arthur d spatt financial disclosure report for 2009

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  • 8/3/2019 Arthur D Spatt Financial Disclosure Report for 2009

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    ao lo [ FINANCIAL DISCLOSURE REPORT R e p o r t R e q u i r e d b y t h e E t h i c sin Go verr tment Act of 1978g e ~ : 1 / 2 0 1 0 [ FOR CALENDAR YEAR 2009 ( 5 U . S . C . a p p . z O t - I t 1)I . P e r s o n R e p o r l i n g ( l a s t n a m e , f i r st , m i d d l e i n i t i a l ) 2. Court or Organization 3 . D a l e o f R e p o r tSpate, Arthur D. Easte rn Dis tr ic t of New Y ork 0 5 / ! 0 2 0 1 0

    4 . T i t l e ( A r t i c l e I l l j u d g e s i n d i c a l c a c t i v e o r s e n i o r s : a t u s ; 5 a . R e p o r t T y p e ( c h e c k a p p r o p r i a te t y p e ) 6. Reporting Periodm a g i s t r a t e ju d g e s i n d i c a t e f u l l - o r p a n - t im e )[ ] Nominat ion . D a t e 01 / 01 / 2 009U.S. Dist r icrJudge, Senior [] lmtial [] A .... I [] Final to1 2 1 3 1 / 2 0 0 9

    ~b? [ ] . a .m endedRc por t7. Chambers or Office Address 8 . O n t h e b a s i s o f t h e i n f o rm a t i o n c o n t a i n e d i n I h i s R e p o r t a n d a n ym o d i f ic a t i o n s p e r t a in i n g t h e r e t o , i t i s , i n m y o p i n i o n , i n c o m p l i a n c eLong Island Federal Courthouse ~,ith a pp l i ca b le l a w s a n d r eg u l a t i ons ,P.O. B o x 9 0 1 4Cent ral Is lip , New York 11 722 Re,ie~ing Officer D a t e

    IMP OR TAN T NO T ES: rhe ins truct ions accomp any ing th is form mt~t be fo t towed. Complete a l l parts ,ch ec l , i n g th e N O N E b o x]o r ea ch p o r t w h e re y o u h a ve n o rep o r t a b l e i n f o rma t i o n , S i g n o n l a s t p a g e .

    I . P O S I TI O N S . r n ~ o r r i , , . i n d i 3 id u M o n l y ; s e e p p . 9 - l J o f f ! l in g i . . .. . " t i o n s . )~ N O N E (No reportable positions.)POSITION NAME OF ORG ANIZATION/ENTITY

    I.2.3 . ,--4. ~ -- ~-

    1 1 . A G ~ E M E N T S . (Reportlng individualonl); see p~ 14-16 offiling instr,ctions.) p i~ NONE ~No reportable agreements.)

    DATE pAKFIES AND TERMSI. 1979 Prior pens ion ~d profi t -shanng p lans ro lled over (See Ride~ I annexed here to)

    2 . t 9 79 lnd i v i d ua l R e t ir e me n l ~Ke o gh " Plan ( Se e R i d e r 2 anne x e d )

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    Iame of Person Report ing Date of ReportFI NANCI AL DIS CLOS UR E REPO RT I s p a. . Arth ur D . 0 5 / 1 0 / 2 0 1 0Page 2 of 12I I I . N O N - I N V E S T M E N T I N C O M E . tR ,po . i .g i .d i~ ia~a la ,d*po~, ,~,~,~pp . 17 -24 o . t .~l i , r=. ,~. io~*OA. F l iers Non-Investment Income

    NONE (No reportable non-investment income.). D ATE S O U R C E A N D T Y P E ~( you r s , n o t s p ou s e s )

    I. 2009 New York State Retirement Pension $18,627.962.

    3.

    4.

    B . S p o u s e s N o n - I n v e s t m e n t I n c o m e - if you were married during any portion of the reporting year, complete this section.(Do l la r orno t~ t~ t no t reqo ired excep t f i~ r h ono ra r ia . )

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

    I.

    3.4.

    IV. REIMBU RSEMENTS -( Inc lu d es rh od e to ~7~ ou se a nd d ep en d en t ch t ld ren ." s ee p p 2 J - 2 7 0 f f i l ing in s tru c t i ,~ns l

    N O N E (No reportable reimbursements.)S O U R C E D A T E S L O C A T I O N P U R P OS E I T E M S P A I D O R P R O V I D E D

    I.

