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Filing '- fTO L 0 -tr () n , . o- (Z cJ :: : OJ ' ., 1"1 ,_ = = A c c r c: .. ( I m w . < r Y w UNITED STATES DISTRICT COURT DISTRICT OF MAINE 156 FEDERAL STREET GEORGE Z. SINGAL PORTLND, MAINE 04101 CHIEF JUDGE (207) 780·31 19 June 26, 2006 Hon. Ortrie D. Smith, Chair Judicial Conference of the United States Committee on Financial Disclosure One Columbus Circle, N.E. Washington, D.C. 20544 . Re: Dear Judge Smith: Calendar Year 2005 t In response to your letter of June 20 , 2006 requesting infrmation as to my wif's employer, she was employed by Community Health and Counseling Services in Bangor, Mane. · Thank you, GZS/pl
Transcript
Page 1: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

Filing

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UNITED STATES DISTRICT COURT

DISTRICT OF MAINE

156 FEDERAL STREET GEORGE Z. SINGAL PORTLAND, MAINE 04101 CHIEF JUDGE

(207) 780·31 19

June 26, 2006

Hon. Ortrie D. Smith, Chair Judicial Conference of the United States Committee on Financial Disclosure One Columbus Circle, N.E.

Washington, D.C. 20544 ..

Re:

Dear Judge Smith:

Calendar Year 2005

thIn response to your letter of June 20 , 2006 requesting information as to my wife's employer, she was employed by Community Health and Counseling Services in Bangor, Maine.

·

Thank you,

GZS/pl

Page 2: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

Sb.

POSITION NAME OF ORGANIZATION/ENTITY

PARTIES AND TERMS

3.

5.

Report Required by the Ethics FINANCIAL DISCLOSURE REPORT AOIO in GovemmentActo/1978 'Rev. 112006 FOR CALENDAR YEAR 2005 (5 U.S.C. app. §§ 101-111)

1. Pelll&ll Reporting (last name, first, middle inilial) 2. Cevrt er Orgaaizatien

Singal, George Z U.S. District Court - Maine

4. Title (Article m judges Indicate active or senior status; Sa. Report Type (check appropriate type) magistrate judges indicate fuD- or part-time)

0 Nomination, Date

Judge (Active) Initial Annual Final0 ® 0

Amended Report 0

3. Date el Report

05/06/2005

6. Reporting Period

01/01/2005 to

12/31/2005

7. Chambers or Office Address 8. On the basis of the Information contained In this Report and any modifications pertaining thereto, It ls, In my opinion, In compliance With ajijillcalile Jaws liiid reguhitloiis.

156 Federal Street Portland ME -04101

U :S. District Court

Reviewing Officer Date

IMPORT ANT NOTES: The instructions accompunying this form must be followed. Complete all parts, checking the NONE box for each pmt wllere ;poll llave no reportable information. Sign on last page.

I. POSITI 0 NS. (Reporting indivUlual only; see pp. 9-13 of instnu:lions.)

D NONE (No reportable positions.)

I. Board of Visitors University of Maine Law School

2.

4.

II. AGREEMENTS. (Reporting indMdual only; see pp. 14-16 ofinshuctions.)

(KJ NONE (No reportable agreements.)

1.

2.

3.

Page 3: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

SOURCE AND TYPE

,,

Ji\ \fl· o'.'.,

SOURCE ANP IYPE

SOURCE DESCRIPTION

4.

Name of Penon Reporting Date of ReportF ANCIAL DISCLOSURE REPORT

Singal, George Z Page2 ofll 05/06/2005

ill. NON-INVESTMENT IN COME. (Reporting mdivid11a1 and spouse; see PP. 17-2-1 of instructions.)

A. Filer's Non-Investment Income

[Kl NONE (No reportable non-investment income.)

INCOME (yours, not spouse's)

I.

2.

3.

5.

