Ralph R Erickson Financial Disclosure Report for 2010

8/3/2019 Ralph R Erickson Financial Disclosure Report for 2010

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! AO 1 0Rev. 1/2011 I FINANCIAL DISCLOSURE REPORTFOR CALENDAR YEAR 201 0 Report Re quired by the Ethicsin Government Act of 1978(5 U.S.C. app..~.~ 101-111)I. Person Reporting (last name, first , middle init ial)E f i ckso n , Ra l p h R .

4. Title (Article III judges indicate active or senior status;magis t ra te judges ind ica te fu l l - o r pa r t - t ime)

US Distr ict Judge--Active

7. Chambers or Off ice AddressQuent in Bur d ick US Cour thouse655 1st Ave. N ., Ste. 410Far go , N D 5 81 0 2-4 95 2

2. Court or Organizat ionDistr ict of North Dakota

i 3 . D a t e o f R e p o r t05/10/2011

5a. Report T)ve (check appropriate type)] N o m i n a t i o n , Da te!D Initial [] Annual [] Final5b. [] Amended Repoa8.On the basis of the information contained in this Report and any

modifications pertaining thereto, it is, in my opinion, in compliancewith applicable laws and regulations.

Revie~ing Off icer Date

: 6. Reporting Period01/01/2010

to12/31/2010

IMPOR TANT NO TES: The ins tructions accompanying th is form must be fo l lowed. C omplete a l l parts ,checking the NONE box for each part where you have n o reportable information. Sign on last page.

I . P O S I T I O N S . (Reporting individual only; seepp. 9-13 of filing instructions.)D (No reportablepositions.)O N E

POSITION N A M E O F ORGANI ZATI ON/E NTI TYI. Trustee Trust # I2. Director Sharehouse Founda t ion , Fa rgo , ND3.

4.5.

I I . A G R E E M E N T S . (Reporting individual only; see pp. 14-16 of filing instructions.)D (No reportable agreements.)ONE

DATE1.1 /15 /88 401K Ohnstad Twichell , P.C.2.2/I 5 /93 N DPERS County Ret i r emen t P lan3. 1/02/05 NDPER S Sta te Judicia l Re t i r ement P lan4. 12/31/96 4 5 7( b) P lan Sta te o f N or th Dako ta

P A R T I E S A N D T E R M S


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FINANCIAL DISCLOSURE REPORTPage 2 of 7

N a m e o f P e r s on R e p o r t i n gE r i ck s o n , R a l p h R .

Date of Report05/10/2011

I l l . N O N - I N V E S T M E N T I N C O M E . (Reporting individual andspouse; seepp. 17-24 of filing instructions.)A. Filers Non-Inves tment Income~ - ~ (No reportable income.)O N E non-investment

D A T E S O U R C E A N D T Y P E

2.3.

4.

I N C O M E( y o u r s , n o t s p o u s e s )

B . S p o u s e s N o n - I n v e s tm e n t I n co m e - if you were married during any portlon of the repo~ting year, complete this section.(Dollar amount not required except for honoraria. )

~ (No reportable non-investment income.)O N ED A T E SO U R C E A N D T Y P E

I . 12/31/2010 Sel f -employed Optomet r i s t2.3.4.

I V . R E I M B U R S E M E N T S - transportation, lodging, food, entertainment(Includes those to spouse and dependen t children," see pp. 2 5-27 of filing instructions.)

~ (No reportable reimbursements.)O N E

2.3.4.5.

S O U R C E D A T ES L OCATION P U R P O SE IT EM S P A ID O R P R O V ID ED


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Name of Person Report ingE r i c ks o n , R a l p h R .

Date of Report05/10/2011

V . G I F T S . (Includes those to xpouse and dependent children; see pp. 28-31of filing inxtructions.)N O N E (No repo rtable gifts.)

SOUR C EI.2.3.4.5.

DESCRIPTION VALUE

V I . L I A B I L I T I E S . a . c tu d e ~ , h o ~ o o l s p o u ~ e a n d d e ~ , e . d e ., children; see pp. 3 2 - 3 3 of filing instructionx)NONE (No reportable liabilities.)

C R E D I T O R DESC R I P T I ONI.2.3.4.5.

VALUECODE


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N a m e o f P e r s o n R e p o r t in gErickson, Ralph R.

D a t e o f R e p o r t05/10/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - income, value, transact ions (Includes those of spouse and dependent chi ldren; see pp. 34-60 of fi ling instruct ions. )[~] N O N E (No reportable income, assets, or transactions.)

