Q CHAMBERS OF DAVID FOLSOM US DISTRICT .UDE UNITED STATES DISTRICT COURT EASTERN DISTRICT OF TEXAS 50 STATELINE AVENUE TEXARKANA, TEXAS 75501 TELEPHONE (93) 794S7 July 20, 2009 Honorable Bobby R. Baldock Committee on Financial Disclosure Administrative Ofice of the United States C9urts, Suite - - 2-301 One Columbus Circle, NE Washington, DC 20544 R: 2008 Amended Financial Disclosure Report Dear Judge Baldock: In response to your letter to me dated July 9, 2009, I have attached four signed copies of my 2008 Amended Financial Disclosure Report. I believe I have addressed all the deficiencies that were enumerated in your letter. I apologize fr the inconvenience. Should you need additional infrmation, please contact me. Yours sincerely, David J. Folsom ,. = = 0 ( _ :: C I c_ r = DF/gc o ::· . ( N ,�- r :YZ N cc: Gene Cogbill, CPA Ii;_-_ J - ) < o -r· r . 0 C f w Folsom, David J
Transcript
Q
CHAMBERS OF
DAVID FOLSOM
US DISTRICT .JUDGE
UNITED STATES DISTRICT COURT EASTERN DISTRICT OF TEXAS
500 STATELINE AVENUE
TEXARKANA, TEXAS 75501 TELEPHONE
(903) 794-40S7
July 20, 2009
Honorable Bobby R. Baldock
Committee on Financial Disclosure
Administrative Office of the United States C9urts, Suite - -2-301
One Columbus Circle, NE Washington, DC 20544
RE: 2008 Amended Financial Disclosure Report
Dear Judge Baldock:
In response to your letter to me dated July 9, 2009, I have attached four signed copies of
my 2008 Amended Financial Disclosure Report.
I believe I have addressed all the deficiencies that were enumerated in your letter.
I apologize for the inconvenience. Should you need additional information, please
contact me.
Yours sincerely,
David J. Folsom ,.._, = =
0
(/) _a :::0 CJ
I c__ rn = DF/gc o::· .- (") N�� rn
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cc: Gene Cogbill, CPA Iii;:._-_
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< o-rtr· rn ., 0 CJ fT1
w
Folsom, David J
POSITION ORGANIZATION/ENTITY
TERMS
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5.
AOlO Rev. 112008
FINANCIAL DISCLOSURE REPORT
FOR CALENDAR YEAR 2008
I. Person Reporting (last name, first, middle initial) 2. Court or Organization
Folsom, David J. U S Dist Ct., Eastern Texas
4. Title (Article Ill judges indicate active or senior status; Sa. Report Type (check appropriate type) magistrate judges indicate full- or part-time)
D Nomination, Date
Judge--Active D Initial [{] Annual
Sb. [{] Amended Report
D Final
Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app. §§ 101-111)
3. Date of Report
07/20/2009
6. Reporting Period
01/01/2008 to
12/31/2008
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
U.S. Courthouse & Post Office with applicable Jaws and regulations.
500 State Line Ave., Rm 309 Texarkana, TX 75501
Reviewing Officer Date
.. ..
IMPORTANT NOTES: The instructions accompanying this form must be followed. Complete all parts, checking the NONE box for each part where you have no reportable information. Sign on last page.
J. POSITI 0 NS. (Reporting individual only; see pp. 9-13 of filing instructions.)
D NONE (No reportable positions.)
NAME OF
I. Member Texarkana Animal League Board
3.
II. AGREEMENTS. (Reporting individual only; see pp. 14-16 of filing instructions.)
[ZJ NONE (No reportable agreements.)
I.
2.
3.
PARTIES AND r:-:.-.1
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SOURCE AND TYPE INCOME
OR
3.
FINANCIAL DISCLOSURE REPORT
Page 2 of9
Name of Person Reporting
Folsom, David J.