B. Spouse's Non-Investment Income - .({you were marrkd during any portion ofthe reporting year, colnJl/eU! this sectio1r.

(Dollar amount not required except for honoraria.)

D NONE (No reportable non-investment income.)

I. 2005 Social Worker

2.

3.

4.

5.

IV. REIMBURSEMENTS -transportation, lodging, food, entertainment.

(Includes those to spouse and dependent children. See pp. 25-27 of instructions.)

D NONE (No reportable reimbursements.)

1. New York Intellectual Property Law Association Dinner honoring Federal Judges 3/26/05 NYC Transportation and meals

2.

3.

4.

5.

Page 4: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

SOURCE DESCRIPTION

CREDITOR DESCRIPTION

VALUE

VAWECODE

2.

Name of Person Reporting Date of Report FINANCIAL DISCLOSURE REPORT

Page 3of11 Singal, George Z 05/06/2005

V. GIFTS. (lncltuks those to spouse and dependent childreIL See pp. 28-31 of instnu:tions.)

IKJ NONE (No reportable gifts.)

I.

3.

4.

5.

VJ. LIABILITIES. (lnclUiles those ofspouse and dependent cltildren. See pJ1. 32-34 of instructions.)

IKJ NONE (No reportable liabilities.)

I.

2.

3.

4.

5.

Page 5: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

B.

'

J;

Systeriis

'

Name of l'enOll Reporting Date <If' Report F ANCIAL DISCLOSURE REPORT

Page4of11 Singal, George Z 05/06/2005

VII. INVESTMENTS and TRUSTS -income, value, transactions (incllU/es those ofthe spollSI! and dependentchi!Jren. See pp. 34-57 o/]Wng instructions)

D NONE (No reportable income, assets, or transactions.)

A.

Description of Assets

(including trust assets)

Place "(X)" after each asset

exempt from prior disclosure

Income during

reporting period

(I) (2)

c.

Gross value at end of

reporting period

(1) (2) (1)

D.

Transactions during reporting period

ifnot exempt from disclosure

Amount

Code I

(A-H)

Type(e.g.

div., rent,

or int.)

Value

Code2

(J-P)

Value

Method

Code 3

(Q-W)

Type(e.g.

buy, sell;

merger,

redemption)

(2) Date

Month-

Day

(3)

Value

Code 2 (J-P)

(4) Gain

Code 1

(A-H)

(5) Identity of

buyer/seller

(if private

transaction)

I. Amgen Inc. Common Stock None K T

2. Cisco Common Stock None K T

3. Exxon Mobil Corp. Common Stock A Dividend K 't

4. Intel Corp. Common Stock A Dividend K T

5. American Funds Small Cap Fund A Dividend K T

6. Fnmklin Sma).J Cap Fund A Dividend J T r

7. Templeton Foreign Fund A Dividend K T

8. U.S. Treasury Note A Interest J T

9. American Express Common Stock A Dividend T Sell 8/2 K c

I 0. Applied Materials Common Stock None K T

11. Bristol Myers Squibb Common Stock A Dividend K T

12. Blan Corp. Common Stock None J T

13. Fleet Boston Corp. Common Stock now A Dividend J T Bank America

14. General Electric Co. Common Stock A Dividend J T

15. Hersey Foods Corp. Common Stock A Dividend J T

16. Merck Corp. Common Stock A Dividend K T

17. Microsoft Corp. Common Stock A Dividend K T

l. Income Gain Codes: A =Sl,000 or less B -51.001 -52.500 C =52.501 -55,000 D -55.001 - 515,000 E -515.001 -5so.ooo

(See Columos Bl and 04) F-SS0,001 -5100,000 G =SI00,001 -SJ,000,000 HI -SI.000,001 - SS,000,000 H2 -More than .SS,000,000

2. Value Codes J =SlS.OOOor less K=Sl5,00I -550.000 L -sso,001 -5100,000 M -5100,001 - 5250,000

(See Columns Cl and 03) N -5250,001 -5500.000 0 =5500,001 -51,000,000 P 1 -51.000.001 • 55,000,000 P2 -s5.ooo,001 -525,ooo,ooo

3. Value Meth od Codes P3-S25,000,00l - 550,000,000 R -Cost (Real Estate Only) P4-More than SS6,000.000 T -Cash Market (See Column C2) Q-Appraisal V=Other S =Assessment

U -Book Value W=Estimated.

