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Transcript of >Z - Home | Judicial Watch … · DSPION SOE . TN R TN VEOE* 1 . 2 3 4 6 7 2 3 4 .. NANCIL...
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Report pertalaln1 my oprnlon,
wltli applicable regulations.
POSIDON NAME OF ORGANJZATION/ENIITY
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PARTIES AND TERMS
· i2AIJi SOUR.CE AND TYPE
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GROSS INCOME
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AO-lO(WP) FINANCIAL DISCLOSURE REPORT . Report Required by the Ethlcs In Govenunrnt .4ct of 1918,Rev. 1'2004 FOR CALENDAR YEAR 2003 (S U.S.C. .4pp. §§101-111)
1. Penoa Reporting (Llut name.jirat, middle initial) 2. Court or Qrpalzatloa 0· , i.i;tvt<:! <k>ucs+
3. Date of Report :l {Q,T...... . \f °P-i"b l [(,(1 l'S ?..
4. Title (Article Oljudges indicate active or ienior 1ta111S; lndlca;e ull- orpart-time)
s. Report Type (cheek appropriate type) 6. Repo la1 Period
.S . r1Ck ..Jt.J e. _Nomination, Date a.vi. i. <o .,::
S,tt.Vl cbc- tb _Initial Annual Final ,, oo 8. On the basis or the lnformatioa contained In this and
any modlOcatioa1 thereto, lt ls, ln la compliance laws and
I. POSffiONS. (R tntllvidualonly,·1upp. 9-13 ofln11n1t:t1ons.)
D NONE (No reportable positions.) .
IL AGREEMENTS. (Reportingindividual only;'" pp. U-16 oflutructionsJ (t) :::0 C'> -- mJ2Am r-""' o(l>:Z NONE (No reportable agreements.) ;:oZ
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m. NON-INVESTMENT INCOME. (Report1ngindtvidualmuJapouse:,.pp.11-240/1na1ruc11onsJ
A. Filer's Non-Investment Inc0me
NONE (No reportable DOD-investment income.)D 1
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B. Spouse's Non-Investment Income - If you were married during any portion of the reporting year, please complete this· · section. (dollar amount not required except for bonoraria)
NONE (No reportable non-investmcnt·income.)
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DBSCR!PTION
SOURCE DESCRIPTION
CREPITOR DESCRIPTION VAWECODE*
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.. FINANCIAL DISCLOSURE REPORT Name ofPcnon Reporting
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IV. REIMBURSEMENTS transportation, lodging, food, entertainment. -
(Includes those to spouse and dependent children. See pp. 25-27 of Instructions.)
SOURCE
NONE (No such reportable reimbursements.)
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V. GIFI'S. (Includes those to spouse and dependent children. See pp. 28-31 of I tructions.)
VALUE
NONE (No such reportable gifts.)
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VI. LIABILITIES. (Includes those of spouse and dependent children See pp. 32-33 of Instructions.)
NONE (No reportable liabilities.)
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.. FINANCIAL DISCLOSURE REPORT Date of ReportName of Pcnon Rcpm1ing
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VII. Page 1 INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children. See pp. 34-57 of Instructions.)
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Name ofPenon Reportlna Dato of Report
FINANCIAL DISCLOSURE REPORT
VII. Page 't INVESTMENTS and TRUSTS •• income, value, transactions (Includes than of spouse and dependent children. See pp. 34-$7 of /111tructions.)
D NONE (No reportable income, assets,
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Signa
Name of Penon Reporting FINANCIAL DISCLOSURE REPORT
Vlll. ADDITIONAL INFORMATION OR EXPLANATIONS (Indicate part ofReport.)
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IX. CERTIFICATION.
I certify that all information given above (including information pertaining to my spouse and minor or dependent children, if any) is accurate, true, and complete to thebest of myknowledge andbelie and that any information not reported was withheld because it met applicable statutory provisions permitting non-disclosure.
I further certify that camed income from outside employment and honoraria and the acceptance of gifts which have been reported are in ·
compliance with the pr_ovisions of S U.S.C. app., § 501 et. seq., S U. .C. § 7353 and Judicial Conference regulations.
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLYFALSIFIBS OR FAILS TO FILE nns REPORT MA y BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. App., § 104.)