SF278 (Rev.0312000) Executive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORT Form Approved: 5 C.F,R. Part 2634 OMB No. 3209 - 0001 U.S. Office of GovernmentEthics

DateofAppo~~nt. CandldacY;jElection. Calendar Year Termination TerminationDate(IfAppJl-NewEntrant, Reporting Incumbent Fee for Late Flllngor Nomination MoneJl Dav.Year Covered by Report Filer D cable)(Month,Day, Year)Status Nominee, or Igj Any Individual who Is required to fileD(CheckAppropriate Candidate this report and does so more than 30 daysBoxes) I I I I after the date the report is required to be Last Name Plrst Name and Middle Initial flied, or, If an extension Is granted. more than 30 days after the last day of the

Reporting Individual's Name Gingrich Newton L. filing extension period, shall be subject

to a $200 fee.Department or Agency (If AppJJcabIe) Position for Which Flllng

Title of Position

Reporting Periods Incumbents: The reporting period is the preceding calendar year except Part

President of the United States

Address (Number, Street, CIty, State, and ZIP Code) Telephone No. (Include Area Code) Location of 11 of Schedule C and Part 1of Schedule D Present Office where you must also Include the flllng3110 Maple Drive, Suite 400, Atlanta, GA 30305 678·973·2306(or forwarding address) year up to the date you file. Part 11 of

Schedule D Is not applicable.Title of Posltlonts) and Date(s) Held Posltlon(s) Held with the Federal

Government During the Preceding Termination Fliers: The reporting12 Months (If Not Sameas Above) period begins at the end of the period

covered by your previous flllng and ends at the date of termination. Part 11 of

Name of Congressional Committee Considering Nomination Do You Intend to. Create a QJ.Iallfied DIversified Trust7 Schedule D is not applicable.Presidential Nominees Subject to Senate Confirmation DYes ON:> Nominees, New Entrants and

Candidates for President and Vice President:CertifIcation Signature of Reporting Individual Date (Month. Day, Year)

1CERTIFY that the statements I have Schedule A-The reporting periodmadeonthisformand all attached for Income (BLOCK C) is the precedingschedulesaretrue.completeandcorrecttothe bestofmy knowledge. calendar year and the current calendar;1/~ L 7-1~-201/~ year up to the date of fmng. Value assets

Signature of Other Reviewer as of any date you choose that Is withinDate (Month, Day, Year) /'Other Review 31 days of the date of fl1lng. ,(If desired by agency)

Schedule B-Not applicable.

Schedule C, Part 1 (Liab1l1tles)--TheAgency Ethlcs Official'sOpinion Signature of Designated Agency EthiCS OffiCial/Reviewing Official Date (Month, Day, Year) reporting period Is the preceding calendar

year and the current calendar year up toOnthe basis ofblformalion contained inthis report, I conclude that the filer isin compliance any date you choose that Is within 31 days with applicablc laws and regulations (subject to of the date of filing. anvcomments inthebox below).

Signature Schedule C, Part 11 (Agreements or Office of Government Ethics

Date (MontIl, Day, Year) Arrangements)-Show any agreements or

Use Only arrangements as of the date of fl1lng.

Schedule D --The reporting period is Comments of RevieWing Officials (If addltJonaJ space Is requIred, usc th« reverse stae of thIs sheet) the preceding two calendar years and

the current calendar year up to the date of filing.

(Clleck box If fWng extenston granted & tudicnte number of dayS~) ~ Agency Use Only

OGE Use Only (Check box If comments are conttnued on the reverse staa) D

SupersedesPrior Editions. Which Cannot IleUsed. 278-112 NSN 7540-01-070-8444 OGl1'Adobc Aerobar version LO.1 (3/29/01)

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SF 278 (Rev. 0312000) 5 C.F.R. Part2634 u.s. Office of Government Ethics

PageNumber SCHEDULE A

2- of /?

Valuation ofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in BlockC for that item.

BLOCKB BLOCKC

Type Amount .-.... §

200 g 0 §l DateOthertI' a....

~ 8 ~ Income (Mo., Day, g g !l3 (Specifyg Yr.)VI VI

i ~ ) la o§§§~§0

] , '0IVI

I ~ N tI' Type &VI 8 <oJ~ g tI'I... ~~ N VI8 Only If£ ~§~g§;ig~g ActualVI VI ...

... I, ~

...• ~ ~ ... , ~ 8~ Honorariaj ... ... I

~

... ., I

• ~ ~ § N~ vi ... tI' ~ . 8 ... § Amount)• ~ l:i:; 'cvg... ... -,..j~tI'tI' ..... 08... ... ...0 'ilVI StI'··· ...... 8,-; ~vi'""

~

-... i 1§ ~<oJ

VI ~

VI ~a. -..· ......... 88 ~8t1'i

iCoa. ~ ~ l':! ~ l':!"'8fi;S ~ ~g'""o '""VI ~ ~ ~ <oJ .~Co. d ~ o ~~~Vlo ~~QJ~a.... ... ~ ... ...N ~ ~ VI VI N . ~.El a ~N"'NVI"'VI"'O'" ;>~ ~ ~ ~ ~ ~ ~tI' ~ ~ ~ ~ EJ~ ~~~tI'~~~ ~o

x x x,-I­ ,-f- 1­ 1-.1-­ f- l­ I- 1--1-- ----1---­.- '­

,­Law PartnershipIncome S130,000

7\-,- ,... l- i- 1--1-­

~]-[ I-

I­,-I­ -. 1-­ ....,..­ ,- f­f­ .­'­- -- - - 1-- f-- -- ­J=tI-­

-,-_ -x _I_L_ .:..1_-­- --I---­- 10­I­ ,..- -- ­=1=1 x ­- _. 1--1--1-- -- ­--- --x x x

S-Corp DlstrlbuUve Shere2,453,409

X X

s-eersX DlstrlbuUve

Shere572,274

X X

X X X

Reporting Individual's Name

Gingrich, Newton L.