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B.

(i) (J)

05/06/2005

D_

(I)

Name of Person ReportingFINANCIAL DISCLOSURE REPORT

Page 5of11 Singal, George Z

VD. INVESTMENTS and TRUSTS -income, value, transaeaons (inctw1es those of the spouse""" dependent children. See pp. 1-1-s1 offiling instructions)

0 NONE (No reportable income, assets, or transactions.)

A. c.

Description of Assets Income during Gross value at end of (including trust assets) reponing period reponing period

Transactions during reponing period

(2) (I) if n ot exempt from disclosure

(2) (3) (4) (5) Date Value Gain Identity of Month- Code2 Code! buyer/seller Day (J-P) {A-H) (if private

transaction)

Place "(X)" after each asset

exempt from prior disclosure

Amount

Code I

(A-H)

Type (e.g.

div., rent,

or int.)

Value

Code2 (J-P)

Value

Method

Code 3

(Q-W)

18. Phamacia Common Stock A Dividend K T

Type (e.g.

buy; sell,

merger,

redemption)

19. Pepsico Common Stock A Dividend K T

20. Proctor and Gamble Co. Common A :Oividend K T Stock

21. Sun Microsystems Inc. Common Stock None J T

22. Vodafone ADR Common Stock A Dividend K T

23. Wal-mart Inc. Common Stock A Dividend K T

24. Pfizer Inc. Common Stock A Dividend K T

25. RMA Tax Free Fund A Interest J T

26. Maine State Housing Bond A Interest K T

27. Auburn Maine Bond A Interest K T

28. Maine Health Bond A Interest K T

29. Maine Health Bond A Interest J T

30. Euro Pacific Growth Fund A Dividend K T

31. Paine Webber Tax Free Fund A Interest J T

32. Vanguard Whole Market Fund B Dividend M T

33. Vanguard S&P Fund A Dividend J T

34. Magellan Fund A Dividend K T

l. In c ome Gain Codes: A =Sl,000 or less B l.001 • S2.SOO C 2,501 -SS,000 D S,001 -515.000 E=515,001 -SS0.000

(See Columns Bl and D4) F =SS0,001 -SJ00,000 G =5100,00J -SJ.000.000 HJ =SJ.000,001 -SS,000.000 H2 =More than .SS,000,000 2. Value Codes J =515.000 or less K 15,001 -SS0,000 L =550,00J -Sl00,000 M =SJ 00,001 - 5250,000

(See Columns Cl a nd 03) N 250,001 -5500,000 0 500,001- Sl,000,000 Pl =Sl,000.001-55,000,000 P2 =55.000,001 • 525,000.000

3. V alue Method Codes P3 25,000,001 -SS0,000.000 R =Cost (Real Esla te Only) P4 More than 5 0,000,000 T =Ca sh Ma rket

(See Column C2) Q =Appraisal V=Other S =Assessment

U ==Book Value W=Estimated

Page 7: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

B.

48.C

49.

Name of Person Reporting Date of ReportFINANCIAL DISCLOSURE REPORT

Page 6of11 Singal, George Z 05/06/2005

VII. INVESTMENTS and TRUSTS -income. va1ue, transactions (includes those oft1re spouse and dependent children. See pp. J4-s1 offilinc instructions)

D NONE (No reportable income, assets, or transactions.)

A. Description of Assets

(including trust assets)

Place "(X)" after each asset exempt from prior disolosure

Income during

reporting period

c.

Gross value at end of

reporting period

D.

