Академический Документы
Профессиональный Документы
Культура Документы
1/2011
Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app. 101o111)
5b. [] Amended Report 7. Chambers or Office Address 8. On the basis of the information contained in this Report and any modifications pertaining thereto, it is, in my opinion, in compliance ~ith applicable laws and regulations. Reviewing Officer Date
IMPORTANT NOTES: The instructions accompanying this form must be followe~ Complete all parts,
checking the NONE box for each part where you have no reportable informatlot~ Sign on last page.
NAME OF ORGANIZATION/ENTITY
2. 3. 4. 5.
Ha.q_qertv, Ancer L.
III. NON-INVESTMENT IN COME. :Reponi.# individual and spouse seepp. 17-24 of filing instructions.)
A. Fliers Non-Investment Income
~
2. 3. 4.
B. Spouses Non-Investment Income - t/~,ou were married daring an.vportion of the reportingyear, complete this section.
(Dollar amount not required except for honoraria.)
1.2010 2.2010 3. 4.
DATES
LOCAT1ON
PURPOSE
V. G IFTS. ancludos ,hose ,o s~,ou,e ond depend~nt children; see pp. 28-31 of filing instructions.)
NONE (No reportable gifts.)
SOURCE 1. 2. 3. 4. 5. DESCRIPTION
VALUE
VI. LIABILITIES. ancludes those o: spo~se and de~,endent children; see pp. 32-33 of filing instructions.)
D NONE (No reportable liabilities.) CREDITOR
1. 2. 3. 4. 5. On Point Credit Union(y) American Express Credit Card Credit Card
DESCRIPTION
VALUECODE
J J
VII. INVESTM ENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
(I)
Amount Code I (A-H)
(2)
Type (e.g., div., rent, or int.)
O)
Value Code 2 (J-P)
(2)
Value Method Code 3
(Q-W) I. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1 I. 12. 13. 14. 15. 16. 17. Key Bank of Oregon U.S. Government Bonds Tenants in Common, Harrison Co., Texas Victory Tax-Free Money Market Sierra Pacific Development Fund II American Spectrum Realty, Inc Com Victory Prime Obligation Class A Target Focus (y) Target Traic (y) Bric Part Ser 8 Monthly (y) Touchstone Large Cap Growth Fund (y) Aguila Three Peaks High Income Fund (y) Loomis Sayles Bond Fund(y) Davis NY Venture Class A (y) Dodge and Cox Income Fund (y) American Funds: Europacific Growth Fund Class F (y) American Funds: Fundamental Investors Fund (y) A A A A
A
Interest
Interest
J
J
T
T
J J J J J
W T T T T
I. Income Gain Codes: (See Colunms BI and IM) 2. Value Codes (See Columns CI and D3) 3. Value Method Codes Isee Column C2)
A =51,000 or less F =$50,0OI - 5100,0~0 J =515.000 or less N =$250.001 - 5500.000 P3 -525.000,001 - 550.000.000 Q =Appraisal U =Book Value
B -$1,0OI - 52,500 G =$100,001 - 51,0OO,000 K 515,001 - $50.000 O =$500,001 - $1,0~0.00~ R =Cosl (Real Estate Onlyl V Other
C =$2,501 - $5,000 HI =51.000.001 - $5.009.000 L -S50.001 - 5100.000 PI 51.000.001 - $5.00~.0~0 P4 =More than $50.0~0,000 S =As:,cssmenl W =Eslimatcd
D =55.001 - 515,000 H2 =More than $5,0~0.0~ M =$100.001 - $250,000 P2 -$5.000.001 - $25.000,000 T =Cash Market
E =$15.0~1 - S50,000
VII. INVESTMENTS and TRUSTS - income, value, t ..... ctions (Includes those of spouse and dependent children; see pp. 34-60 oJfiling instructions.)
NONE (No reportable income, assets, or transactions.)
A. Description of Assets (including trust assets) Place "(X)" after each asset exempt from prior disclosure B. Income during reporting period (1) Amount Code I (A-H) (2) Type (e.g., div., rent, or int.) C. Gross value at end of reporting period (I) Value Code 2 (J-P) (2) Value Method Code 3 (Q-W) Transactions during reporting period
(2)
(3)
(4)
Gain Code I (A-H) Identi~y of buyer/seller (if private transaction)
18.
19.
20.
(y)
I. Income Gain Codes: (See Columns B I and 134 ) 2. Value Codes ~SceColumns CI and D J) 3. Value Mclhod Codes (See Column C2)
A =$1,000 or less F =$50.001 - S 100.000 J =$15,0~O or less N =$250.0OI - $500.000 P3 $25.0OO.001-$50.0OO.000 Q-Appraisal U =Book Value
B =$1,001 - $2,500 G -S 100.001 - $1.00O.000 K =$15.0~I - $50,0~) O -$500,001 - $ I.OO0.O(tO R Cost { Real E,tale Only) V Olhcr
C =$2,501 - $5,000 H I = $ 1.000.001 - $5.1300.000 L =$50,0OI - $100,000 PI =$1.0OO.001 - $5,/~O,000 P4 = More than $50,000,000 S =Asscssmcnl W =Estimated
D =$5,001 - $15,000 H2 =More than $5.00~.0OO M =$10~.0OI - $250,0~0 P2 =$5,O00,001 - $25,000,000 T =Cash Market
E =$15.001 $50,000
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 the best of my knowledge and belief, and that any information not reported was withheld because it met applicable statutory provisions permitting non-disclosure.
I further certify that earned income from outside employment and honoraria and the acceptance of gifts which have been reported are in compliance with the provisions of 5 U.S.C. app. 501 et. seq, 5 U.S.C. 7353, and Judicial Conference regulations.
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FALLS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. 104)
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544