Assets and Income

BLOCK A

For you, your spouse, and dependent children, report each asset held for Investment or the production of income which had a fair market value exceeding $1,000 at the close ofthe rei0rt ­ing period, or which generated more than in income during the reporting period, togetherwith such income.

For yourself, also report the source and actual amount ofearned income exceeding $200 (other than from the U.S. Government). For your spouse, report the source but not the amount of earned income of more than $1,000 (except report the actual amount of any honoraria over $200 of your spouse).

NoneD

Central Airlines Common1---------- ­DoeJones&Smlth. Bometown.StateExamples 1-------------KempstoneEquity FundI-­ - - - -._____

IRA: Heartland 500Index Fund

I Gingrich Productions, Washington, DC

2 Gingrich Productions, Washington, DC (S)

3 The Lubbers Agency, Inc, Key Biscayne, FL

4 Convertible'Promissory Note from the Gingrich Group, LLC to Gingrich Productions, Inc.

5 36085 Sherwood Street, Whitehall,WI, Rental House

6 Basilica of the National Shrine, Washington, DC (5)

.* This category applies only If the asset/income is solely that of the filer's spouse or dependent children. If the asset/Income is either that of the iller or Jointly held by the filer with the spouse or dependent children, mark the other higher categorles of value, as appropriate.

PriorEditions Cannot Ile Used. OGF)AdgbeAcrgbat version1.0,I (3/29/0I)

SF 278(Rev. 0312000)5 C.F.R. Part2634 U.S. Officeof Government EthIcs

Reporting Individual's Name

,

Assets and Income

BLOCK A

1 FLCXXXII, 24 HourFitness

2 FLCXXXII, IMG

3 FLC XXX II, Cash

4 UBSBank USA

5 FidelityAdvisorsNew InsightsFundClass C (IRA)

6 RoyceTotal Return FundConsultant Class (IRA)

7 PlmcoTotal Return Fund Class C (IRA)

8 American FundsCapitalIncomeBuilderFund ClassF, (IRA)

'l Blackrock GlobalAliocaUon Fund Inc C (IRA)

'It This category agPlles only if the asset/income Is solely that of the filer's spouse or dependent children. If the asset/income is either that of the filer or Jointly held by the filer wit the spouse or dependent children. mark the other higher categories of value, as appropriate,

Page Number SCHEDULE A continued

(Use only if needed) :3 of /g

Income: type and amount. If "None (or less than $201)" is Valuation ofAssets at close of reporting period checked, no other entry is needed in Block Cfor that item.

BLOCKB BLOCK C

Type Amount ...... ,...j

i ...... ,...j~ 0& 0 Other Date,...j N

~

a ~ Incomeii& (!I1o"Day,&§~ m0 (Specify§§

8 Yr.)If')If') a§

8 ~0 § If')

}'::I~ Type &If') N If')&§ ..... 8~ ~§~ ~~ 8~ I ~N If') ....;'

§q,...j Only IfActual&&If') 0,If') ,...j IIf') ~ ,...j I,...j~ If') If')tfl ;g ~ ~ ,...j

aij Honoraria,...j Amount)

--5 ~ ~ ,I N If'),...j ,...j ,...jI ~ ~ I~ ~~, ~~ I §

--5 ~ ,

0

I ,...j ,...j ~ g ~,...j I,...j I ,...jI ~,...j ,...j ~ 8I ,...j,...j

8 ,...j i g.n,...jg i,...j , ,...j ,...j ,...j ~ ~~a& a Cil

~

8 ~ ~ a!EiI ~ s ,...j,':::0 ..... aIf')(I) 8~s a vi ~ 8 If') 8 ~ vi 0 If')e:l e:l 1 ~ ,...j ,...j,...j If') ,...j ,...j N a '"" If') If') N N ,...j ,...j ,...jN If') If')

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 3 ~ 9'} ~~ tfl ~ .s ~

~ Q ~ ~ ~ ~ ~~ ~ ~ X X

X X

X X

X X X

X XX

X X X

X X X

X X X

X X X

.

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SF 278 (Rev. 03/2000)5 C.P.R. rart 2634 U.S. Office ofGovernment Ethics

lteportlngIndlvldual's Name

, SCHEDULE A continued (Use only if needed)

PageNumber

q of /g

Assets and Income Valuation ofAssets at close of reporting period

Income: type and amount. If "None (or less than $201)" is checked, no other entry is needed in Block Cfor that item.

BLOCK A BLOCKB BLOCKC

Type Amount ,.-., .... a .... V')

§~~ § ~ 8] vi' V'l .... .... V') V')

V') J ,\.< 0

, .... .... a8'-' ....

I a V'l o~ .... .... V'l V') V') V')

§.0 V'l N V') , ....

~ .... V')

~ V'l V')

J .... ~ V'l N V')

§ §~ .... V') , ....

~ V'l V')

~ ~ § V'l V')

g ,

I.... V')

~ ....~

V')

!§~

~ 0

§~V'l V'l V')N

V') ,

~ , .... ....

~8 g V'l V')

~ V'l

V'l N V') V')

j '-'

~ ~ ~-~ ~ ~ ~ ~ ~

~ ]~

~ ~ .;;a 0

~ '&:j

~ ~ '8 ~ ell '-' ~

&s .s

-­.... 0 N V')

~ ~ ].~

o S'3 '-'

I3

~ .... V') , .... 0 N V')

8 ~V'l N~

V'lV') V'),

J .... .... a 0 V'l .... N

V') V')

~ ~ 0 V'l V'l .... V') V') J, .... .... 8avi' V'l .... V') V')

~ 8.... V')

J .... 8 0 V'l V')

~ 8. §..... V')

~,

.... 8 ....

V') g \.<

8.... V')

§ Other

g Income (Specify

! Type &V'l V') Actual,

Amount).... 8 V'l gV')

\.<

8.... V')

Date (!'t1o.,Day,

Yr.)