A. B. C. D.Description of Assats Incom e during Gross value at end Transactions during reporting period

(including trust assets) reporting period of reporting period(I) (2) (I) (2) (I) (2) (3) i (4) (5 )

Place "(X )" after each asset Am ount Type (e.g., V alue V a lue Type (e.g., D a t e Value Gain Identity ofexempt from prior disclosure Code I div., rent, Code 2 Method buy, sell, m m /d d/y y C od e 2 Code I buyer/seller(A-H) o r i n t . ) (J-P) Code 3 redemption) ( J - P ) (A-H) (ifprivate

(Q-W) ! t r a n s a c t i o n )

I. A W S H X A D i v i d e n d J

2. L si L o g i c C o rp . N o n e J

3. I n te l , I nc ., comm on s tock4. Alcate l Lucen t com mon s tock

A DividendN o n e

JJ

TT

5. Oakmark Se lec t , mutua l fund6. P r o c t o r & G a m b l e , co m m o n s t o c k

A DividendA Dividend

JJ

TT

8.

9.

I I .

1 4 .

W e l ls F a r g o & C o . , c o m m o n s t o c k A Dividend J~ Trust,B SEP IRA (No C lnt . /Div. MInvestment Authori ty)Feder a ted Cap i ta l Reser ve Fund , Sta te Bank A Interes t K& Trus t (X) 401KIN G A etna 4 5 7( b) IN G ( Aetna) V P Index A lnt. /Div. KPlus Lar ge Cap .IN G Aetna 4 5 7( b) Fide l ity V IP Gr ow th A Int . /Div. KPortfolio 109

T

T

T

T

IN G Aetna 4 5 7( b) T.Row e Pr ice MC Gr - A Int . /Div.lnit-449IN G A etna 4 5 7( b) Oppenheimer G lobal P t - A lnt. /Div.Ini t--432 TGate Ci ty Savings-Savings Account A Interes t JDig i ta l Br oadcas t Cor por a t ion N o n e J W

Guar d ian Insur ance Tr us t D Dividend M TGuardian Insurance ~ Life Insurance ECash Va lue ) Dividend M T

I , In co m e G ain Co d es: A = $1,000 or less B = $1,001 - $2,500 C = $2,501 - $5 ,000 D =$5,001 - $15,000(See Columns B I and D4 ) F = $ 5 0 , D O I - $ 1 0 0 , D O 0 G = $ 1 D O , D O I - $ I ,D O 0 , D O 0 H I = $ I ,D O 0 ,D O I - $5,DO0,0~ H 2 = M o r e t h a n $ 5 , 0 D O . 0 D O

2, Value Codes J = $15.000 or less K = $ 1 5 . D O I - $ 5 0 ,D O O L - $ 5 0 . 0 0 1 - $ I D O , D O 0 M =$100,D01 - $250,DO0(See Co lumn s C1 an d D J ) N = $ 2 5 0, 00 1 - $ S D O , D O 0 O =$500.001 - $1,000.DO0 P I = $ 1 .D O 0 . D O I - $ 5 , D O 0 , 0 0 0 P2 =$5,DO0.DOI - $25.000.000

P 3 - $ 2 5 . D O 0 ,D O I - $ 5 0 . 0 0 0 .0 0 0 P 4 = M o r e t ha n $ 5 0 .D O O . 0 D O3. Value Method Codes Q = A ppr a i sa l R =Cost (Real Estate Only) S = Asse ssmen t T = Cash Marke t(Scc Co lumn C2 ) U = Bo o k V a lue V -Ot her W = Es t ima ted

E = $ 1 5 , D O I - $ 5 0 ,D O 0


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N a m e o f P e r so n R e p o r t i n gErickson, Ralph R.

D a t e o f R e p o r t05/10/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - income, value, transactions (Includes those of spouse an d dependent children; seepp. 34-60 of filing instructionx.)N O N E (No reportable income, assets, or transactions.)

D e s c r i p t io n o f A s s e t s I n c o m e d u r i n g( i nc luding t rus t a s s e t s ) r e por t i ng pe r iod

(O (2)Place "(X)" after e~ch asset A m o u n t Type (e.g.,

exempt from prior disclosure Code I div . , r en t ,(A-H) or int.)