Date of Report
07/20/2009
III. NON-INVESTMENT JN CO ME. (Reporting individual and spouse; see pp. 17-24 of filing instructions.)
A. Filer's Non-Investment Income
[lJ NONE (No reportable non-investment income.)
2.
(yours, not spouse's)
I.
3.
4.
:n. Spouse's Non-Investment Income - lf you were married during any portion of the reporting year, complete this section.
(Dollar amount not required except for honoraria.)
· D NONE (No reportable non-investment income.)
SOURCE AND TYPE
I. 2008 Empire Electric Company
2.
4.
JV. REJMB URSEMENTS - transportation, lodging,food, entertainment
(Includes those to spouse and dependent children; see pp. 25-27 of filing instructions.) •
D NONE (No reportable reimbursements.)
SOURCE DATES LOCATION PURPOSE ITEMS PAID PROVIDED
1. Federal Circuit Bar Assn 6/25 to 6/29
2. U of Texas Law School 217 to 2/9
3. U of Texas Law School 10/29 to 10/31
Monterey, CA
Austin, TX
San Jose, CA
Non FJC education Airfare, meals, hotel
Seminar Airfare, meals, hotel
Seminar Airfare, meals, hotel
DESCRIPTION
VALUE
4_
FINANCIAL DISCLOSURE REPORT
Page 3of9-
Name of Person Reporting
Folsom, David J.
Date of Report
07/20/2009
V, GIFTS. (Includes those lo spouse and dependent children; see pp. 18-31 of filing instructions.)
[ZJ NONE (No reportable gifts.)
SOURCE DESCRIPTION
I_
2_
3.
5.
VJ. LJABJLJTJES. (Includes those of spouse and dependent children; see pp. 31-33 of filing instructions.)
[ZJ NONE (No reportable liabilities.)
VALUE CODE CREDITOR
2_
3.
4.
5_
1---
2.
Page 4 of9
Date of Report Name of Person Reporting FINANCIAL DISCLOSURE REPORT
Folsom, David J. 07/20/2009
VII. INVESTMENTS and TRUSTS - income, value, transactions r1nc1udes those of spouse and dependent children; see PP· 14-60 of ft line instructions.>
0 NONE (No reportable income, assets, or transactions.)
A. B. c. D. Description of Assets Income during Gross value at end of Transactions during reporting period
(including trust assets) reporting period reporting period
( l) (2) (l) (2) (!) (2) (3) (4) (5) Place "(X)" afier each asset Amount Type (e.g., Value Value Type (e.g., Date Value Gain Identity of
exempt from prior disclosure Code I div., reni, Code 2 Method buy, sell, Month - Code 2 Code I buyer/seller (A-H) or int.) (J-P) Code 3 redemption) Day (J-P) (A-H) (if private
(Q-W) transaction)
1. Century Bank--checking account None K T
....
Century Bank--checking account A Interest K T
3. Century Bank-certificate of deposit A Interest K T
4. Commercial National Bank• A Interest K T Open 11/21 K Account opened
5. Commercial National Bank • A Interest K T Open 11121 K Account opened
6. Commercial National Bank • A Interest K T Open 11121 K Account opened
7.