Dnlylf Honoraria

1 First Eagle Global Fund Class C (IRA) X X X

2 FT-Franklin Income C, ,<IRA) X X X

3 IVA Worldwide Fund Class C (IRA) X X X

4 Plmco All Asset Fund (IRA) X X X

5 AmericanFunds CapitalWorld Growth &Income X X XFund (IRA)

6 FT Mutual Shares (IRA) X X X

7 Templeton Income Fund (IRA) XX X

8 IShares OJ Select Dividend Index Fund (IRA) X XX

'l IShares Trust Russell 1000 Growth Index Fund X XX(IRA)

* This category applies only If the asset/income is solely that of the filer's spouse or dependent chiidren. If the asset/income is either that of the fUeror jointly heldby the filer with the spouse or dependent children. mark the other higher categories of value. as appropriate.

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SF 278 (Rev. 0312000) 5 C.F.R. Part 2634 U.S. Officeof Government Ethics

Reportlng Individual's Name SCHEDULE A continued

Page Number

. (Use only if needed) s: of

Assets and Income Valuation ofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in BlockC for that item.

BLOCK A BLOCKB BLOCKC

Type Amount

- i ~ ~

i -8.. i ~

ii 0

i Other

~

~ ~ J N

~ g ~

SA Income

~ ~ ~ i 0 § a

~ ~ i (Specify

II') II') § I8 II') N ~ 'a ~ § II') Type &

8 II') ~

~ '-' '-' l. 8N II') ~ ~ ,.

~ ~ ~ § ~ ~ Actual

~ II') II') ~ ~ ~ ~

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, Amount)~ ~ ~ ,

I I ~ ~ 8.. s .~ II') ~ ~ ~ I ~

~ 8.. j ~ ~

~ , I .~ ~

...,

~ E E i ~ e ~ ~ ~ I ,.

~ 8AI ~ ~

~ 8.. 8.. SA ~ I , I 8 v;

~ II')

i ~ ~ ~

~ 8.. ~ ~

SA ~

~ e I ~ ~ ~ 8A ~ ~ &

~

J8A 0 g ~ ! ~ ~ 'C

! J~ 8.. 0 8.. g "" !II') II') II')

~ ~ .~ .~ 0 II')

II')

~ ~ ~ II') ~ N II') ~ II') N a Q N ..., N II') ~ II') ~ ~

~ ~ ~ ~ ~ ~. ~ ~ ~ ..... u ~ ~ EI') EI') EI') EI') EI') ~

1 Rydex EFT Trust S & P 500 Equal Weighted Index Fund, Inc (IRA)

X X X

2 American Funds Capital World Growth & Income X X X

3 FT Mutual Shares C (IRA) X X X

4 Alliance Bernstein (401K) 2010 Ret Strategy R X X X

5 Invesco Money Market X X X

6 Prudential Short term Corp Bond (S -401K) X X X

7 AlllanceBernsteln 2030 Ret Strat (S·401 K) X X X

8 FidelityAdvisors New Insights Fund (J) X X X

"I Royce Total Return Fund Consultant Class (J) X XX

* This category applies only If the asset/income Is solely that of the filer's spouse or dependent children. If the asset/Income Is either that of the filer or Jointly held by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate, .

PrIorEdItions CannotBe Used. aGE/Adobe Acrobatversion i.o.i (3/29/01)

/'ir

Date oso; Day,

Yr.)

. Only If Honoraria

SF 278(Rev. 0312000)5 C.F.R. PartZ634 U.S. Office ofGovernment Ethics

Reporting Individual's Name

I

Assets and Income

BLOCK A

1 FT-Franklln Federal (J)

Z Legg Mason Western Asset Managed Mun. (J)

3 AmericanFunds Capital Income Builder Fund (J)

4 Blackrock GlobalAllocation Fund Inc (J)

5 First Eagle Global Fund (J)

6 IVA WorldWide Fund (J)

7 Nuveen High Yield Municipal Bond Fund (J)

8 Plmco All Asset Fund (J)

q AmericanFunds CapitalWorld Growth & Income Fund (J)

1< TIllscategory applies only if the asset/income Is solely that of the fller's spouse or dependent children, If the asset/income Is either that of the flIer or Jointly heldby the fller with the spouse or dependent children, mark the other higher categories of value, as appropriate.

PageNumberSCHEDULE A continued (Use only if needed) 0 of /3'

Valuation 0 f Assets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCKB BLOCKC

Type Amount .-. .-c

& .-.8 0.-c§§ § ] 0 Other Date.-c ~ 8N

§ .... j

~ §8 ~ Income (!vIo., Day,§ § § (Specifylr) Yr.)lr) § S0 .~I/") ~ ~ §I/") §N§ Type &lr)....§ ~~ 8 S§ ~ ~ 8~ IN0 ~I/") ~.-c .-c & Actual Only if0lr) 8I § 8AI/") .-c ~vi I

8.-c I~ I/") I/") .-c ~ ~ ~.-c

~ ~ ~~ § Amount) Honoraria&.-cI ~ N I/")

& .-cI .-cI

j ~ ~ .-c~ I.... ~

o ~ ~

~ ~ Q::j~,~ I 'iii §.-c .-c I I

&.-c.-c .-cI ~ I ,

8.-c

8.-c IS I/") lr).-c .-c~ .-cS &

&g ~.-c'-' .-c~ ~ ~SA '-' I .-c~

A .-c

& ~ ~

8 ~ ~gg ~!G "B

~

~

8.-c0 ....§A &0 I/")~ vi ~0 8 I/") ~ vi q0 I/")~ ~ ~ ~I/").-c .-c .-c .-cI/") .-cI/") N NN I/") I/") .-cN .-c .-c

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ a is ~~ ~ ~ 3 ~~ ~~ .2 ~

.E ~ ~ ~ ~~ ~ ~ X X X

X X X

X X X

X X X

X X X

X X X

X X X

X X X

X X X X

Prior Editions Cannot Be Used. OGE/Adobe Acrobat version 1.0.1 (3/29/01)

SF278 (Rev. 0312000) 5 C.F.R. Part 2634 U.S. Officeof Government Ethics

Reporting Individual's Name

SCHEDULE A continued Page Number

, (Use only if needed) -.::;­ of

Assets and Income ValuationofAssets at close of reporting period checked. no other entry is needed in BlockC for that item.

