------- ------,-

UNITED STATES HOUSE OF REPRESENTATIVES

FORMA

For use by Members, officers, and employees

F,INANCIAL DISCLOSURE STATEMENT FOR CALENDAR YEAR 1999

_LlL/it<_Y- p dtV'f! _

~'I5a~ VIA AMAlV"Tc

--- -------- ------------ ------------ ----------- ------ ----- - - - - - - -- --_--------- -------------;--------------

Y~L/I1 S;~r<./A/ S CA (Wa~~;::;;:JOfo6P)~Z>-7~P

(Full Name)

rvl Member of the U_S. State: --------------

~ House of Representatives District: _

---~ -- - -_ .. _-------- _. ------- --- - .. _------

>< .lI\nnual (May 15) D Amendment

Filer Status

--- -~ --- ----

Report Type

PRELIMINARY INFORMATION - ANSWER EACH OF THESE QUESTIONS

RECEIVED LEGISl.ATIVE f,ESlllmCE CEtHER

OOMAYI5 hH8:32 .

,~:;~ljs~ff~1il\ (.1)

(Office Use Only)

A $200 penalty shall be assessed against anyone who files more than 30 days late.

I. Did you or your spouse have "earned" income (e.g., salaries or fees) of $200 or more from any source in the reporting period?

If yes, complete and attach Schedule I.

VI. Did you, your spouse, or a dependent child receive any

Yes fV1 No D reportable gift in the reporting period (i.e., aggregating more Ves D No Ix I

~ than $260 and not otherwise exempt)?

_ ____lfyl}~,_<:_<>mple_!E:_ and attacl"!. Schedu~_'{_I. _

II. Did any individual or organization make a donation to charity in D [g] VII. Did you, your spouse, or a dependent child receive any

lieu of paying you for a speech, appearance, or article in the Ves No reportable travel or reimbursements for travel in the reporting Ves 1\7'1 No D

reporting period? - period (worth more than $260 from one source)? ~

_1_f __ y~s..LE~!!!plet~ and attach Sc!l~tlLJI~_II_._ r---l! __ \f_es, com~lete and attach Schedu~le~V~I~I.'_ _

III. Did you, your spouse, or a dependent child receive "unearned" VIII. Did you hold any reportable positions on or before the

income of more than $200 in the reporting period or hold any Ves Ix I No D date of filing in the current calendar year? Ves I X I No D

reportable asset worth more than $1.000 at the end of the period? If yes, complete and attach Schedule VIII.

!fy_esLc;:~rnpL~!~_!"1~I_<l!!~ch ~~!!_~dul~I~___ .. _ _

IV. Did you, your spouse, or dependent child purchase, sell, IX. Did you have any reportable agreement or arrangement

or exchange any reportable asset in a transaction exceeding Ves IV1 No D with an outside entity? ves.D No Ix I

$1,000 during the reporting period? Q.J If yes, complete and attach Schedule IX.

l!_y_~!'_~.£~~pJet~i!!:1_tl_I!!!!'~t'~hed~'!_!_'!:_________________________________________ _ _

y. D.id you, your spouse, or a d':lpendent chil? have .any reportable _ D No 18] Each question in this part must be answered and the

liability (more than $10,000) dunng the reporting period? Yes ' " "

If yes, complete and attach Schedule V. approprtate schedule attached for each Yes respcnse.

EXCLUSION OF SPOUSE, DEPENDENT, OR TRUST INFORMATION - ANSWER EACH OF THESE QUESTIONS

vesD NO~

----

TRUSTS-Details regarding "Qualified Blind Trusts" approved by the Committee on Standards of Official Conduct and certain other "excepted trusts" need not be disclosed. Have you excluded from this report details of such a trust benefiting you, your spouse, or dependent child?

-------- --- -------------------------------------------------------------------------

EXEMPTION-Have you excluded from this report any other assets, "unearned" income, transactions, or liabilities of a spouse or dependent child because they meet all three tests for exemption?

vesD NO~

CERTIFICATION - THIS DOCUMENT MUST BE SIGNED BY THE REPORTING INDIVIDUAL AND DATED

This Financial Disclosure Statement is required by the Ethics in Government Act of 1978, as amended. The Statement will be available to any requesting person
upon written application and will be reviewed by the Committee on Standards of Official Conduct or its designee. Any individual who knowingly and willfully falsifies,
or who knowingly and willfully fails to file this report may be subject to civil penalties and criminal sanctions (See 5 U.S.C. app. 4, § 104 and 18 U.S.C. §1 001).
Certification Signature 01 Reporting Individual Date (Month. Day, Year)
I CERTIFY that the statements I have made on this fOr~( ~~~
and all attached schedules are true, complete and
correct to the best of my knowledge and belief.
- Ip .• eLof~_1

SCHEDULE I - EARNED INCOME

List the source, type, and amount of earned income from any source (other than the filer's current employment by the U.S. Government) totalling $200 or more during the preceding calendar year. For a spouse, list the source and amount of any honoraria; list only the source for other spouse earned income exceeding $1,000.

