l>1sfndT,44 - .L, ve Cbam1>rt 3 od any modllkllio as pertainiac; thereco, le ts. I• n\Y opini on,

appliabJe rq ulaUons.

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D OF ORGAN!ZA TION/ENTITY

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section. (dollar amount not required excep1 for honorarla)

FINANCIAL DISCLOSURE REPORT

FOR CALENDAR YEAR 2004

Repon Required by rll &'"' in Goi-unmen/Aaof 1918, (5 U.S.C App. JflOl·I I I)

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lnhial __y"Annual Fin1I 0 e.fllhU. .f 2LJ () 7"

In rompUanct: wltla la'°'"s and "' ZJaoa.dwa-V

a h(/1 /1.e II) -J

IMPORT ANT NOTES: The instroc1ions accompanying this fonn must be followed. Complete all partS, checking the NONE bax for each part where you have 110 reportable infon11atio11. Sign 011 last page.

J. POSITIONS:' (Reportln:l lvidual only; mpp. 9-/J o//ns/ructlons.)

POSffiON NAME

NONE (No reportable positions.) \

)

IL AGREEMENTS. (lleponlng md.vldual only:seepp. IM 6 of lnstn.ctions.) l2Am

NONE (No reportable agreements.) PARTIES AND

..

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IJT. NON-INVESTMENT INCOME. (Rep

DESCRIP'f!ON

of lnsrrucJions.)

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D CREDITOR

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reponing period

Place f,XJ" I

Va l ue exempt rom Code I Codc2 (l·P) (Q-W) redemption) -- --- -·

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C-S2,SO l-SS 000 Income/Gain Codes: (See Col. B l , 04)

A=S l , OOOo rless F•SS0,001 · $ 1 00,000 B • S l ,001-S2,500 G=S I 00,001-S 1,000.000 =$1,000,001-SS.ooo.ooo

2

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Value Codes : !-SIS 000 or less K • $15,001-SSO,OOO N=S2SO,OOl - SSOO.ooo O-S 500.001-S I ,000,000 P3=S2S,OOO, OO 1-SS0, 000.000

icthod Cocle$:

Date ___ ..J_-f_2_-_t>_.r ____ _

• • ;'II • • ' .. + :t

�----------------

FINANCIAL DISCLOSURE REPORT

Name ot Ptr$0n Reponing Dattof R.epon

I certify that all infonnation given above (includi ng 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 withbeld because it met applicable statutory provisions pennitting non-disclosure.

I further certify that earned income from outside employment and honoraria and the acceptance ofgifts which have been reported are in compliance with the provisions of5 U.S.C. app., § 501 el seq., 5 U.S.C. § 7353 and Judicial Conference regulations.

Signature

NOTE: A ILFULL Y FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CNIL AND CRIMINAL SANCTIONS (5 U.S.C. App.,§ 104.)

-FILING INSTRUCTIONS:

Mail signed original and 3 additional copies to: Conuuittee on Financial Disclosure Administrative Office of the

United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544

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...A monthly benefit from the Public Employees Retirement Fund of Nevada that had a .· .,; gross.income for Column Bat the end of the reporting year at Income Code E, $15,001 to · . . . 50,000 that is dividend or interest, but I am not certain. I do not know the Gross Value for .' ColumnC;

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2 .. A'monthly benefit form the Southern Nevada CUlinary and Bartender's Fund that had a gross income for Column Bat the· end of the reporting year at Income Code B, Sl,000 to $2 ,500 that is dividend or interest, but I am not certain. I do not know the Gross Value for-.

. . . · 'A monthly Social Security benefit that had a gtoss ineome for Column B at the end of the

reporting year at TAeome Code E, $15,001 to50, 000that is dividend or interest, but I am . ·not certain.I cfo not know the Gross Value for Cohmin C.

4. A personal residence in Clark County, Nevada that in 2003 for Coliµnn C at the end of the reporting period had a value Code L, $50,000'to $100,000 with.a Vlue Code Q that is abased upon the last appraisal. The residence did not have any incd'ine !lhd ·remained in need of repairs.

5. 'acres in BastropCounty, Texas that for the end of the reporting year had a value code M, Sl00,000 to 250,000 based upon the Value M ethod Code Q, a tax appraisal by county authorities. The title to this property has my - member and a as co-owners and there is a trust agreement that covers this property. To my knowledge, the

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member of the Committe e · staffas to whether the above information was reportable and was. ·.! . •:" . advised thit theinformation did not have to be re ported.- Ifthe Committeehas any questions or·

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