BLOCK A BLOCKB BLOCKC

Type Amount .­ § ]....

~ .­

~

~ .... §§ g 0 § Other....

§ .., Nf>'t g §

~ f>'t

§ g Income

~ § g§ 0

i ~

~ §~ g§ (Specify§ 0 8 In Vl

.~

§~ § Type &Vl N f>'t 8 § VlcS 8 Vl f>'t ~

~ ] ] ~ 8 f>'t ActualN Vl .... , g 0 ....j Vl Vl .... f>'t f>'t f>'t §~ , , .... ~ ~

In Vl Vl .... f>'t g , §~s N~ Amount).... f>'t ~ , , , .... ....

~ ..s .~ Vl .... f>'t f>'t , ....f>'t g '8 - f>'t f>'t f>'t 8s , , .... .... .... g E ~ ~ ~ o s .... , , ...., .... ....

~ ~ ~ ..; § f>'t

, , , .... .... ~

....~ In8 Vl

i g -­ .... ~ f>'t ~

~ ~ 'B -­ , .... .... .... 8 s f>'t f>'t

! ~ 8 ~ ~ ~ ~ ! .... 8~ 0

~ ~

I-<Vl cS In ~ .;:

~ 3 0 Vl ~ 0 8.... .... Vl .... N Vl .... In N ~ ~ S i5 1:: N .... N~ In .... In .... ....f>'t f>'t f>'t f>'t f>'t ~ ~ ~ f>'t ~ - f>'t f>'t f>'t f>'t f>'t ~ f>'t f>'t

1 IShares Trust S&P Smallcap 600 Index Fund (J) X X X X

2 IShares Trust Russell 1000 Value Index Fund (J) X X X X

3 IShares Trust Russell Mldcap Index Fund (J) X X X X

4 IShares OJ Select Olvld Index Fund (J) X X X

5 Templeton Income Fund (J) X X X

6 American Superconductor (J) X X X

7 AT&T Inc (J) X X X

8 Blackboard INC (J) X X X

Cj BoltTechnology Corp (J) X X X

* This cate&ory applies only if the asset/Income Is solely that of the flier's spouse or dependent children. If the asset/income is either that of the filer or Jointly held by the f er with the spouse or dependent children, mark the other higher categories of value, as appropriate.

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/F

Income: type and amount. If "None (or less than $201)" is

Date (Mo., Day,

Yr.)

Only if Honoraria

SF278 (Rev. 0312000) 5 C.F.R. Part 2634 U.S. Offlce ofGovernment Ethics

Reporting Individual's Name SCHEDULE A continued

Page Number

, (Use only if needed) ~ of

Assets and Income ValuationofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block Cfor that item.

BLOCK A BLOCKB BLOCKC

Type Amount .-. § ].... § .-.s § .... §§ g 0 0 Other....

~ ~ gg ... N 8~~

~ ~ ~

§ & Income

~ § ~ ~ ~ 0

I ~

~ & &~ (Specify

8 V) V)

'j:J & 8 Type &8 V) V) N VI} .... 8 & V)

VI}

~ ...

~ 8N V) .... VI} I

~ ~ § 0 .... ~ q, Actualj V) V) .... ~ ~ ~

I I .... '" j V)

V) V) .... ~ I

&& ~ N & Amount).... ~ ~ I I , .... .... g ~

V) .... ~ ~ J .... ~ J I gg j

~ ~ ~ gl5 .... .... ....

~ ~ ~ § l5 .... J J ....I .... .... s ~ ~ ~ I J I s V).... V)

~ .... .... ....-­ ....

~ ~ VI} (;0'}

~ C\l -­ J .... .... ....

~ ~ ~ ~

~ ~ 8 8 ~ ~ ~ Co ... ~ ,'::::

~ .... ~ 0

~ 8 ... ~

V) V) V) i .;;: & 3 0 V)

V) 0 ~= N.... .... V) .... N V) .... V) N

~. CJ is .s N .... V) .... V) .... .... VI} VI} VI} ~ VI} VI} 0 VI} VI} VI} ~ ~ ~ ~ VI} ~ VI} ~

1 Corning Inc (J) X X X

2 Discovery Communications ser A (J) X X X

3 Esco Technologies (J) X X X

4 Forest Laboratories Inc (J) X X X

5 Gamestop Corp (J) X X X

6 Hewlett Packard (J) X X X

7 John Bean Technologies Corp (J) X X X

8 Lincoln Ntl Corp Ind (J) X X X

'I Maxim Integrated Products Inc (J) X X X

* This category applies only if the asset/Income Is solely that of the fller's spouse or dependent children. If the asset/Income Is either that of the filer or Jointly held by the filer with the spouse or dependent children. mark the other higher categories of value, as appropriate.

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/g

Date (Mo., Day,

Yr.)

Only if Honoraria

-- --

SF278 (Rev. 0312000) 5 C.F./t Part 2634 U.S. Office ofGovernment EthIcs

Page Number SCHEDULE A continued (Use only if needed) q of 1'8'

Reporting indIvIdual's Name

.

Assets and Income

BLOCK A

1 Perrigo Co (J)

2 Quaker Chemical Corporation (J)

3 Raytheon CO (J)

4 Walgreen Co (J)

5 Campbell Soup (J)

6 Celgene Corp (J)

7 Martek 810 Science (J)

8 Lasercard Corp (J)

q Dr Pepper Snapple Group Inc (J)

* This category applies only If the asset/Income Is solely that of the flier's spouse or dependent chlldl'en. If the asset/Income Is either that of the flier or Jointly held by the filer with the spouse or dependent children. mark the other higher categories of value, as appropriate,

ValuationofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block Cfor that item.