8. EDWARD JONES {Securities account) #8
9. Money market funds A Interest 1 T
10. Automatic Data Processing A Dividend J T
11. Briadrudge Financial Solutions None 1 T
12. Eli Lilly& Co A Dividend J T
13. Illinois Tools Works A Dividend 1 T
14. Scana Corp A Dividend J T
15. Franklin Equity Income Fd A Dividend J T
16. Franklin Flex Cap Growth Fd A Dividend J T
17. Mutual Discovery Fd Class A A Dividend J T "Franklin" dropped fr name
I. Income Gain Codes: A =S 1,000 or less B =S 1,001 - $2,500 c =$2,501 -$5,000 D =$5,001 -$15,000 E=$15,001 - $50,000
(See Columns B1 and 04) f =$50,001 - $100,000 G =SJ00,001 -Sl,000,000 HI =Sl,000,001 -$5,000,000 H2 =More than $5,000,000
2. Value Codes J=$ 15,000 or less K =S15,00 I -$50,00!> L=$50,001 -$100,000 M =SI 00,00 I -$250,000 (See Columns CI and DJ) N =$250,001 - $500,000 O=S500,001-Sl,OOO,OOO Pl =Sl,000,001 -$5,000,000 P2 =$5,000,001 -$25,000,000
P3 =$25,000,00 I - $50,000,000 P4 =Mo1<: than $50,000,000
3. Value Method Codes Q =Appraisal R =Cost (Real Estate Only) S =Assessment T =Cash Market
(See Column C2) U =Book Value V=Other W =Estimated
Page 5of9
FINANCIAL DISCLOSURE REPORT Name of Penon Reporting
Folsom, David J.
Date of Report
07/20/2009
VII. INVESTMENTS and TRUSTS - income, value, transactions r1nc1udes those of spouse and dependent children; see PP· 34-60 of filing ins1ruc1ions.J
D NONE (No reportable income, assets, or transactions.)
A. B. c. D. Description of Assets Income during Gross value at end of Transactions during reporting period
(including trust assets) reporting period reporting period
(I) (2) {I) {2) {I) (2) (3) (4) (5) Place "(X)" after each asset Amount Type{e.g., Value Value Type (e.g., Date Value Gain Identity of
exempt from prior disclosure Code I div., rent, Code2 Method buy, sell, Month- Code2 Code I buyer/seller {A-H) or int.) (J-P) Code 3 redemption) Day (J-P) {A-H) {if private
{Q-W) transaction)
18. Franklin Small Cap Value Fd A Dividend J T
19.
20.
21. WACHOVIA (Securities Account) #9
22. Centennial MM Trust A Interest K T
23. OSI Pharmaceuticals A Dividend J T
24. Whole Food Market A Dividend J T
25. Southcoast Community Bank CD A Interest Matured 07/01 K CD Matured
26. Putnam Voyager Fund None J T
27.
28. Ohio National Financial Services Annuity D Interest L T
29.
30. Ohio National Financial Services Annuity A Interest J T
31.
32. SEP/INDIVIDUAL RETIREMENT ACCO UNTS:
33. American Funds (SEP/IRA) B Dividend M T
34. Cash Management Trust of America Only fund in SEP/IRA
I. Income Gain Codes: A =S 1,000 or less B =St,001 -$2,500 c =$2,501 -$5,000 D =$5,00I -$15,000 E =$15,001 • $50,000
(Sec Columns BI and 04) f =$50,00t -SI00,000 G =$100,001 -$1,000,000 HI =$1,000,001-$5,000,000 H2 =More lhan $5,000,000
2. Value Codes J =$15,000 or less K =$15,001 -S50,000. L =$50,00 I - SI 00,000 M =SI00,001 • $250,000
PJ =$25,000,001 - $50,000,000
3. Value Method Codes Q =Appraisal R =Cosl (Real Estale Only)
(See Column C2) U =Book Value V=Olher
(See Columns Cl and DJ) N =$250,00 I -$500,000 0 =S500,00 I -$1,000,000 Pl =$1,000,001 -$5,000,000 P2 =S5.000,001 -$25,000,000
P4 =More lhan $50,000,000
S =Assessment T =Cash Markel
W =Estimated
-
- Page 6of9
Date of Report Name of Person Reporting FINANCIAL DISCLOSURE REPORT
Folsom, David J. 07/20/2009
VII. INVESTMENTS and TRUSTS - income, va1ue, transactions anc1udes those of spouse and dependent children; see PP· 34-60 of filing instructions.)