Source

Type

Amount

------------ ------------------------------- ---------------------- ---------- ----- ---------- ------------------~-- -----------

Keen~ !:)t~t~ _ _ _ _ _ _ _ _ _ _ _ _ __ _ __ _ _ __ _ __ _ __ _ __ _ __ _ _ _ __ __ _ _ _ _ _ _ _ _ _ _ ~per()v~d_Te_a(;_hing Fee_ __ !6--,O~O _

Examples: _ ~t~e_o~ tv!_aryl~n~ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ l:_e~is~a~v~ ~e~s~o~ __ _ _ _ _ _ _ _ ~9--,O_~O _

_ C2iv~1 ,!!~r ~~u~d~a~e_(<2c~ ~n~) _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~p~u~e_Spe_e~ ~l--,OQO _

Spouse Salary NA

Ontario County Board of Education

____ r1._~~ l<~rltt_~""ENT F(..(,v~ ~ ~:::sJ~~~L4?vQ!)-- 2) 7 7 ,

5t"t't(S"c P£NSIC;;/ 3(' /5;2..

---------------------------- --------------- ~-------

,-----------------------------~- ----------- -- -- ------ -------------

- ---------~------ -------~---- ------------------------ - ---------------------.-------- ------,

----------------------------------------------------1--------------1----------,

------------------------------ --- ------------------ -~------~------~- ---------------- ~--------

------------------ ----------------~------------------------------------------- ---------- ----------------------- ----------

----------- ---- --- - - --- -- -- -- ------------------------ -------------- -------------

---------------------------------------------

-------- ----~ -- ---------,

-----------------------------------------------------------------------------------

------------------ ----------

For payments to charity ill lieu of honoraria, use Schedule II.

SCHEDULE II -. PAYMENTS IN LIEU OF HONORARIA MADE TO CHARITY

List the source, activity (l.e., speech, appearance, or article), date, and amount of any payment made by the sponsor of an event to a charitable organization in lieu of an honorarium. A separate confidential list of charities receiving such payments must be filed directly with the Committee on Standards of Official Conduct. An envelope for transmitting the list is included in each Member's filing package.

Source

Amount

Date

Activity

------------------- ------------------ - ---~------------------- ----------------------- ---------

------------

--------------- ------------------------------------------ ---- --_._--------------- -------------

._------------------------------------------------------------------- --------------------------

----------- ---------

-----_. ------------------ ---- -- -- - -- ------ -----------------

------------------------------------ -------- -------- -------------------------------- -------------- -------------

------------------------------------------------------------- --- - --- ---------------- -----------1-------------

-------------------- -------------.-------------------- ------------ -----------

--------------------------------

--------------------1------------- ---------

-------1-----------------------------1--- -------1

-------- -- ---------- - ------------------ --------------

1------------------------------------- ---------------- -----.--------

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SCHEDULE III - ASSETS AND "UNEARNED" INCOME