BLOCKB BLOCKC

Type Amount

,..;

~& ,..;

! 0~ ]

0,..; Other Date~ 8N§~

§ ~ Income (Mo"Day,'=~~~ g~ (Specifyli'.l Yr,)~ IrlIrl§ ~ 0

8 ~'0Irl ~Ng§ aType &§ Irl Irl ~ 8 ~~

g ~

I

~ 8~ IN ,..;8c:5

g ~

I Irl ,..; Only if~ Actual0 ~,,..;vi ~~Irl

8,..; "1~ , ~ ,..;Irl Irl,..; r:l~ ,..;~ Amount) Honoraria,I ,..; N

l ,..; ,..; ~ ~ ~ ~~ a

£ ~ , I

al '~ ~ ~ ~ ~,..;

I "3I e ~ 10<. ,..;

Irl ~

~ • ~

~ I

& ,..; ,..; I I,

-~

I

8 ,..;

,..; ~,,..;,..; ,..;~ ~& &g0 ,..; V")...; &Irl,..; ,..;

~ ~ ~ & 0

,..; ,..;j .~ ~~ •~~ ,..;& § 8 10<

610<~ V")& Irl gg~8 §~V") ~ ~ Irl 0'~~ & vi c:5 ~,..; ,..; ,..;V") ,..; ,..; ~V") V") N N ,..;,..; ,..;N V") V")N~ ~ ~ ~ ~ ~ ~ ~~ ~~ ~ a is j 0~~ ~ ~ ~ ~ ~~

X X X

X X X

X X X

X X X X

X X X X

X X X

X X X

X X X

X X X

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SF 278 (Rev. 0312000)5 C.P.R. Part 2634 U.S. Office of Government EthIcs

Reporting Indlvtdual's Name

, SCHEDULE A continued Page Number

(Use only if needed) /0 of /g'

Assets and Income Valuation ofAssets at close of reporting period

Income: type and amount. If "None (or less than $201)" is checked, no other entry is needed in Block Cfor that item.

BLOCKA BWCKB BWCKC

Type Amount .-. .... & .... ~

~ j 5-­~ ~

~a In In.... ~ ~ ,, .... .... 8& .n.... .... ~ ~

~a 8 In

N.... ~ ~ ,, .... .... ~8

0 In .... ~ ~

§~ 8 an ~ , .... & 0 In N ~

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~ ~ ~ ~ ~In N as as a Q~

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,-. .... 0 N ~

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~ '3 -­ I .... ~ ~ .... 8~3 0 c ~ N ....- ~ ~

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aa ~ ~ § §In .... ~

~ ~ g I ...., .... g& .... In ~ ~

8 s..

~8.... .... ~ ~

Other Income (Specify Type & Actual

Amount)

Date (Mo., Day,

Yr.)

Only If Honorarla

1 Bank India (Wachovla CD) (S) X X X

2 Sovereign Bank CD (S) X X X

3 Fidelity Short Interest Municipal Income Fund (S) X X X

4 Bank India (Wachovla CD), (J) X X X

5 Homestreet Bank CD (J) X X X

6 Sovereign Bank CD (J) X X X

7 Sterling Savings Bank CD (J) X X X

8 Columbus Bank CD (5) X X X

q MedalJlon CD (S) X X X

* ThIs category applies only If the asset/Income Is solely that of the filer's spouse or dependent children. If the asset/Income Is either that of the fller or JOintly held by the flier wIth the spouse or dependent children, mark the other hlgher categories of value, as appropriate,

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SF278 (Rev. 03/2000) 5 C.F.R. Part 2634 U.S. Office of Government Ethics

ReportlngIndividual's Name SCHEDULE A continued

PageNumber ,

(Use only if needed) II of

Assets and Income Valuation ofAssets at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCK A BLOCKB BLOCKC

Type Amount

-­ § 'C • .-t

I~ I § .-. 0.-t

i § i-t< 0

~ ~ Other.-t

~ §. 5 N

IncomeEo/)

§ Eo/)

~ ~ ~ ~ 0

i l!l

~ 8 ~ § (Specify§

~ I/') I/')

~ ~ ~g 8 I/') N Eo/). '::I 8 § ~ I/') Type &I/') .... ....

~ 8N ...; Eo/) Eo/) I

~ ~ § Eo/) Actualj 1/'). I/') a j I/') .-tI/') .-t (fl Eo/) Eo/) I 0 .-t ] N I/') I/') .-t Eo/) g­ o § Amount).-t Eo/) Eo/) I 0 I

~ .-t g. ~ 'iii .n .-t (fl (fl I .-tEo/)

j ...; Eo/) (fl

~£ 0 I .-t .-t .-t 8. E E al ~

o a Eo/) I 0 .-t qI 8 (fl 0 , .n.-t .-t

~ 8 .-t I/')

~ I .-t .-t 8 .-t.-t

~ ~ Eo/)

~ Eo/)

~ IS -­ 0 .-t .-t .-t 8 8 Eo/) § Eo/)

I ~ g- g­~ ~

5-.. 5­ '0

! s .-t ~ 0 8 g­~ ~

I/') 0 .n '~ ~ '§. 0 I/') .n 0I/') u Jj § ~ N .n ...;.-t .-t I/') .-t N I/') .-t I/') N ~ .: Q oS N .-t .-t I/') .-tEo/) Eo/) Eo/) Eo/) Eo/) Eo/) Eo/) Eo/) Eo/) u Eo/) Eo/) Eo/) Eo/) Eo/) (fl (fl Eo/)

1 GE MoneyBank CD (J) X X X

2 Columbus Bank& Trust (J) X X X

3 Medallion Bank CD (J) X X X

4 Box.net(Draper FisherJurvetson Fund VIII) X X

5 BrightSourceEnergy (Draper FisherJurvetson VIII) X X

6 GreatPolnt Energy(DraperFisherJurvetson FundVIlJ) X X

7 Synthetic Genomlcs (Draper FisherJurvetson Fund VII) X X

8 Flurry(DraperFisherJurvetson FundVIII) X X

" Meebo(Draper FisherJurvetson Fund VIII) X X

• This category applies only if the asset/income is solely that of the filer's spouse or dependent children. If the asset/income is either that of the f1ler or jointly held by the f1ler with the spouse or dependent children, mark the other higher categorles of value, as appropriate.