0 NONE (No reportable income, assets, or transactions.)
A. B. c. D.
Description of Assets Income during Gross value at end of Transactions during reporting period
(including trust assets} reporting period reporting period
(I} ..(2) (I} (2} (I} (2} (3} (4} (5) Place "(X)" after each asset Amount Type(e.g., Value Value Type(e.g., Date Value Gain Identity of
exempt from prior disclosure Code I div., rent, Code2 Method buy, sell, Month- Code 2 Code I buyer/seller (A-H) or int.) (J-P) Code3 redemption) Day (J-P) (A-H} (if private
(Q-W) transaction)
35.
36. MERRILL LYNCH (SEP/IRA): No. 3
37. ML Retirement Money Fund A Dividend J T
38. AIM Constellation Fund A Dividend J T
39.
40. MERRILL LYNCH (SEP/IRA) No. 4
41. ML Cash account A Dividend K T
42. Federal Natl Mtg Assn A Interest J T Buy 2/07 J
43. PMC Sierra Inc None K T
44.
45. WACHOVIA #10
46. Cash account A Dividend J T Open 11120 J Opened cash account
47. AGE MM, World Saving Bank, CA B Interest Distributed 11120 Distriubted 11 /20
48. Goldman Sachs Group A Dividend J T
49.
50. FLOYD CAPITAL MGMT--Schwab (SEP/I RA): #7
51. American Beacon MM Funds None Closed 01105 M Acct transf to Schwab MM
I. Income Gain Codes: A =S 1,000 or less B =S 1,00 I -S2,500 C =S2,50 I -$5,000 D =SS,001 -SIS,000 E =$15,001 -S50,000
(See Columns BI and 04) f=S50,00l -SIOO,OOO G =SI00,001 -Sl,000,000 HI =Sl,000,001 - $5,000,000 H2 =More than SS.000,000
2. Value Codes J =$15,000 or less K =$15,001 -$50,000 L =$50,001-SIOO.OOO M =SI 00,00 I -$250,000
(Sec Columns Cl and DJ) N =$250,001 -$500,000 0 =$500,001 -$1,000,000 Pl =Sl,000,001 -$5,000,000 P2 =$5,000,001 -$25,000,000
PJ =$25,000,001 -$50,000,000 P4 =More than $50,000,000 3. Value Method Codes Q =Appraisal R =Cost (Real Estate Only) S =Assessment T =Cash Market
(See Column C2) U =Book Value V =Other W =Estima ted
T
Im
I. Income Gain Codes: A =Sl,000 or less B =Sl,001 -$2,500 C =$2,501 -$5,000 D =$5,00 I • S 15,000 E=SJS,OOJ -$50,000
(See Columns B 1 and 04) f =S50,00I • SI00,000 G =SI00,001 • Sl,000,000 HI =Sl,000,001-$5,000,000 H2 =More than SS,000,000
2. Value Codes J =SI 5,000 or less K=Sl5,001-S50,000. L =$50,001 -SI00,000 M =$100,001 -$250,000
(See Columns Cl and DJ) N =$250,001 - $500,000 0 =$500,001 -$1,000,000 Pl =SJ,000,001 -SS,000,000 n =$5,000,001 -$25,000,000
PJ =$25,000,001 -$50,000,000
3. Value Method Codes Q =Appraisal R =Cost (Real Estate Only) T =Cash Market
(See Column C2) U =Book Value V=Other
P4 =More than $50,000,000
S =Assessment
W=Estimated
FINANCIAL DISCLOSURE REPORT
Page 7 of9
Name of Person Reporting
Folsom, David J.
Date of Report
07/20/2009
VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; see PP· 34-60 of filing instructions.)
D NONE (No reportable income, assets, or transactions.)