Transactions during reporting period

(I} (i) (I) (2) (I) ifoot exempt from disclosure

Amount

Code I (A-H)

Type(e.g.

div., rent,

or int.)

Value

Cocle2

(J-P)

Value

Method

Code 3

(Q-W)

Type(e.g. buy, sell,

merger,

redemption)

(2) Date

Month-

Day

(3) Value

Code 2

(J-P}

(4) Gain

Code!

(A-H}

(5) Identity of

buyer/seller

(if private transaction)

35. Dreyfus Premier Third Century Fund A Dividend L T

36. Janus Fund A Dividend K T

37. Blue Hill Terrace Real Estate A Dividend J w Partnership

38.Woodland Manor Real Estate A Dividend ] w Partnership

39. Scudder Tax Free Fund A Interest M T

40. Home Depot Inc. Common Stock A Dividend ] T

41.Motorola Inc. Common Stock A Dividend T Sell 8/2 K c

42. The following are IRA assets:

43.WYE A Dividend K T

44.AIG A Dividend K T

45.AMAT None J T

46.:Bk A Dividend K T

47.BP A Dividend ] T

A Dividend K T

50.EMC None ] T

51.XOM A Dividend K T

l. lncome Gain Codes: A-SJ,000 or less B-Sl .001-52.500 c "'52,501 -$5,000 D "'55,001 - 515,000 ll=S15,00J -550,000

(SeeColnmnsBI andD4) f=SS0,001 -SI00,000 G-SI00.001 -51.000,000 HI =51,000,001 -SS,000,000 H2 =MorelbaDSS,000,000

2. Value Codes J =515,000 or less K=515,001 - 550,000 L=S50,00l -5100,000 M =SI00,001 -5250,000

(See Columns Cl and 03) N =5250,001 - SS00,000 0 =5500,001 - 51,000,000 Pl -s1. ooo,001 -55,ooo.ooo n -55,000.001 - 525,ooo.ooo

3. Value Method Codes P3 =525,000,001 - SS0,000,000 R =Cost (Real Estate Only) · P4 =More than SS0,000,000 T =Cash Market

(See Column C2) Q =Appraisal V=Other S =Assessment

U =Book Value W=Estimated

Page 8: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

B.

(1) (i) (I) (I)

Name of Person Reporting Date..tReportFINANCIAL DISCLOSURE REPORT

Page 7of11 Singal, George Z 05/06/2005

VII. INVESTMENTS and TRUSTS -income, value, transactions <mchules those of the spouse am1 dependent children. See pp. 3-1-s1 offilinc mstnu:tions)

D NONE (No reportable income, assets, or transactions.)

A. Description of Assets

(including trust assets)

Place "(X)" after each asset

exempt from prior disclosure

52.FRE

c. Income during Gross value at end of

reporting period reporting period

(2)

Amount Type(e.g. Value

Code I div., rent, Code2

or int.) (A-H) (J-P)

A Dividend K

Value

Method

Code 3

(Q-W)

T

D.

Transactions during reporting period

Type(e.g.

buy, sell,

merger,

redemption)

ifnot exempt from disclosure

(2) (3) (4) (5) Date Value Gain Identity of Month- Code 2 Code 1 buyer/seller Day (J-P) (A-H) (ifprivate

iransaction)

53.DNA None J T

54.GMH None K T

55.HD A Dividend K T

56.INTC A Dividend T Sell 8/2 J c

57. IBM A Dividend K T

58.JDSU None J T

59.JNJ A Dividend T Sell 8/2 J c

60.LU A Dividend J T

61.MRK A Dividend T Sell 8/2 K D

62.MSFT A Dividend J T

63. :NX'ft now Sprint/Nextel None J T Merger 8/17 J

64.NT A Dividend J T

65.PFE A Dividend T Sell 8/2 K A

66.PG A Distribution J T

67.WMT A Dividend J T

68.DIS A Dividend T Sell 6/28 J B

I. Income Gain Codes: A=Sl,OOOorless B =Sl.001 - 52.500 C =S2.501 -SS,000 D =SS,001 -SlS,000 E =SlS,001 - SS0.000 (See Columns Bl and D4) F =SS0.001 -SJ00,000 G =Sl00.001 -Sl,000.000 HJ =Sl,000,001 - 55,000.000 H2 =Morc lhan.55,000.000