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IF

Income: type and amount. If "None (or less than $201)" is

Date (Mo: Day,

Yr,)

Only if HonorarJa

SF 278 (Rev. 0312000) 5 C.F.R. Part 2634 U.S. Officeof Government Ethics

Reporting Individual's Name Page NumberSCHEDULE A continued (Use only if needed) /2- of / 'is

Assets and Income Valuation ofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCK A BLOCKB BLOCKC

Type Amount.

~ § ~ ~ ] ;;; §8§a §§~ ~ ~a~g~~§§~~~a~~~ ~1I"I1I"I~1iI')V'}V'} AI I~§>J::J:: !l.I~V'}V'}.I , I.§~ ~o .EE-oE-o -V'},,~~~ 880., 't:I III I':l ~

'g't:l OJ'" SIiI') I, '~~o...;' A"';S' ~~ 888...;' A .§A~ii d)..... ~ V'} V'} ........ !S <LI~ 1Il'§"Q;' ~o~88~V'}8V'}!l.I8~~8A08~1-<§ § .,~~~~: ~ .... ~ .... l::0~811"18 A A81-<0:Vc A11"1 ° 11"1 QJ.,., 11"1 0 0 .... c ... Q,o A A A11"1 ° !l.I AO ~ ~ II"I ~ N II"I > ~ II"I N ~X ~ <LI = m Z N ~ N 11"1 ~ 11"1 ~ > ~ .... ei:. _ U V'} iii') V'} V'} V'} V'} V'} 0 V'} 6Z V'}V'}V'}V'}V'}V'}o*** ~~

1 'VIVOtech (DraperFisherJurvetson FundVIII) X XI

2 IPing Identity(DraperFisherJurvetson FundVIII) X XI

3 I Eventful (DraperFisherJurvetson FundVIII) X XI 4 I SugarSync (DraperFisherJurvetson FundVIII) X X

I

5 I ContextWeb (DraperFisherJurvetson Fund X XVIII)

~pay Inc. (DraperFisherJurvetson FundVIII) X XI

7 rDeeyaEnergy(DraperFisherJurvetson Fund ·X XVIII)

8 ICoalTek(DraperFisherJurvetson FundVIII) I

'1 l RS Live MediaPrivateLimited (DraperFisher Jurvetson FundVIII)

* This category applies only If the asset/income is solely that of the filer's spouse or dependent children. If the asset/Income is either that of the fUeror Jointly heldby the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate.

X X

X X

Other5 § §N IncomeV'} ° §

A

(Specify Type &.~ ~ ~§a~~§§~a Actual~ ~ ~>2 A AII"III"I~V'}8A I § Amount).ei: .... Q) C5 N 11"1 ~ V'} V'} I ~ -...;'V'}V'}V'} I I ° 8

Date (Mo., Day,

Yr.)

Only if Honoraria

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SF 278 (Rev. 0312000) 5 C.F.R. Part 2634 U.S. Office of GovernmenrEthics

Reporting Individual's Name Page NumberSCHEDULE A continued (Use only if needed) /3 of /??'

Assets and Income Valuation 0 f Assets Income: type and amount. If "None (or less than $201)" isat close of reporting period checked, no other entry is needed in Block C for that item.

BLOCK A BLOCKB BLOCKC

Type Amount

::;- 0~ 0 g ~ ~ ] 008 Other Date;:; .~~ ~ Income (!VI0., Day,~ 0 a g8o g8· 00 5 (Specify~~o g8 0 . ~vi'VlOic Yr.); 0~88bq,0'0 Type &£aog:q~§8~~~a~~~ £ 8~8qgo'8~8 Actual Only if ~VlVl~~V}~·' 1~~::>2t: ~ ~~ VJ,qvi'~ ~ ~o I g"~ Amount) HonorariaQ)~V}~, I ~~ ~oo.EE-'r-oI .... Q)ONVl~~v}, o~~-V}, I ~~~oooo. 't:l ~-.-;-V}V}V}, ,~oo

S ~ ~ Ooo.-;-q, O.si~~ ~ dJ ~~ SV}' " ~~o.-;-q,vi'j~'-'~ I

°OOV} "'ca'-', ~~~ooo.V}gV}~'=:Q)~ 0 00 ~ ~~8aaooo~gg

oV}~~$.~~~g' .... VlOOVlOQ) • • VlQ)(J\J Q) 'Cl, d 0 8.. VJ. 8.. vi' 0 8 3 . 6Q)O ~ ~ Vl ~NVl:?~ VlN:?X J>i:Aj ~ '5 1:!~zON~NVl~Vl~ ~

V}V}V}~V}V}O~~V}O~~\",IZ Q~ .... u ~V}~V}~V}~ V}

1 'DFJ DragonFund(DraperFisherJurvetson I IXI I I I I I I I I I I I I I I I I IXFundVIII)

2"1 DraperFisherJurvetson VIII CashFund X XI

3 I Brightklte, Inc. (DraperFisherJurvetson Fund X X XVIII)

4 ICastTV DraperFisherJurvetson FundVIII) X

I X I IX

5 I Decentral (DraperFisherJurvetson FundVIII) X X X

I

6 I EDGAROnline(DraperFisherJurvetson Fund X X XVIII)

7 IMlartech (DraperFisherJurvetson FundVIII) X X X

I

8 I RevaElectricCar (DraperFisherJurvetson X X XFundVIII)

;-1 Rewer, Inc (DraperFisherJurvetson FundVIII) I X I I I I I I I I I I I I I I I I I IX IX

* This category applies only if the asset/income is solely that of the filer's spouse or dependent chlldren. If the asset/income is either that of the flier or Jointly held by the filer with the spouse or dependent chl1dren, mark the other higher categories of value, as appropriate,.