A. B. c. D. Description of Assets Income during Gross value at end of Transactions during reporting period
(including trust assets) reporting period reporting period
(1) (2) (1) (2) (1) (2) (3) (4) (5) Place "(X)" after each asset Amount Type (e.g., Value Value Type (e.g., Date Value Gain Identity of
exempt from prior disclosure Code I div., rent, Code 2 Method buy, sell, Month- , Code 2 Code 1 buyer/seller (A·H) or int.) (J-P) Code 3 redemption) Day (J-P) (A-H) (if private
(Q-W) transaction)
52. Schwab U S Treasury Money Fund c Interest M Open 01/05 M Trans fr Am Beacon M MFds
53. Mosaic Co Com A Dividend Sold 12/04 J A
54. Apple Inc Com A Dividend Sold 12/04 J A
5. Sunpower Corp Com Class A A Dividend Sold 12/04 J A
56. Baidu Com Inc Spon ADR Rep A A Dividend Sold 12/04 J A
57. Companhia Siderurgica Nacional Sponsored A Dividend Sold 12/04 J A A
58. CGM TR Focus Fund A Dividend Sold 12/04 J A
59. American Century Nut FDS Inc Heritage A Dividend Sold 12/04 J A
60. Loomis Sayles Bond Cl I A Dividend K T Buy 12/29 K
61.
62.
63.
64.
65.
66.
67.
FINANCIAL DISCLOSURE REPORT
Page 8of9
Name of Person Reporting
Folsom, David J.
Date of Report
0712012009
VIII. ADDITIONAL INFORMATION OR EXPLANATIONS. (lndicatepartofReporL)
-
-- -----
FINANCIAL DISCLOSURE REPORT
Page 9of9
Name of Person Reporting
Folsom, David J.
Date of Report
07/20/2009
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 complia ce with the provisions of 5 U.S.C. app. § 501 et. seq., 5 U.S.C. § 7353, and Judicial Conference regulations.
Signature
L-00\_\ L-01 NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. § 104)
FILING INSTRUCTIONS
Mail signed original and 3 additional copies to:
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301
One Columbus Circle, N.E. Washington, D.C. 20544
foi;om,
3.
AOlO Rev.112008
FINANCIAL DISCLOSURE REPORT
FOR CALENDAR YEAR 2008
I. Person Reporting (last name, first, middle initial) 2. Court or Organization
David J. U S Dist Ct., Eastern Texas
4. Title (Article Ill judges indicate active or senior status; magistrate judges indicate full- or part-time)
Sa. Report Type (check appropriate type)
D Nomination, Date
Judge--Active D Initial 0 Annual
Sb. D Amended Report
D Final
Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app. §§ 101-111)
3. Date of Report
05128/2009
6. Reporting Period
01/01/2008 to
12/31/2008
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
U. S. Courthouse & Post Office with applicable laws and regulations.
500 State Line Ave., Rm 309 Texarkana, TX 75501
Reviewing Officer Date
IMPORT ANT NOTES: The instructions accompanying this form must be followed. Complete all parts, checking the NONE box for each part where you have no reportable information. Sign on last page.
I. POSITI 0 NS, (Reporting individ11al only; see pp. 9-13 of filing instr11ctions.)
D NONE (No reportable positions.)
POSITION NAME OF ORGANIZATION/ENTITY
I. Member Texarkana Animal League Board
2.
4.
II. AGREEMENTS. (Reporting individ11al only; see pp. 14-16 of filing instructions.)
[ZJ NONE (No reportable agreements.)
l.
PARTIES AND TERMS
;lj rn () rn -
< rn 0
2.
3.
lll . .
ORGANIZATION/ENTITY
3.
AOJO Rev. 112008
FINANCIAL DISCLOSURE REPORT
FOR CALENDAR YEAR 2008
I. Person Reporting (last name, first, middle initial) 2. Court or Organization
olsom, David J. U S Dist Ct., Eastern Texas
4. Title (Article III judges indicate active or senior status; Sa. Report Type (check appropriate type) magistrate judges indicate full- or part-time)
D Nomination, Date
Judge--Active D Initial Annual
Sb. D Amended Report
D Final
Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app. §§ 101-111)
3. Date of Report
05/28/2009
6. Reporting Period
01/01/2008 to
12/31/2008
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
U. S. Courthouse & Post Office with applicable laws and regulations.
500 State Line Ave., Rm 309 Texarkana, TX 75501
Reviewing Officer Date
IMPORTANT NOTES: The instructions accompanying this form must be followed. Complete all parts, checking the NONE box for each part where you have no reportable information. Sign on last page.
