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Due By April 28, 2006 Khode Island Clhics, Commission 2005 YEARLY FINANCIAL STATEMENT 05 FS-4 te 4 ALAN A ARSENAULT PO -B0X-580 CHARLESTOWN RI‘ 02813 7 4 ALL QUESTIONS REFER TO THE CALENDAR YEAR JANUARY 1, 2005 THROUGH DECEMBER’ 31, 2005 UNLESS OTHERWISE SPECIFIED. Please answer all questions and where your answer is “none” or “not applicable" so state. ANSWERS SHOULD. BE PRINTED OR TYPED, and additional sheets may be used if more space is needed. For clarification of any question, read instruction sheet. Note: If you are a state or municipal official or employee that is required to file a Yearly Financial Statement, a fallure to file the Statement is a violation of the law and may subject you to substantial penalties, including fines. If you received a 2005 Yearly Financial Statement in the mail but believe you did not hold public position in 2005 or 2006 that requires such fing, you should contact the Ethics Commission (See Instruction Sheet for contact information). 1 OL! Tae oFFicn wer or ty 2 rh eile ness ‘etn ‘ema va cont 3. List Public Position(s) you hold and governmental unit: OF bad IN TibnicPALTy, STATE OR REGIONAL aren) Iwas elected in Wa Iwas appointed in M/A Iwas hired in 298) Gear Gear) yee) Ifyou ne longerhold publi poston, state year of termination o resignation V/A) {WORCIPALTY, STATE OR REGONATT 4. List elected office(s) for which you were/are a candidate in either calendar year 2005 or 2006 (Read instruction #4) N/A | 5. List the following: NAME OF SPOUSE NAME(S) OF DEPENDENT CHILD OR CHILDREN | Lapcarer Arse Rv WA | “Pant ALINE HERE! Wy o/n oy Nouisod SS3NISNE 40 SS3UAQY aNY SYN ‘BGWIAW ATW JO 3YN Uuonisod jueweBeueW e 10 ‘eaysnsy‘ieused ‘Jeaylo ‘iojoeuIp e se UoNISod & PI84 pile 1uepuadep 10 ‘esnods uno ‘no YoIUA Ul "youd-UoU! 40 youd ‘sseutsNg Aue Jo SseJppe pue aWeU ey) 3877 WN S1assv vy ‘SNOONI LSM ONINIZOY ‘USGI ATMS 3O SAWN WN a ee SSSOOY ONY 341STEL 40 SIN Wi “ASM. 40 SAWN (snowy ¥817 ON 0G) ‘unoUy 1! sjasse js17 ‘eUIOoU! $s016 @10Ur 10 OO0'L$ Pariso! AljenpIAIpUl UEuPIYO 40 plyo JuBpuadep Jo ‘asnods nok ‘nok yolym wow} ‘sna, Aue Jo seIsn] sy} JO SsaIppe pue eWeU ‘Jsruj AUE Jo SwIEU OM 18/7 Dat 41981897 "gad DUNT No r7¥3q base 403 20M) YT7IL scone Ove HL NS Fa NolLaloeaa wo ssauaay {SSN JO 3unLWN sary 7Sau3U! |eIoUeUY @ peY pIlyo juepUadep 10 ‘esnods 4nof ‘nok yoiy% ul “souspises jediouud snok ueU) Jayjo ‘eye3Se Jes Aue Jo uoRduoSep jeBe| 10 sseippe au 18/7 Adasaad ~ 8961 La 00 TweDRy ori VION LSD L WIS — 18bt vousa7HN so Nan = LUNE Uy Df

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