Beruflich Dokumente
Kultur Dokumente
Re~. 1,0~0
08!02/2010
6. Repo~ting Period 0 I101/2009 to 12/31/2009
[] Initial
5b. [] Amended Report 7, Chambers or Office Address P, O. Box 1060 Laredo, Texas 78042 8. On the basis of the information contained in this Report and any modif~atioas pertaining thereto, it [% in my opinion, in compliance with applicable laws and regulations.
Reviewing Officer
Date.
IMPORTANT NOTES: The instructions accompanying this form must be followed. Complete aft parts, checking the NONE box for each part where you have no reportable information. Sign on last page.
NAME OF ORGANIZAT|ONfENTIT~
Boys & Girls Clubs of Laredo
~. ~
~ ......
1.
2.
Date of Report
[ Kazen, George P.
o81o212o~o
IlL NON-INVESTMENT INCOME. CR,poni.e i,~,~uat a,d ,po,,e; s,, p~,. 17-24 of filing instruclions.)
A. Fliers Non-Investment Income NONE (No reportable non-investment income.) ~DATE SOURCE AND TYPE ~COME
(yours, not spouses)
2. 3.
4.
B. Spouses Non-Investment Income - tf you were married during any portion of the reporting year, complete this section,
(Dollar amoa~t not required except f!~r honoraria.)
DATE
1. 2. 3. 4.
LOCATION
PU~OSE
2. 3. 4. 5.
~-~
1. 2. 3, 4. 5.
VI. LIABILITIES. a,ctud,, tSos, oy,p .... and dependent children; see pp. 32.33 of filing instructions.)
NONE (No reportable liabilities.) CREDITOR
I. 2. 3. 4. 5,
DESCRIPTION
VALUE CODE
Page 4 of 7
VII. INVESTMENTS and TRUSTS 2. income, voW.e, ~.,~ao~ (t.a~, t~ose o/ ~.. ..d dependent children; see pp. 34-60 of filing instructions.)
[] NONE (No reportable income, assets, or transactiqns, ) A. Description of Assets (including trust assetS) Place "(x)" after each asset exempt from prior disclosure B. Income during reporting period (~) (2) Amount Type (e.g., Code I dlv., reut. (A-H) or int.) C. Gross value at end of reporting period (|) (2) Value Value C(xlc 2 Method Code 3 (J-P) (Q-W) J K J J J K W U W W W T D. Transactions during reporting period (I) Type (e.g., buy, sell. ~odemption) (2) (3) (4) t . Date Value Gain mm/dd/yy Code 2 Code 1 (J-P) (A-H) (5) Identity of buyer/sel~er , (if private transaction)
1. 2. 3. 4. 5. 6.
Royalty lmerest Webb County, Texas Hilltop Farms, Ltd, (1.8%) Webb County, Texas Royalty Interest-Parcel I, Shackelford County, Texas Royalty Interest-Parce~ 2, Shackelford County, Texas Undivided 113 Interest, R~nch, Shackelford County. Texas MFS Mutual Funds-IRA
Royalty None
: 7,
8. 9. 10. I1. 12. 13. 14. 15. 16. 17.
Column C2)
U =B~k Value
V ~r
W =Estimated
Date of Report
08/02/201o
I Kazen, Georse P.
VII. INVESTNflgNTS and TRUSTS -- .co., ~t.e, .~n,~o.~ URn.de, ,ho,e o/,~n~e ~ dependent Children; see pp. 34-60 of filing instructions.)
D
18.
Dividend Interest
J N
i9.
USAA Federal Savings Bank Account Royalty Interest--Parcel4-- Shackelford County, Texas American Balanced Fund-A Compass Bank Royalty interest--Parcel 5--Shackelford County, Texas Royalty interest--Parcel 6--Shackelford County Spectra Energy Corp. (IRA) Technology Sector Fund (IRA)
A A C A B
K J M K J K J J
T W T T W W T T
A A
Dividend Dividend
28.
29.
U =Be, ok Value
V =Olh~r
W =Estimated
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 informalion not reported was withheld becau~ it met applicable statutory provisions permitting non-disclosure. ! 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.
Signatm
NOTE: ANY INDIVIDUAl., WHO KNOWINGLY AND WILFULLY FALSIF 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