I. POSITIONS. (Reporting individual only; see pp. 9-13 of filing instructions.)
D NONE (No reportable positions.)
POSITION NAME OF
I. Member Texarkana Animal League Board
2.
4.
5.
II. AGREEMENTS. (Reporting individual only; see pp. 14-16 of filing instructions.)
[Z] NONE (No reportable agreements.)
PARTIES AND TERMS
I.
2.
2.
3.
1. Federal Circuit Bar Assn 6/25 to 6/29 Monterey, CA
2. U of Texas Law School 2/7 to 2/9 Austin, TX
Non FJC education
Seminar
Date or Report Name or Person Reporting FINANCIAL DISCLOSURE REPORT
Page 2-of9 olsom, David J. 05/28/2009
III. N 0 N-INVESTMENT IN CO ME. (Reporting individual and spouse; see pp. 17-24 of filing instructions.)
A. Filer's Non-Investment Income
[{] NONE (No reportable non-investment income.)
(yours, not spouse's) SOURCE AND TYPE INCOME
1.
3.
4.
B. Spouse's N on-Inv_e_stment Income - If you were married during any portion of the reporting year, complete this section.
(Dollar amount no/ required except for honoraria.)
D NONE (No reportable non-investment income.)
SOURCE AND TYPE
1. 2008 Empire Electric Company
2.
4.
IV. REIMBURSEMENTS -transportation, lodging,food, entertainment
(Includes those lo spouse and dependent children; see PP- 25-27 of filing instructions.)
D NONE (No reportable reimbursements.)
SOURCE DATES LOCATION PURPOSE ITEMS PAID OR PROVIDED
Airfare, meals, hotel
Airfare, meals, hotel
3. U of Texas Law School I0/29to 10/31 San Jose, CA Seminar Airfare, meals, hotel
4.
SOURCE DESCRIPTION VALUE
Name of Person Reporting Date of Report FINANCIAL DISCLOSURE REPORT
Page 3 of9 olsom, David J. 05/28/2009
V. GIFTS. (Includes those to spouse and dependent children; see pp. 28-31 of filing instructions.)
[l] NONE (No reportable gifts.)
I.
2.
3.
4.
5.
[Z] NONE (No reportable liabilities.)
CREDITOR
I.
VI. LIABILITIES. (Includes those of spouse and dependent children; see pp. 32-33 of filing instructions.)
DESCRIPTION VALUE CODE
2.
3.
4.
___ T I y: l
e=
-
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--l---
e
- :r
__ __ _
14.
17.
Date of Report Name of Person Reporting FINANCIAL DISCLOSURE REPORT Page 4 of9 olsom, David J. 05/28/2009
VII. INVESTMENTS and TRUSTS -income, value, transactions (Includes those of spouse and dependent children; see PP• 34-60 of filing instructions.)
D NONE (No reportable income, assets, or transactions.) -
D.A.
Transactions during reporting period Description of Assets lncom= uring Gross val ; at end of
(including trust assets) reporting perio reporting period
(I) (2)i - --{l)---r--(2) --Place "(X)" after each asset : Amount Type (e.g., Value i ValueI .:
Code I j div., rent, Code 2 ! Ibuy, sell, Month - i Code 2 : Code I iexempt from prior disclosure Method buyer/seller
i (A-H) or int.) (J-P) ' Code 3 redemption) Day (J-P) (A-H) (ifprivatej transaction)--·-·· --· -·---··-· --·-· ·-·-·-- _________ ! L___ _____:. . _____ __ ____ _____ --·-···-···- ·-·· . L --- -
I. Century Bank--checking account None K T
2. Century Bank--checking account A Interest K T
3. Century Bank--certificate of deposit A Interest K T
4. Commercial National Bank • A Interest K T Open I 1/21 K Account opened
5. Commercial National Bank . A Interest K T Open 11/21 K Account opened
6. Commercial National Bank . A Interest K T Open 11/21 K Account opened
7.