    2,3.4.

    5.

  • 8/3/2019 Arthur D Spatt Financial Disclosure Report for 2009

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    FINANCIAL DISCLOSURE REPORT [ N a m e o f P ~ r x o n R e p o r t in g [ Da te of Repor tP a g e 3 o f 1 2 1 1 s p a l - t. A r t h u r D . I 0 , , ,v . G I F T S . (Inctuaes t ! ,ose to s~o , se a ,a a ,p , na ~t chi ldren; see pp . 28-31 o f f i l ing ins truct ions . )

    ~ NONE (No reportable g~s.)~ DESCRIPTION VALUE

    1 . U.S . T~asuq U~ n t he dea t h o f I $ 0 . 0 0

    2 . rece ived l i fe insurance procceds in the fo~ of a check from the U.S.3. Treasu~ in the sum of $3,424.78, which she endorsed to the orde r of4. Carol Cennard5.

    V I . L I A B I L I T I E S . a n , .t ~ d , ~ , h o ~ , o / s p o u s , , ~ d a o p e , a . .. . h ~ r e , : x e c p p . 3 2 - 3 3 Of filing i n s t r u c t i o n s . )N O N E (No reportable liabilities.)

    CREDITOR DESCR, IPTION VALUE CODE1.2 .3.

    4.5.

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    F I N A N C I A L D I SC L O S U R E R E P O R T [ r ~ a m e o f ~ c r ,o , r ~ e p o " i n g I D . . .. r a e p o .P a g e 4 o f 12 ~ Spatl, A.hur D. ] 0 5 1 1 0 1 2 0 1 0

    VII. INVESTMENTS and TRUSTS -- i ......... t,,, i ...... 6ons anc luaes those o[spous ,~d d epeMent chi ldren; see p, . S4-60 o f f i l ing instruc tions . )N O N E (No reportable income, assets, or transactions.) ~

    D e s c r i p t i o n o f A s s e t s I n c u m c d u r i n g ~ G r o s s v a l u e a t e n d T~nsac lio,s du ring repoaing peri~ j(includingt~sl ~sse~s) ~ r e p o r t i n g p ~ r i ~ ~ o l r ~ o ~ i n g , p e r i o d - ~~

    (4) -~- - ~5) ~ -~P l a c e " ( X ) " a l t e r e a c h a s s e t ; A m o u ~ t [ Ty~ (e.g. , V a lu e V a lu e T)~ (e.g. , Da~e . Va lue

    e x e m p t f ro m p f i ~ r d i s c l o s u r e C o d e I d i v , r n t , C o d e 2 M e ~ o d b u y , s e l l , m~d~ y y ( CMe 2 C ~ e I b u y c r / ~ c l k r ,,

    I. STOCKS: [ 2 . AIR TOU CH COM M U N ICAT I ONS A Div idend J T

    3. AMERITECH - COMMON A Divideml J T4. AT&T - COMMON A Dividend J T

    5. BELL ATLANTIC - COMMON A Dividend J T6. CHEVRON - TEXACO A Di, idend K T7 . COMCAST - COMMON A Dividend J T

    8 . E A S T M A N KODAK - COMMON A Dividend J T9. PACIFIC TELESIS - COMMON A Dividend J T

    10 . PEPSICO - COMMON A Dividend K T

    I I_ SOUTHWESTERN BELL - COMMON A Dividend J T

    1 2 . U.S. WEST - COMMON A Dividend J T13 . XEROX - COMMON A Dividend J T14 . U.S. W EST MEDIA GROUP A I n t e r e s t J T

    15 . EASTMAN CltEMICAL CO. A Dividend J T

    16 . AIRTOUCH COMMUNICAIIONS A Dividend J T17 . NCR CORP. A Dividend J T

    (See C o lumns C I ~ d D ]) N ~$250.~I - $500.~ O ~$500,~1 - $1,0~0,~ PI ~l,00O,~l - $5.~,~ 12 =$S,~.~l - $25,~,~P] =$25,~.~)1 - $50.~).~0 P4 ~M~e then $50,~.~) ~

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    F I N A N C I A L D I SC L O S U R E R E P O R T N .... fP ... . . R e p o r H n g I D a t e o f R e p o r tPage 5 of 12 Spatt, Arthur D.[