G r o s s v a l u e a t e n do f r e p o r t i n g p e r i o d( 1 ) (2)

V a lue V a lueC o d e 2 M e tho d(J-P) C o d e 3( Q - W )

( 1 )Type (e.g.,

buy, s e l l ,r e d e m p t i o n )

T r a n s a c t io n s d u r i n g r e p o r t i n g p e r i o d

( 2 ) ( 3 ) ( 4 )D a t e V alue G ain

mm/dd/yy C o d e 2 Code I( J - P ) (A-H)

( 5 )Iden t i ty of

buye r / s e l l e r( i f p r iva te

t r a ns a c t ion)

1 8 . Gu ardian Insurance (Cash Value) D Dividend

1 9 . Gu ardian Insurance (Cash Val~e) C Dividend

20 . Gu ardian lnsurance (Cash Value) A Dividend

21 . Jackson National Life ~ Life A I n t e r e s tInsurance)

LK

J

K

TT

TT

I . In co me G a in Co d es : A =$1,000 or less B =$1,0~1 - $2,500 C =$2,501 - $5,000 D =$5,091 - $15.0(~(See Co lumn s BI an d D4) F =$50,001 - $100,000 G =$1~0,001 - 51,00~.0~) H 1 =$1.00~,001 - $5.00~,0~0 H2 -More than $5.0~0.000

2. V alue Co d es J = $ 15,000 or less K =$15,001 - $50.000 L =$50.001 - $100.000 M =$10~.001 - $250.000(See Col um ns CI and D3) N =$250.001 - $500,000 O =$ 50 0,0 01 - $ 1,0 00 .0 ~) P I = $1 .0 00 ,0 01 - $ 5,0 00 ,0 ~0 P2 =$5.000.001 - $25.000.0~0

P3 =$25,000,001 - $ 50.009.000 P4 =More than $50.000,0~13. Value Method Codes Q =Appraisal R =Cost {Real Estate Only) S =Assessment I- =Cash Market(see Col um n C2) U = Bo o k Va lue V = Othe r W =E.-. t imated

E :SIS,001 - $ 50.000


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N a m e o f P e r s o n Report ingE r i c ks o n , R a l p h R .

D a t e of Repor t05/10/2011

V I II . A D D I T I O N A L I N F O R M A T I O N O R E X P L A N A T I O N S . (Indicate part of report.)V II I n v c s ~ c n t s a n d T r u s t s . L in e 8 . O n J a n u a r y 2 , 2 0 1 I ~ S E P I R A w a s r e s t a t e d , I n t h e n e w t r us t d o c u m e n t s s h e h a s n o a u t h o ri t y o v e r a n y i n v e s t m e n t s .The IRA is he ld in a m ixture of Bonds , Cash Equiva lents , and Equi t ie s a s de te rmined by the p lan adminis t r a tor a t A le rus F inanc ia l .

V I! Inves tments an d Trus ts . L ine 20 . The pol icy was acquired on Oc tobe r I , 2007 but had no cash vague unt il Oc tobe r I , 2010.


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FINANCIAL DISCLOSURE REPORTPag e 7 o f 7

Name of Person Report ingE r i ck s o n , R a l p h R .

Date of Repor t05/10/201 I

IX. CERTIFICATION.I c e r t i fy t h a t a l l in f o r m a t i o n g i v e n a b o v e ( i n c l ud i n g i n f o r m a t i o n p e r t a i n i n g t o m y s p o u s e a n d m i n o r o r d e p e n d e n t c h i ld r e n , i f a n y ) i s

accura t e , t rue , and comple t e t o the bes t o f my knowledge and be l i e f , and tha t any in fo rmat ion no t repo r t ed ~vas wi thheld because i t met app l icab le s t a tuto ryprov i s ions perm i t t ing no n-d i sc losure .I f u r th e r c e r t if y t h a t e a r n e d i n c o m e f r o m o u t s id e e m p l o y m e n t a n d h o n o r a r i a a n d t h e a c c e p t a n ce o f g i f t s s v h i ch h a v e b e e n r e p o r t e d a r e i n

c ompl ia nc e wi th the p rov i s ions o f 5 U .S .C. a pp . 5 0 1 e t . s e q . , 5 U .S .C. 735 3 , a nd Ju d ic ia l Confe re nc e re gu la t ions .

Signature: S/Ralph R. Erickson

N O T E : A N Y I N D I V I D U A L W H O K N O W I N G L Y A N D W I L F U L L Y F A L S I F I ES O R F A I L S T O F IL E T H I S R E P O R T M A Y B E S U B J E C T T O C I V I LA N D C R I M I N A L S A N C T I O N S ( 5 U . S . C . ap p . 1 0 4 )

Committee on Financial DisclosureAdministrative Office of the United States CourtsSuite 2-301One Columbus Circle, N.E.Washington, D.C. 20544

Ralph R Erickson Financial Disclosure Report for 2010

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