2. Value Codes J =SIS.OOOor less K =SlS,001 -SS0,000 L =SS0,001 -Sl00,000 M =Sl00,001 -S250,000 {See Columns C 1 end DJ) N =5250,001 -5500,000 0 =5500,001 -Sl,000.000 Pl =Sl,000,001-55,000,000 P2 =ss.000,001 - s2s.ooo.ooo

3. Value Method Codes Pl =525,000,001 - SS0,000.000 R =Cost (Real Estate Oniy) P4 =More than 556,000;006 T =Cash Market (Sec Column C2) Q =Appraisal V=Other S =Assessment

U =Book Value W=Estimated

Page 9: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

Name of Person Reporting Date of ReportFINANCIAL DISCLOSURE REPORT

Page 8of11 Singal, George Z 05/06/2005

VII. INVESTMENTS and TRUSTS -income, va1ue, transaetions (uu:ludes those of the spouse am1 t1epen11en1 children. see pp. 1-1-s1 of filing instructions)

D 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

c.

Gross value at end of

reporting period

D.

Transactions during reporting period

(I)

Amount

Code I

(A-H)

(2)

Type(e.g.

div.; rent,

or int.)

(!) Value

Code 2

(J-P)

(2)

Value

Method

Code 3

(Q-W)

(!) Type(e.g.

buy, sell;

merger,

redemption)

ifnol exempt from disclosure

(2) (3) (4) (5) Date Value Gain Identity of

Month- Code 2 Code I buyer/seller

Day {J-P) {A-H} (if private

transaction)

69.WFC A Dividend J T

70.WCOM None J T

71.HQH A Dividend t Sell 6/28 j s

72.HQL A Dividend T Sell 6/28 J B

73. Paine Webber Retirement Money Fund A Dividend M T

74. GMNA Pool B Dividend T Sell 6/28 K A

75. US Treasury Note 8 Dividend K T

76.Bank America Note B Dividend K T

77.Household Finance Note B Dividend K T

78. GMAC Note B Dividend K T

· · ·- - -···

79. Franklin Small Cap Growth Fund None J T

80. Hartford Mid Cap Fund A Dividend J T

81. General Mills Note A Dividend K T

82. Boeing Note A Dividend K T

83. Agere Common Stock A Dividend J T Gift 10/I J

84. AT& TCommon Stock A Dividend J T Gift 10/1 J

85. Avaya Common Stock A Dividend J T Gift 10/1 J

1. lnco me Gain Codes: A =SI.000 or less B =s1.001 • s2.5oo c=52,501 - S5,000 D=55,001 -SlS.000 E =SIS.001 - S50.000 (Se e Columns Bl and 04) F=SS0.001 -SI00.000 G=SI00.001-Sl.000.000 HI =Sl.000.001 • SS.000,000 H2 =More tban.SS,000.000

2. Value Codes J =SI 5,000 or less K=SIS,001- S50.000 L=SS0,001 • Sl00,000 M =SI00,001 -5250,000 (See Columns Cl a nd 03) N =5250,00 I • SS00,000 0=5500,001 • Sl,000.000 Pl =Sl.000.001 • SS,000.000 P2 =SS,000,001 -525,000.000

3. Value Method Codes PJ =525,000 ,001 • SS0,000.-000 R =Cost (Real Estate Only) N-More thao SS0,006,060 T =Cash Market (See Column C2) Q =Appraisal V=Other S =Assessmen t

U =Book Value W =Estimated

Page 10: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

B. c.

(i)

Name llf Person Reporting Date <If Report FINANCIAL DISCLOSURE REPORT

Page 9of11 Singal, George Z 05/06/2005

VII. INVESTMENTS and TRUSTS -income. va111e, transactions rurc1udes those of the spouse ant1 dependmtchi#lren. See pp. J-t-s1 of filing instructions)

D NONE (No reportable income, assets, or transactions.)

A.

Description of Assets Income during

(including trust assets) reporting period

Place "(X)" after each asset

exempt from prior disclosure

(1) Amount

Code 1

(A-H)

86. Bell South .Common Stock A

Type(e.g. div., rent,

or int.)

Dividend

Gross value at end of

reporting period

(I) Value

Code2

(J.P)

J

(2) Value

Method

Code 3

(Q-W)

(IJ

Type(e.g.

buy, sell;

merger,

redemption)

T Gift

D.

Transactions during reporting period

(2) Date

Month-

Day

10/1

ifnot exempt from disclosure

(3) (4) (5) Value Gain Identity of

Code 2 Code! buyer/seller

{J.P) (A-H) {if private

transaction)

J

87. Comcast Common Stock A Dividend J T Gift !()/) ]

88. Lucent Common Stock A Dividend J T (lift 10/1 J

89. NCR CorpCommon Stock A Dividend J T Gift IO/I J

90. Qwest Common Stock A Dividend J T Gift 10/l J

91. Verizon Common Stock A Dividend J T Gift 10/l J

92. Vodafone Common Stock A Dividend J T Gift 10/1 J

93. Amsouth Bank Common Stock A Dividend J T Buy 10/1 J

94. Stanly Works Common Stock A Dividend K T Buy 10/l J

95. Kerr McGeeCommon Stock A Dividend K T Buy 10/1 J

I.Inco me Gain Codes: A =Sl.000 B 1.001 •S2,500 C =52,501 •55,000 D =55,001·515,000 E =515,001 •550.000 or less

(See Columns Bl aod 04) F 50,00 I •5 I 00,000 G 100,001·51,000,000 HI =51,000,001 -55,000,000 H2 =More than55,000,000

2. Value Codes J =SlS.000 o r less K=515,001-550,000 L =550,001 •SI00,000 M =5100.001 -5250,000

(See Columns CI and DJ) N =5250,001 •5500,000 0 =5500,001-51,000,000 Pl =51.000,001. SS,000,000 P2 =55,000,001 •S25,000,000

P3 25,000,001-SS0,000,000 P4 =Mo re than 550,000,000 J. Value Melhod Codes R =Cost (Real Estate Only) T=CashMarl<et Q =Appraisal S =Assessment

U =Book VaJue W=Estimated {SeeCohmtn C2) V-=Other

Page 11: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

Date of Report Name or Person Reporting FINANCIAL DISCLOSURE REPORT

Page 10of11 Singal, George Z 05/06/2005

VIll. ADDITIONAL INFORMATION OR EXPLANATIONS. (lndica1epartofReport.J

Page 12: UNITED STATES DISTRICT COURT - Judicial Watch · Aubn Maine Bond A Interest K T 28. Maine Healh Bond A Interest K T 29. Maine Halh Bond A Interest J T 30. Euro Paciic Growth Fund

_____ nate_r--+--far/t'--1'.)-,,/_ ,

FINANCIAL DISCLOSURE REPORT Name of Person Reporting Date of Report

Page 11of11 Singal, George Z 05/06/2005

IX. CERTIFICATION.

J certify that all information given above (including information pertaining to my spouse and .minor or dependent children, ifany) is accurate, true, and complete to the best o( my knowledge and belief, and that any information not reported was withheld because it met applicable statutory provisions penmtting non-disclosure.

I further certify that earned income from outside employment and honoraria and the acceptance o(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.

Signature

NOTE: ANY INDIVIDUAL WHO KNOWI 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 Finaiidal Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544


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