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SF 278 (Rev. 0312000)SC.F.R. Part 2634 us,Office of Government EthlcB

lwportlng individual'sName

,

Assets and Income

BLOCK A

1 TargetCast Networks (DraperFisherJurvetson FundVIII)

2 Tesla Motors{DraperFisherJurvetson FundVIII

3 Worldof Good Holding Company, Inc. (Draper FisherJurvetson FundVIII)

4 John LockeFoundation

S American FamilyAssociation

6 American FamilyAssociation

7 Wachovla Checking and Savings(J)

8 WelisFargo Checking and Savings (S)

'l Congressional Federal CreditUnion(S)

* This categoryapplles only if the asset/incomeis solely that of the filer's spouse or dependent children. If the asset/income is either that of the filer or Jointly held by the fller with the spouse or dependent chlldren, mark the other higher categories of value, asappropriate.

Page NumberSCHEDULE A continued (Use only if needed) It( of 18'

Valuation 0 f Assets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCKB BLOCKC

Type Amount

'"" 08 ]~ 0'"" 0...;' Other

a Date~ 8N ~ ~8~ Income (No., Day,

§ ~0§ 0~; ~ ~ (Specify; Yr.)~ iiiiii0§~ S'J:!iii I~N Type &iii §~ iii§~~oS 8 ~ oS§ 8~ 0~ N §0 ~ iii Only if~ Actual0 8 ~iii0iii Iiii ~ '"" I~ iiiiii~ ~8

J ~

~ ~ '""N~~'""~ ~ , Amount) Honoraria0 I '"" ~0

I ~ ~ ~ ~ '"" 0

~

~ ~ '"" o I

~

'"" ~

E-~ '"" ~ I'"" I

§ ~ '"" I ~ 'r::lcS

I'r::l , '"" I

iii

I

~

'"" ~8~ 8 ~'"" 8'"" (lJ'"" iii a ~ iii '"'.e­ '2s'"" 8 '"" 8~ 8 '"" '"" '""

8 ~

8 ~ ~§~ ell ~ '""'"" '5 '"" 8 8

-~ '""0o~ §~ ~.&0& ~iii .~ iii0'""u1iii ~ u1 cS~1Ii~ '"' N~iii NN Niii iii iii§ c~ ~ ~ '"" '"" ~ ~ '""~ ~ '"" ~ '"" ~ ~~ is~ 3 ~

~ , '""

~ ~ ~~ '""~ ~ ~~ ~ ~ 8 '""'"" X X X

X X X

X X X

515.000.00 01/14/2010

52,000.00 09/01/2010

52.000.00 10/26/2010

X X X

X X X

X XX

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SF 278 (Rev. 0312000)5 C.F.R. Part 2634 U.S. OffJce of Government Ethics

Reporting Individual's Name

,

Assets and Income

BLOCK A

1 American Family Association

2

3

4

5

6

7

8

'I

* This category applies only if the asset/income Is solely that of the filer's spouse or dependent children. If the asset/Income Is either that of the filer or Jointly held by the fJler with the spouse or dependent children, mark the other higher categories of value, as appropriate.

Page Number SCHEDULE A continued (Use onlyIf needed) ofIS:- I??

Valuation ofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block Cfor that item.

BLOCKB BLOCKC

Type Amount ,-. .... § ,-.§ ....§~ §~ 0'-lo § Other Date.... NWOO) WOO) § Income (Ato.,Day,§ &0§ (Specify§

] ~ V') Yr.)~ V') §0§ V') WOO) 'J:!V') N § Type &V')§~ §~§ ~~ ~ WOO) , ~ §WOO) 8 §

E WOO)N0 8 V') ....

IIi ~ ....§, Only ifActual0 8,V') V') WOO) ~ .... WOO) WOO) .... v:. V') WOO)V') ........ aWOO) WOO) , § Amount) Honoraria, § ...., N.... .... WOO) WOO)an g ....

,

g §§

0 J]

JWOO) , §et: WOO) §WOO)8 WOO) ,.... E........s­ ...., ....,s........o

--5 WOO) , 0

, , ,~ .... V') .... .... ,..;' 8.£, anj.... §~

If)If) WOO)

3 ~ .... .... ....~ If)8 8 m 'B-e .... ~ ~ ~ V')~ an 0 .~8 V') an ~~ 0 V')~ ~ ~ ~~ .... 2:lV').... .... .... N~.... ~V') V') N NN V') V')~ . .... .... ....WOO) WOO) WOO) WOO) WOO) WOO) If)WOO) WOO)If) WOO) QI~ WOO)~ If) If) If) WOO) WOO) 0~ .s ~

$2,000.00

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12106/2010

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SI' Z78 (Rev. 031Z000)5 C.I'.R. PartZ634 U.S. Office ofGovernment Ethics

Reporting Individual'sName

,

Part I: Liabilities Report liabilitIes over $10,000 owed to anyone creditor at any time during the reporting period by you, your spouse, or dependent children. Check the highest amount owed during the reporting period. Exclude

Creditors (Name and Address)

Examples ~r!!pI!!!:!~l1k. W~i~Jl,D~ __ JohnJones,lZ3 Jsi, Washington, DC

1 American Express, PO Box650448, Dallas, TX

Z Tiffany & Co, PO Box 1728 Memphis, TN

3 Wells Fargo, PO Box660455, Dallas, TX

4

5

"This category applies only If the liability Is solely that of the filer's spouse or dependent children. If the lIablllty Is that of the filer or a Joint lIablllty of the fUer with the spouse or dependent children, mark the other higher categories, as appropriate.

Part II: Agreements or Arrangements Report your agreements or arrangements for: (1) continuing parnctpanon In an employee benefit plan (e.g. pension, 401k, deferred compensation): (2) continua­tion of payment by a former employer (including severance payments); (3) leaves

Status and Terms of any Agreement or Arrangement

Example I Pursuantto partnership agreement, will receive lumpBum paymentof capital account& partnership share calculated on service performed through 1/00.

1 Salary and Ownership QuarterlyS·Corp Dividend Distributions

Z

3

4

5

6

PageNumber

SCHEDULE·C 1ft; of I~

a mortgage on your personal residence None 0 unless it is rented out; loans secured by Category of Amountor Value(x) automoblles; household furniture or appliances; and liabll1tiesowed to

§ ,

certain relatives listed in Instructions. , §§ .:.§ §§J .:.§ ~8 .See instructions for revolving charge .:.§ gg

88-§

.

