,999

D $10,000-$24,999 D $25,000-OR MORE

D LESS THAN $5,000 D $5,000-$9,999

D S10,000-$24,999 D $25,000-OR MORE

D LESS THAN $5,000 D $5,000-$9,999

D $10,000-$24,999 D $25,000-OR MORE

D LESS THAN $5,000 D $5,000~$9,999

D $10,000--$24,999 Q $25,000--OR MORE

D LESS THAN $5,000 D $5,000-$9,999

D $10,000-$24,999 D $25,000-OR MORE

D LESS THAN $5,000 D $5,000-89,999

D $10,000-$24,999 D 325,000-OR MORE

D LESS THAN 35,000 D 50,000-59,999

CD $10.000-$24,999 CD S25.000-OR MORE

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Revised 1?/01/2008

Page 9: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800

BOARDS AND EXECUTIVE POSITIONS

H NOT APPLICABLE

1 -800-325-8506

PART 12

List all boards of directors of which you, your spouse, or a dependent child are a member and all executive positions you,your spouse, or a dependent child hold in corporations, firms, partnerships, limited partnerships, limited liability partner-ships, professional corporations, professional associations, joint ventures, other business associations, or proprietorships,stating the name of the organization and the position held. For more information, see FORM PFS-INSTRUCTION GUIDE.

When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.

ORGANIZATION

2 POSITION HELD

3 POSITION HELD BY

ORGANIZATION

POSITION HELD

POSITION HELD BY

ORGANIZATION

POSITION HELD

POSITION HELD BY

ORGANIZATION

POSITION HELD

POSITION HELD BY

ORGANIZATION

POSITION HELD

POSITION HELD BY

D FILER D SPOUSE D DEPENDENT CHILD

D FILER D SPOUSE D DEPENDENT CHILD

D FILER D SPOUSE D DEPENDENT CHILD

D FILER D SPOUSE D DEPENDENT CHILD

D FILER D SPOUSE

COPY AND ATTACH ADDITIONAL PAGES AS

D DEPENDENT CHILD

NECESSARY

Revised 12/01/2008

Page 10: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1 -800-325-8506

INTEREST IN BUSINESS IN COMMON WITH LOBBYIST PART 14

Jj NOT APPLICABLE

Identify each corporation, firm, partnership, limited partnership, limited liability partnership, professional corporation, profes-sional association, joint venture, or other business association, other than a publicly-held corporation, in which you, yourspouse, or a dependent child, and a person registered as a lobbyist under chapter 305 of the Government Code that both havean interest. For more information, see FORM PFS-INSTRUCTION GUIDE.

1 BUSINESS ENTITY

2 INTEREST HELD BY

BUSINESS ENTITY

INTEREST HELD BY

BUSINESS ENTITY

INTEREST HELD BY

BUSINESS ENTITY

INTEREST HELD BY

BUSINESS ENTITY

INTEREST HELD BY

NAME AND ADDRESS

fj FILER CJ SP<~>USF Q PFPFNPFMT HHII n

NAME AND ADDRESS

[3 FILER D SPOIISF G nFPFNnFNTCHiin

NAME AND ADDRESS

[H Fll FR C] SPOUSE G DFPFNDFNT CHII H

NAME AND ADDRESS

D FILER D SPOUSE D DEPENDENT CHILD

NAME AND ADDRESS

PI FILER fl SPOUSE fl nFPFSinFNT nHII n

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Revised 15:01,2008

Page 11: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506

REPRESENTATION BY LEGISLATOR BEFORE PART -j 6STATE AGENCY

0 NOT APPLICABLE

This section applies only to members of the Texas Legislature. A member of the Texas Legislature who represents a personfor compensation before a state agency in the executive branch must provide the name of the agency, thename of the person represented, and the category of the amount of the fee received for the representation. For moreinformation, see FORM PFS-INSTRUCTION GUIDE.

Note: Beginning September 1, 2003, legislators may not, for compensation, represent another person before a stateagency in the executive branch. The prohibition does not apply if: (1) the representation is pursuant to an attorney/clientrelationship in a criminal law matter; (2) the representation involves the filing of documents that involve only ministerial actson the part of the agency; or (3) the representation is in regard to a matter for which the legislator was hired beforeSeptember 1 , 2003.

1 STATE AGENCY

2 PERSON REPRESENTED

3FEE CATEGORY

STATE AGENCY

PERSON REPRESENTED

FEE CATEGORY

STATE AGENCY

PERSON REPRESENTED

FEE CATEGORY

-•-•

STATE AGENCY

PERSON REPRESENTED

FEE CATEGORY

D LESS THAN $5,000 D $5,000--$9,999 D $10,000--$24,999 Q $25,000--OR MORE

D LESS THAN $5,000 D $5,000-$9,999 Q $10,000-$24,999 D $25,000~OR MORE

D LESS THAN $5,000 D $5,000-$9,999 Q $10.000-$24,999 fj $25,000--OR MORE

i ! LCCG TI IAN OG.OOO i I (pe.ooo eo,ooo i I sjj-t 0,000 -cpiEM.ooo j j o£o,ooo-on Monc

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY

Revised 12/01/2008

Page 12: Austin, Texas, Mayor Will Wynn's personal financial statement filed April 2009

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506

LEGISLATIVE CONTINUANCES

[Vj NOT APPLICABLE

PART 18

Identify any legislative continuance that you have applied for or obtained under section 30.003 of the Civil Practiceand Remedies Code, or under another law or rule that requires or permits a court to grant continuances on thegrounds that an attorney for a party is a member or member-elect of the legislature.

NAM EOF PARTYREPRESENTED

DATE RETAINED

STYLE, CAUSE NUMBER,COURT & JURISDICTION

DATE OF CONTINUANCEAPPLICATION

WAS CONTINUANCEGRANTED? YES DNO

NAME OF PARTYREPRESENTED

DATE RETAINED

STYLE, CAUSE NUMBER,COURT, & JURISDICTION

DATE OF CONTINUANCEAPPLICATION

WAS CONTINUANCEGRANTED? EH VES

COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY