Beruflich Dokumente
Kultur Dokumente
R~. lt~oto
rl. Person Reporting (last name, [u~, middle initial)
6. R*~ing
IMPORTANT NOTES: The inarucdons accompanying this form mu~ be fol/owe~ Complete aO pa~s,
checking the NONE box for each pa~ where you have no repo~able informatiom Sign on I~t page,
NAME OF ORGANIZATION/ENTITY
4. 5.
2. 3.
~ ~..; ~ ....
Carroll, Earl H.
~ Filer$ Non-lnvestment Income ~ NONE ~o reportable non-investment income.) DA~ 1. 2. 3. 4. SQURCE (you~, not s~uses) - -"
B. Spouses Non-lnvestmen t Income - lf you w~re rtuwrled during any ponion of the reporting year, complete
(Dollar ontoum not required ~rcept for honorwia.)
3 4.
IV. REIMBURSEMENTS (Includes those to ~e and de~ndent children: see pp. 25-27 of filing i~t~ctiom.)
~
1, 2. 3 4. 5
NONE ~o reportable reimbursement.) SO~C~ DA~ LOCATION PURPOSE ITEMS PAID OR PROVIDED
4. 5,
B.
~m d~g
C.
Gross vfl~ It
D.
(A-H) I ~int.)
3.
4.
7.
8.
12.
14.
I ~
~.
l~o~ ~g ~ng ~
c.
~ G~ value al ~d of : ~ng ~6~ ~ V~uc [ Val~ ~ Ty~(c.g. ~ C~c2 I Me~ l ~y, sdl,
o.
Tractions during r~ing ~
P~cc(~aflcr~ch~ exemptfromp6ordi~l~
ld~tilyof ~y~/scllcr
29. 30, -
32.
33.
35.
38.
42.
46.
(incl~iagO~ptlon mt of Am ~)
[(A-t0 [
or mr.)
(J-~
59.
!63.
64. 65.
66.
68.
Signaturel
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FALLS TO FILE Tills REPORI" MAY BE SUBJEtLF 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