    05/I0/2010

    VII. INVESTMENTS an d TRUSTS - i . . . . . . , . , a t u e . t . . .. . . a o n , a . c t ~ a e ~ ~ h o ~ , o ~ . . .. .. a a p , . a , . ., . n u a ~ , . ; , , , ~ , . 3 4 - ~ o o Z , ~ i . g~ N O N E (No reportable income, ~sets. or lransactions.),~ ~. 1 ~. " .............................c. -b ........................D e s c r i p t i o n o f Assets I n c o m e d u n n g G r o s ~ v a l u e a t e n d T ~ n ~ c t i o n s d u r i n g r e p o r ti n g p e r i o d~ (includlag t~st assets) rc~Oing per iod of repo~in2pedo~_ .............................; ~ (I ) (2 ) ( I) (2 ) (l) i (2) ~ (3) (4)D a e ~ V a ue G a i n I d e n t i t y o f,i P l a c e " { X ) " a R c r e a c h a s s e t ~ A m o u n t T ~ ( e g . , V a ~ u e ~ Value T ) ~ e . ( e g . , m~d~yy Code 2 C o d e I buy~sel lere x e m p t t ~ o m p ~ o r d i s c l o s u r e ~ C o d e I d i v . , t e n 1 , C o d e 2 Meth~ b u y , s e l l ,

    ~ TRICON GLOBAL A Dividend J T19 . SBC COMMuNIcATIONS A Dividend J T

    2 0 . COMPAQ COMPUTER A Dividend J T2 1 . GENERAL ELECTRIC CO. A Dividend J T

    2 2 . AGERE SYSTEMS, INC. A Dividend J T

    2 3 . YI,.IM BRANDS, INC. A Dividend J T. . 2 ~ . IIEWLETT PACKARD CO. A Div idend J T

    2 5 . QW EST COMMUNICATIONS A Dividend J T2 6 . CttESAPEAKE UTILITIES CORP. A Dividend J T2 7 . VODAFONE A Dividend J T

    2 8 . iDEARC iNC. A Dividend J T2 9 . LSI Corp. A Dividend J T3 0 . LIMITED PARTNERSIHP3 1 . BERKSH IRE LAND VENTURE CO. A Dividend J U3 2 . BERKSH IRE LAND VENIq3RE CO. A I n t e r e s t J U3 3 . INTEREST

    3 4 . NORTH FORK BANK, including IRA A Interest L Taccounts & cash

    2 . Va h ~ Cod e s J = $ I S,O00 or le~ K -$1 5,00 1 - $50,1X ~0 L ~$50,001 - $ ! 00, t%~0 M = $ 100 , 001 - $ 2 5 0 .000

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    F I N A N C I A L D I SC L O S U R E R E P O R T r ~ . . .. f ~ . . . . .. , e p o . i . ~ I D o t , o r a e p o .Page 7 of 12 Spa, t , A~o. I

    V I I . I N V E S T M E N T S a n d T R U S T S - i . . . . , , ~ a l u e , t . . .. . , io n s ( I n t r u d e s t h o s , o f s p . . . . . . d d e p e n d e n t c h i l d r e n ; s , e p p . 3 4 - 6 0 o f f i l i n g i n s t r u c t i o n s . )N O N E ( N o r e p o r t a b l e i n c o m e , a s s e t s , o r t r a n s a c t io n s . )

    D e s c r i p t i o n o f A s s e t s I n c o m e d u r i n g G r o s s v a l ~ e a l e n d T r a n s a c t i o n s d u r i n g r e p o r t i n g p e r i o d( i n c l u d i n g , r u s t a s s e t s ) r e p or t i n g p e r i o d o f re p or t i n g p er i o d........................t) i (2) (1 ) (2 ) (1 ) F (4 )Amounl ! T y p e ( e . g . , V a l u e V a l u e | Date ] Value G a i n I d e n ~ i . y o fP l a c e " ( X ) " a f t e r ~ a c h a s s e t . T y p e ( e g . ,Code I [ d i v . , r e n t , C o d e 2 M e t . h o d b u y , s e l l. I m r r u d d . ; . v y : C o d e 2 C o d e I b u y e r ] s e l l e rc x c ~ n p t f r o m p r i o ~ d i s c lo s u r e |A - I t ) or i r t t ) ( J - P ) C o d e 3 r e d e m p t i o n ) : (J-P) ( A - H ) ( i f p . , i v a t e( Q - W )5 2 . Rochester, NY A I n t e r e s t J T

    5 3 . North ColonieSchool Dist. A I n t e r e s t K T

    5 4 . Port Author i ty N Y & NJ A I n t e r e s t K T5 5 . L.I. Power Authority A I n t e r e s t J T5 6 . Triborough Br idge & Tunnel Author i ty A I n t e r e s t K T5 7 . NY STATE DORMITORY AUTHORITY B I n t e r e s t K T B u y 06/24 K

    5 8 . NORTHPORT-E.NORTI IPORT A I n t e r e s t K T

    5 9 . Syracuse NY UGO A I n t e r e s t J T

    6 0 . Sachem Cent . Sch . Dis t . A I n t e r e s t J T :6 1 . NY STATE POWER AUTIIORITY A I n t e r e s t J T

    6 2 . N Y State Enviror~mental FACS A I n t e r e s t J T

    6 3 . Buffalo , NY A I n t e r e s t J T6 4 . Niagara Wheat fie ld , NY Cent ral A I n t e r e s t K T

    65 . IIAVERSTIL~W STRONG POINT A I n t e r e s t J r

    6 6 . RENSSELEAR NY MUN. A I n t e r e s t J T B u y 0 7 / 2 0 J6 7 . IRA STOCKS 68 . ALLEGItENY ENERGY INC. A Dividend J T [

    tS e e C 01 ur n na C I a nd D 3) N = $2 50 .0 0 1. $ 50 0.0 0 0 0 = $ 5 0 0 . 0 ~ ; I - $ 1 . 0 0 0 . 0 0 0 P l = % I . O 0 0 .0 0 l -

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    N a m e o f P e r s on R e p o r t in g D a t e o f R e p o r tP a g e F I N A N C I A L 8 o f 1 2 D I S C L O S U R E R E P O R T ] S p a t t , A r t h u r D . 05/10/2010

    VII. INVESTMENTS and TRUSTS - i .... ,, value , t . . . .. . Hon s ( Includes those of sp . . . . . . d d e p e n d e n t c h i l d r e n ; s e t p p . 3 4 - 6 0 o f . fi li n g i n s t r u c , io n s . )"--I NONE (No reportable income, assets, or transactions.)

    D e s c r i p t i o n o f A s s e t s I n c o m e d u r i n g Gr o s s v a lue a t e nd Tr ans ac ti o ns d u r i ng r e p o r t ing p e r i o d(including t~sl assets) r e p o r t in g p e r i o d o f r e p o r t i n g p e r i o d( ] ) i ( 2 ) + - - ( 1 ) ( 2 ) (1) (2),f~!. (4)5)T y p e ( e . g .,lace "(X)" aft .. . . . h as~t A .... t T y p e ( c g . , Value Value [ [Date [ ,~,ue Gain I d e n t i t y o f

    e x e m p t f r o m p r i o r d i s c lo s u r e Code I div.,ren, : C o d e 2 M e t h o d buy, sel l . [mm/dcbyy Code 2 ~ Cod e I b u y e r / s e l l e r

    ............ I ..... !~ ___A22-~__J .......... transaction)6 9 . AMERICAN ELECTRIC POW ER CO., A Dividend J TINC.7 0 . CASCADE NATURAL GAS CORP. A Div idend J T

    7 1 . CENTRAL & SOUTH WEST CORP. A Div idend J T7 2 . CONNECTIV INC. A Dividend J T

    7 3 . CONNECTIV INC. CL A A Dividend J T7 4 . ENERGY EAST CORP.. A Dividend K T7 5 . ENOVA CORP. A Dividend J T7 6 . FPL GROUP INC. A Dividend J T

    7 7 . FIRST ENERGY CORP. A Dividend J T

    7 8 . M1DAMERICAN ENERGY IIOLDINGS A Dividend 1 TCO.7 9 . NEVADA POWER CO. A Dividend J T

    8 0 . NEW ENGLAND ELECTRIC SYSTEM A Dividend J TI 8 I . POIOMAC ELECTRIC POW ER. CO. A Dividend J T

    8 2 . TEXAS UTILIT ES CO. (tloldin g Co .) B Di~idend K T8 3 . TEXAS UTILITIES A Dividend J T8 4 . WESTERN RESOURCES INC. (W ester n A Dividend J T

    Energy, Inc.) [8 5 . PIvlC CAPITAL INC. A Dividend J T

    |. In c o me Ga in Co d e s : A :;$ 1 ,0 0 0 o r |e ss B = $ 1 ,0 0 1 - $ 2 ,50 0 C ~$2 , 50 1 . $5 .0 0 0 D =$5.6~01. $15,(K~0 E =$1 5, 0 0 1 - $50 , 0 ~

    ( S e e Colum ns CI e nd D3 ) N =$250,~1 - $5~,000 0 =$5~,~1 - 11,000,~

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    Name of Person Reporling [ Date of ReportFINANCIAL DISCLOSURE REPORT . Iage 9 of 12 ISpatt, Arthur D.VII. INVESTMENTS and TRUSTS - i .... ,, valu, ira .....ons (Includes those of sp ...... d dependen t chi l dren; seepp. 34-60 o f f i l i ng in s t ruc t i , , n s . )

    [~ N O N E (N o reportable income, assets, or transactions.)Descr ipt ion of Asse ts : Income dur i ng Gross valt~e at end Tr0.nsac t ions du r ing rcpe r t ing pe r iod

    , (including trus t asscL~) re portin g pe riod o f re po rt in g p er io dPl a c e " ( X ) " a f te r e a c h a s se t [Amoun t Type (e .g . , Vah~e Value Type (e . g . , ] Date Value Gain Ident i ty o f

    e x e mp t f r o m p r i o r d i s c l o su r e C o d e I d iv . . ren t , Cod e 2 Me th od bu y, se ll. /mn~dd/yy C e d e 2 C o d e ! buye r / se l le r(A-If ) or in t . ) (J-P) [ Code 3 re dempt ion} | (J-P) (A-H) ! ( i f p r iva t e[ [ [_.(Q-W) ..................... .... : transaction) ___

    86 . ROCHESTER GAS & ELECTRIC CORP. A D i v i de n d J T

    8 7 . SEMPA ENERGY A Dividend J T

    8 8 . SIERRA PACIFIC A Dividend J T

    8 9 . PEPCO HOLDINGS, INC. A Dividend J T

    9 0 . EAGLE MERGER CORP. A Dividend J T9 1 . RGS ENERGY GROUP, INC. A Dividend J T

    9 2 . OCCIDENTAL PEIrROLEUM CORP. A Dividend J T

    9 3. KIMBERLY-CLARK CORP. A D i v h d e n d J T

    9 4. CISCO SYSTEMS INC. A D i v i de n d J T

    9 5. JOHNSON & JOIINSON A D i v i de n d 3 T

    9 6 . PMC COMMERCIAL TRUST A D i v i de n d J T

    9 7 . THE SOUTHERN COIvIPANY A D i v i de n d J T

    9 8. WESTSTAR ENERGY A D i v i de n d J T

    9 9 . PUGET ENERGY INC. A Dividend J T1 0 0 . CIIESAPEAKE UTILITIES CORP. A Dividend J T

    I0 1 . VERIZON COM MUNICATIONS A Dividend J Ti 10n ~ . QUEST DIAGNOSTICS A Dividend K TColum~ CI ~d D3) N =$250,~ t - $500,0~ O =S5~,001 - $ I,~,~ P I ~$ I.~,~1 - $5,~,~ ~ =$5,~.~1 - S25.~0.~

    Colu mn C2 1 U =B ~mk V~lu e V

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    F I N A N C I A L D I SC L O S U R E R E P O R TI r ~ r P . e p o , ~ i a g . .. . . .. . [

    O ~ , e o t a ~ O o ~ t[Page 1 0 of 1 2 S p a t t, A ~ h u r D . 0 5 1 1 0 / 2 0 1 0

    VII. INVESTMENTS a n d TRUSTS - i ........ ~., t ......~on$ (Include$ those of sp ...... d d e p e n d e . t c h i l d r e n ; s e e p p . $ 4 ~ G r i l l i n g i n s t r u c t i o n x . )~ N O N E ~No reportable income, assets, or transactions.)A~ ................ ~ ....... :- -- ........ D.

    Desc~ipi ion of Assets l~come dur ing G r o s s v a h ~ e ~ l e n d T~nsactions during re~ing ~ri~( inc lud ing ta ls l asse ts ) [ r e p o s i n g p e r i o d of ~pot~ing pe r iod [ ........