8. EDWARD JONES (Securities account) #8
9. Money market funds A Interest J T
10. Automatic Data Processing A Dividend J T
11. Briadrudge Financial Solutions None J T
12. Eli Lilly&Co A Dividend J T
13. Illinois Tools Works A Dividend J T
15.
Scana Corp A J TDividend
Franklin Equity Income Fd A Dividend J T
16. Franklin Flex Cap Growth Fd A Dividend J T
Mutual Discovery Fd Class A "Franklin" dropped fr name
A Dividend J T
I. Income Gain Codes: A =$1,000 or less B =$1,00 I -$2,500 c =$2,501 -$5,000 0=$5,001-$15,000 E =$15,001 -$50,000
(See Columns Bl and 04)
2. Value Codes
F =$50,001 -$100,000
J=S 15,000 or less
G =$100,001 -$1,000,000
K=$15.001 -$50,000
HI =$ 1,000,00 I -$5,000,000
L=S50.00l - S IOO.OOO
H2 =More than $5,000,000
M =$I 00,00 I - $250,000
(See Columns Cl and 03) N =$250,00 I -$500,000 0 =$500,001 -$1,000,000 Pl =$1,000,001 -$5,000,000 P2=$5,000,001 -$25,000,000
PJ =$25,000,001 -$50,000,000 P4 =More than $50,000,000
3. Value Method Codes Q =Appraisal R =Cost (Real Estate Only) S =Assessment T=Cash Market
(See Column C2) U=Book Value V=Other W=Estimated
(5)
; ----- -----· -· ·---·---
.
- ---· --·- ·-- --·- ---------- ----
, Description of Assets I Income during c.
Gross value at end of reporting period : (including trust assets)
. - ···
re_!'_ i- P_eri_o ---·- .11 (1) ! (2) (1)--T (2)
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
Place "(X)" after each asset Amount I Type (e.g., Value I Value exempt from prior disclosure Code I j div., rent, Code 2 I Method
Franklin Small Cap Value Fd
WACHOVIA (Securities Account) #9
Centennial MM Trust
OSI Pharmaceuticals
Whole Food Market
Southcoast Community Bank CD
Putnam Voyager Fund
Ohio National Financial Services Annuity
Ohio National Financial Services Annuity
SEP/INDIVIDUAL RETIREMENT ACCO UNTS:
American Funds (SEP/IRA)
I (A-H) ! orint.) (J-P) i Code 3
. : (Q-W)
A Dividend J T
A Interest K T
A Dividend J T
A Dividend J T
A Interest
None J T
D Interest L T
A Interest J T
B Dividend M T
···--------- -
(1)Type (e.g., buy, sell,
redemption)
Matured
1. Income Gain Codes: A =$1.000or less B =Sl,001 -$2,500 C =$2,50 I - $5,000
(See Colwnns BI and D4) f =SS0,001 -SI00,000 G =SI00,001 -Sl,000,000 Ht =$1,000,00 t -$5,000,000
2. Value Codes J =$t5,000 or less K =$15,001 -$50,000 L =$50,00t -$I 00,000
D. Transactions during reporting period
-· --·---·-1 --
(2) (3) (4) IDate Gain Identity of
Month- Code 1 I buyer/seller Day (A-H)
I (if private
I transaction) · ·-··-· ·- !.
07/01 K CD Matured
D =$5,001 -$15,000 E =$15,00 I -$50,000
H2 =More than $5,000,000
M =$I 00,00 I -$250,000
FINANCIAL DISCLOSURE REPORT Page 5 of9
Name of Person Reporting
olsom, David J. Date of Report
05/28/2009
VII. INVESTMENTS and TRUSTS - income, vatue, transactions r1nc1udes those of spouse and dependent children; see PP· 34-60 of filing instructions.)