. §§ §§ ggaccounts. §§

,

§§ 8 ­ g~gggg6vi vi6 68 .VI VlOInterest Term IfDate ........ VI .... .... VI.... VI VI .... .... N NVINVI VlN ~~ ~~ ~~ ~~ ~~ ~~ ~~ ~~ ~~ ~~ ~iRate applicableIncurredType of L1ab1l1ty

1991 xi- Z5 yrs. _B%~°l!lli!ll!!,.o.!!.!e1!!!l.£!:.0l!£!:t~~W!!!£___ 1-­ --I- ­

Date

1--­~-~--- ­-Promlssory note t-i999 1--­on demand x10%

Revolving Account 30 Days X Revolving Account Paid In Full Closed2010 0% X Mortgage on Rental Property 5.125% 30 Year2010 X

.

of absence; and (4) future employment. See instructions regarding the report­lng of negotiations for any of these arrangements or benefits. NoneD

Parties

Doe Jones& Smith, Hometown, State

Gingrich Productions

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7/85

--------------

-------------------------------

SP278 (Rev. 0312000) 5 C.P.R. Part 2634 U.S. Officeof Government EthicS

Reporting Indlvldual's Name

, SCHEDULE D

Part I: Positions Held Outside U.S. Government Report any positions held during the applicable reporting period, whether compen- organization or educanonat tnsntunon. Exclude positions with religious, sated or not. Positions include but are not limited to those of an officer, director, social, fraternal, or political entities and those solely of an honorary trustee, general partner, proprietor, representative, employee, or consultant of nature. any corporation, firm, partnership, or other business enterprise or any non-profit

Organization (Name and Address) Tvne of Orzanlzatton . K~t'l Assn. of RockCollectors, NY, NY Non-prollt edueatlon

Examples Doe JO~ &S~h:ffu;;;;to-;;;:S;re - - - - - - - - - - - --------------Lawflrm 1

TheGingrich Group, LLCWashington, DC Management Consulting Firm

2 Gingrich Communications, lnc.,Washington, DC Domestic For-Profit Corporation

3 Gingrich Holdings, Washington, DC Domestic For-Profit Corporation

4 Gingrich Productions, Inc,Washington, DC Domestic For-Profit Corporation

5 TheGingrich Foundation, Atlanta, GA Charity, Private Foundation

6 Fleishman Hillard, 51. Louis, MO Int'lCommunications andPublic Relations Firm

Part II: Compensation in Excess of $5,000 Paid by One Source Report sources of more than $5,000 compensation received by you or your non-profit organization when business affiliation for services provided directly by you during anyoner.ear of you directly provided the the reporting period. This includes the names of clients and customers 0 any services generating a fee or payment of more than $5,000. You corporation, firm, partnership, or other business enterprise, or any other need not report the U.S. Government as a source.

Source (Name and Address)

lcgalservlce.s

Examples Met;;U-;:rtve';;it;Tc'u;rt ;;rOoe J~s&'S;;;tt'h>:M;;ytown, S~ - - - - ­~~ Jones & Smith, Hometown, State

Legalservices In connection with university construction

1

2

3

4

5

6

Page Number

19- of IS>

None 0 Position Held From (Mo••Yr.) To (Mo.,Yr.)

l'resldent 6/92 Present 1--- ­

Partner 1/007/85

04/2009 05/2011Chairman

05/2011Director 08/2000

05/2011Director 08/2000

0212007 05/2011Director

10/2004Board Member Present

08/2000 05/2011Advisory Board Member

Do not complete this part if you are an Incumbent, Termination Filer, or Vice Presidential or Presidential Candidate.

None 0 Brief Description of Duties

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---- ----

-------------------------------

SF278 (Rev. 0312000) 5 C.F.R. Part 2634 U.S. Officeof Government Ethics

Page NumberReporting IndIvidual's Name

, SCHEDULE D /<8' of It?

Part I: Positions Held Outside U.S. Government Report any positions held during the applicabie reporting period, whether compen- organization or educationai institution. Exclude positions with religious, sated or not. Positions include but are not limited to those of an officer, director, social, fraternal, or political entities and those solely of an honorary trustee, general partner, proprietor, representative, employee, or consultant of nature. any corporation, firm, partnership, or other business enterprise or any non-profit None 0

Organization (Name and Address) Position Held To (Mo.,Yr.)From (Mo., Yr.)Tvoe of Orzanlzation Present

Examples D~O-;;; &SJiillh~;;to-;;,SU;- - - - - - - - - - - ­PresidentK~tll Assn. of RockCollectors, NY, NY .!'~~~~n~ ________ ---------- 6/92

1/00Lawfirm Partner 7/85

1 Healthtrlo, Centennial, CO Health Company 01/2011 PresentAdvisory Board

OS/201005/1999American Enterprise Institute, Washington, DC ThinkTank Fellow

0212005 OS/2011DirectorTheLubbers Agency, KeyBiscayne, FL Domestic For-Profit Corporation

10/2009 OS/2011GEHealthymaglnatlon, NewYork, NY Health Company Advisory Board

Do not complete this part if you are anPart II: Compensation in Excess of $5,000 Paid by One Source Incumbent, Termination FUer, or Vice Report sources of more than $5,000 compensation received by you or your non-profit organization when Presidential or Presidential Candidate. business affiliation for services provided directly b~ you during anyone l':ear of you directly provided the the reporting period. This includes the names of ci ents and customers 0 any services generating a fee or payment of more than $5,000. You corporation, firm, partnership, or other business enterprise, or any other need not report the U.S. Government as a source. None 0

Source (Namc and Addrcss) Brief Description of Duties LegalBervJccs .

Examples Met;;1J-;:;We;;[t~lI~ ~D;;;j=s&;;;tt'h).Monevtown, S~ - - - - ­~~ Jones & Smith. Hometown,State

Legalservices In connection wlth university construction

2

3

4

5

6

1

2

3

4

5

6

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