Beruflich Dokumente
Kultur Dokumente
Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app. 101-110
Active Status
[] Initial
8. On the bash of the Information contained in this Report and any modification8 pertaining thereto, It is, in my opinion, in compliance with applicable law~ and regulations.
Reviewing Officer Date
IMPORTANT NOTES: The instructions accompanying this form must be foltowea~ Complete att parts,
checking the NONE box for each part where you have no reportable information. Igign on last page.
I. POSITIONS. ~R,~,,,rt~
[~ NONE (No reportable positions.)
POSITIQN
NAME OF ORGANIZATION/ENTITY
2. 3. 4,
~,..~.. ~:,
P~TIES A~ ~S
Davis, Le_qrome D.
2. 3. 4.
B. Spouses Non-Investment Income - if you were married during any portion of the reporting year~ complete th~ sectiot~
(Dollar amount no~ required except for honoraria.)
IV. REIMBURSEMENTS (Includes those to spouse and dependent children; see pp. 25-27 of filtng instructions.)
~]
2.
3.
4.
5.
V. GIFTS. a, ct, de, ,ho- 1o ,eo,- o~d d~p,.do~t ~.~; .~ pp. u.31 of fillng instructions.) NONE 0go reportable gifts.)
SOURCE
1. 2. 3. 4. 5.
DESCRIPTION
VALUE
DESCRIPTION
VALUE CODE
(t)
Type (e.g., buy, sell,
(2)
Date
(3)
Value
(4)
Gain Code 1 (A-H) Identity of buyer/seller (if private transaction)
(J-P)
Code 3 (Q-W) T T
redemption)
I. 2, 3. 4. 5. 6. 7. 8. 9.
Equivest Mutual Fund Equivest Variable Life -Eq Balaanced -EQ?Allianc International Pacific Life Variable -Janus Capital Corporation -MFS hvestmcnt Management PNC Investments -Putnam International Equity
D D
Dividend Dividend
L L
Dividend
Dividend
lO. -Putnam Income I I. -Putnam New Opportunities 12. -Putnam New Value 13. -Putnam Small Cap Value Securities 14. 15. 16. 17.
I.Income Gain Codes: (Se Columns BI and D4) 2.Value Codes (See Cehmm CI and D3) 3. Value Method Codes (See Column C2)
A =$1.000 or less F =$50,O01 - $ I O0,OOO =SILO00 or lest N =$250,001 . $500,OOO P3 =$25,~OO,0OI - $50,@00,000 Q=Appraisal U =Book Value
13 "SI,001 - $2,500 G =S10~,001 - $1,000,000 K =$15,001 - $50,000 O =$500.001 - $1,000.000 R =Cost (Real Et~te Only) V ,=Other
C =$2,501 - $5,000 HI =$1,000,001 - $5,000,000 L =S50,001 - $100,000 Pl -$1,000,001 - $5,000,000 P4 =More than $50,000,000 W =Estimated
IE =$15,001 - $50,00~
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~ U.SoC. app. 501 et. seq., $ U.S.C. 7353, and Judicial Conference regulations.
Signature
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)
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544