D NONE (No reportable income, assets, or transactions.) A. -1-··--8
(See Columns Cl and DJ) N =$250,00I -$500,000 0 =$500,00 I -$1,000,000 PI =S 1,000,00 l - $5,000,000 P2 =$5,000,001 -$25,000,000
P3 =$25,000,00 I - $50,000,000 P4 =More than $50,000,000
3. Value Method Codes Q =Appraisal R =Cost (Real Estate Only) S =Assessm ent T =Cash Market
(See Column C2) U =Book Value V=Olher W =Estimated
-·
r· I t·
I '!!·W)
FINANCIAL DISCLOSURE REPORT
Page 6 of9
Name or Person Reporting
olsoni, David J.
Date or Report
05/28/2009
VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; see PP· 34-60 of filing instructions.)
D NONE (No reportable income, assets, or transactions.)
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
A.
Description of Assets
(including trust assets)
Place "(X)" after each asset
exempt from prior disclosure
MERRILL LYNCH (SEP/IRA): No. 3
ML Retirement Money Fund
AIM Constellation Fund
MERRILL LYNCH (SEP/IRA) No. 4
ML Cash account
Federal Natl Mtg Assn
PMC Sierra Inc
WACHOVIA #10
Cash account
AGE MM, World Saving Bank, CA
Goldman Sachs Group
FLOYD CAPITAL MGMT--Schwab (SEP/I RA):#7
American Beacon MM Funds
Schwab U S Treasury Money Fund
I. Income Gain Codes: A=Sl,OOOor less
(See Columns BI and 04) F=$50,00 I -SI 00,000
2. Value Codes J =S 15,000 or less
(See Columns Cl and 03) N =$250,00 I -$500,000
B. c. D.
i Income during Gross value at end of Transactions during reporting period
reporting period reporting period
(i)i(2)- ._ -(!)--,--(2)- -(l)-p(2) , (3)1(----
(5) mount i Type (e.g., Value Value Type (e.g., Date Value · Gain Identity of ode I
I div., rent, Code 2 Method buy, sell, Month - Code 2 Code I buyer/seller
A-H) or int.) (J-P) Code 3 redemption) Day (J-P) (A-H) (if private
-·---- - ----··-· I. Inco me Gain Co des: A =S 1,000 o r less B =S 1,00 I -S2,500 C =S2,501 • S5,000 D =$5,001 -SIS.ODO E =S 15,00 I - SS0.000
(See Columns Bl and 04) f=$50,00 I -SI 00,000 G =$100,001 -Sl,000,000 HI =Sl,000,001 -$5,000,000 H2 =More than SS.000,000
2. Value Codes J =S 15,000 or less K=Si5,00l -S50,000 L=S50,00l -SIOO,OOO M =$I 00,00 I · $250,000
(See Columns Cl and DJ) N =S250,00 I - $500,000 0 =$500,001 -Sl,000,000 Pl =Sl,000,001 -$5,000,000 P2 =$5,000,001 -$25,000,000
PJ =$25,000,00 I - $50,000,000 P4 =More than $50,000,000 3. Value Method Co des Q=Appraisal R =Cost (Real Esta te Only) S =Assessment T=Cash Market
(See Column C2) U =Book Value V=Oth er W =Estimated
Name of Person Reporting Date of Report FINANCIAL DISCLOSURE REPORT
Page 8of9 olsom, David J. 05/28/2009
VIII. ADDITIONAL INFORMATION OR EXPLANATIONS. (Indicate partofReport)
om,
'lv\ '(___ C\ { Lou 9. -
FINANCIAL DISCLOSURE REPORT
Page 9 of9
Name of Person Reporting
David J.
Date of Report
05/28/2009
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.
Signatur
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL Si\NCTIONS (5 U.S.C. app. § 104)
FILING INSTRUCTIONS
Mail signed original and 3 additional copies to:
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544