    Pl a c e " ( X ) " a f i c r e a c h a ~ t Amount Type (e.g., ~ Value l VMoe [ Ive (eg.. Date Value Gain ldcrAhy ofe x e m p t f ro m p f i o r d i s c lo s u r e ~ C o d e 1 I div . . r cn l , C o d e 2 t Me~ buy,~e l l , [m~d~ Co de 2 ~ Co de 1 buyer/ s : l le r~A-H) ~, or in t . ) OP) ] C~e3 r e d e m p t i o n ) [ ](J-P) [(J-P) (A-H)

    ( i f p r iva t e

    1 0 3 . CHEVRON CORP. A D i v i de n d K T

    1 0 4 . ENERGY TRANFER PARTNERS A Dividend K "r

    1 0 5 . NV ENERGY INC. A Dividend K T

    1 0 6 . CORPORATE BONDS

    1 0 7 . TENESSEEVALLEY AUTItORITY Pow e~ A I n t e r e s t J TBo nd 1 9 9 3 Se r ie s C1 0 8 . COMMONWEALTII EDISON CO. 8.02 5% A I n t e r e s t J TDue %q/20021 0 9 . OPPENtlEIMER tlIGll YIELD FUND A B Dividend M T(See Rider 2 )110. W ARWICK NY CENT. A I n t e r e s t K T

    ( S e e Co l u m n s C I m ~ d D 3 ) N =$250 ,C91 - $5~ .000 0 =$560 ,~ [ - ~ 1 ,000 ,0~ Pl =$1,000,001 - $5,0~,~ P2P3 =$25,~0,~1 - ~50,000,~ P4 =More th~

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    F I N A N C I A L D I SC L O S U R E R E P O R T N .... f ~ e . o ~ ~ , p o ~ i .~Page 1 1 of 12 S p a t f , A r t h u r D. I 0 5 ! 1 0 / 2 0 1 0

    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 .RIDER 1 (Respons e to "11 - AGREEMENTS" -- first pag e)As a former par t ic ipat ing member of the Spat t & Bauman , P,C. pens ion and profi t -shar ing p lan , when I wi thdrew from the finn and the pract ice of law in 1978, myshare of the pens ion p lan was severed and "ro lled over . " The funds were not used and were p laced in ind iv idual re li rement accounts in two types of inves tments asfollows:a) bonds l ind s tocks in the aggregate value of $278,592.76 as of December 31,2009.b) cash in the Capi tal One Savings Bank , Great Neck, New York branch, in the sum of $2 7,357.77 as of December 3 I , 2009 .RIDER 2 (Respon se to "11 - AGREEMENTS" -- first pag e)Pr ior to ente r ing in to the Spat t & B auman, P.C, pens ion p lan, when I , ,, , ,as ~ s ingle pract i t ioner l s tar ted an ind iv idual re t i rement "Keogh Plan.~ Wh e n I w i t h d r ewfrom the pract ice of law, I "ro lled over" the Keogh Plan, and i t remains in that un used cond i t ion. The "Keogh" funds are in an Oppenhe i llae r l l igh Yie ld Fund andare in the value of approximate ly $26 ,355,26 a. s of December 31,2009.

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    N a m e o f P e r so n R e p o S i n g D a t e o f R e p o r tF I N A N C I A L D IS C L O S U R E R E P O R TI Sport, .Arthur D. 05/10/2010Page 12 of 12

    I X . C E R T I F I C A T I O N .I ce r t if y t ha t a l l in f o rma t i on g i ven a bove 0n c l ud i ng i n f o rma t i on pe r t a i n i ng t o my spouse a nd min o r o r depen den t ch i l d r en , i f a ny) i sa ccura t e , t r ue , a nd comp l e t e t o t he be s t o f my k now l edge a nd be l i e f , a nd t ha t a ny i n f o rma t i on no t r epo r t ed w a s w i t hhe l d beca use i t me t a pp l i ca b l e s ta t u t o ry .provi s ion s pe rm i t t i ng non -d i sc losu re .I f u r t he r ce r t if y t ha t e a rned i nc ome f rom ou t s i de empl oyment a nd hon ora r i a a nd t he a ccep t a nce o f g i f t s svh l ch ha ve been r epo r t ed a r e i ncompl i a nce w i t h t he p rov i s i ons o f 5 U. S. C. a pp . 5 01 e t . s eq . , 5 U.S . C. 7 35 3 , a nd Jud i c i a l Conf e r ence r egu l a t i ons .

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    NOTE: ANY INDIVIDUAL WItO K NOWINGLY AND W1 LFULLY FALSIFIES OR FALLS TO FILE THIS REPORT MAY B E SUBJECT TO CIVIl,AND CRIMINAL SANCTIONS (5 U.S.C. app. 104)

    FILING INSTRUCTIONSMail signed original and 3 additional copies to:

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