BLOCK A BLOCK B BLOCK C BLOCK D BLOCK E
Asset and/or Income Source Value of Asset Type Amount of Income Transaction
Identify (a) each asset held for investment al close of reporting year. of Income For retirement plans or accounts that Indicate if
or production of income with a fair market value If you use a valuation method do not allow you to choose specific asset was
exceeding $1,000 at the end of the reporting investments, you may write "NA" for
period, and (b) any other asset or source of other than fair market value. income. For all other assets. indicate purchased
income which generated more than $200 in please specify the method used. the category of income by checking (P). sold (8),
"unearned" income during the year. For rental
property or land, provide an address. Provide If an asset was sold and is the appropriate box below. or
full names of any mutual funds. For a self- included only because it generated Dividends. even if reinvested. should exchanged
directed IRA (l.e., one where you have the be listed as income.
power to select the specific investments). income. the value should be "None." (E) in
provide information on each asset in the reporting
account that exceeds the reporting threshold,
and the income earned for the account. For an year.
IRA or retirement plan that is not self-directed.
name the institution holding the account and Q)
E
provide Its value at the end of the reporting A B C D E F G H I J K L 0 I II III IV V VI VII VIII IX X XI
period. For an active business that is not 0
E
publicly traded, in Block A state the nature E
of the business and its geographic location. For '"
additional information, see the instruction u.
0
booklet for the reporting year. Q)
E
0
0
Exclude: Your personal residence(s) (unless E
c.
there is rental Income); any debt owed to you 8 0 In L:
C> 0 I!!
by your spouse, or by your or your spouse's C> 0
a 0 ci ::> Ql
child, parent. or sibling; any deposits totaling 0 0 ci ex: c: 0 a
0 0 a ci 8 C> l- t: 0 a
$5,000 or fess In personal savings accounts; 0 8 0 0 C> I- ea 0 s
ci 0 ci Q) Q. 0
any financial interest in or income derived from a 0 0 0 uj 0 (f) 0 E 0 0 ci
0 0 a ci ci a uj ~ 10 8 (f) => z a> a 0 0 a a
u.s. Government retirement programs. 0 0 ci lO 0 q (I) II: :J 0 0. 0 0 0 a 0 q ~ a
0 g 0 til lO ,... If} I Z u E a 0 0 ci 0
.0 If} W I I 8 « l- ll) .s 0 l() 0 uj 0 ;;; 0
(i} ,... ea 0 Ii) or- I 0
§ w (I) I I I 5 0 a (f) l- e!) 0 0 15 )( q N .0 C;; In W
I I ;; 0 0 w w w (I) V) I ;; 0
If you so choose, you may indicate that an I ;; C; 5 0 0 ci ci z U) ...J l- ii: Q) ~ a C;; I I 0 0 p,
.,..: 5 ;; ~ w ~ 0.0 0 I I I a ~
asset or income source is that of your spouse 0 0 0 ci 0 0 w ex: 0.. >-u. (\j ;; ;; ci
Q) (fl s 0 0 0 0 0 0 0 0 0 I- w :J (I) I ;; ;; 8 0 8,
ffi w 0:: « f- .. <Il a 0 ci ~
(SP) or dependent child (DC) or Is jointly held c: I .0 0 0 l/) a q 0 .0 ?! z I- 0 ~~ c: I ,... q lO uj ci ffi
0 ~ 0 w -c x ::> tl> U C> 0 E
(JT), in the optional column on the far lefl. or- ;;; ;;; l() ;;; N l/) ,... ~ ~ 0 N N .0 10 >
Z (fl (I) (I) w If) 0 II: 0 W a .c Q) Z ;;; ;;; ;n ;;; ;;; °
_ a. <n <fl <fl W
----- --. - - - -- - - - -. - - - - - __ O _ _g!. __ ~ .. --------
SP, SP ~~9.a_ ~.?~~'. ~~o~~. _ . __ .... _ . X X X P
. - - - .. _ .. ------ _ .. .. -- . . - - .. . - . . - - - - - --- -- _ .. --- --- - - -- - - - - - - - - - - -- '-- -' . ... - _. ... - - . .. _ .. . . - .- . .. - - - - - - - - - - - - - -
DC, Examples: Simon & Schuster Indefinite Royallies X
... - - - - - - - - - - - - - - - - - - - - - - - -- ... ... - - - - - - - _ .. . _ . . .. _ .. . . . . - - - - - - '" .. - ... _ .. . . _.- .. - - - - - - - - - - -- -- . ' - -- . -- .. - -. - _ .. .. - ... - - . . - -------------.
JT 151 Bank of Paducah, KY accounts X X X
{'/IV/PJt/ f1~ ___ .. X - - ---' ~. -' X
cONq~n~W,Ac...... ~rrUNl6j X - X - - K - - - -- ----,
-- - -
1'14 tC1'l-.i' F t!!:. .x: #",,~ T ~- x- x
_.- -
~ta4<ILl." L.y-'/l/c;.I ~A I- X ~ X ~ X-
._. .-_. - - I-- 1------_.- -- I- - f- --- --_--_ ..
])~ UN 1?Jt/ E't4I>/lL.--tJP cA IX ~ ~
~ UN(J#g~NL o r CA ~ lX ~ + ..... _ _ For additional assets and unearned income, use next page.

SCHEDULE III - ASSETS AND "UNEARNED" iNCOME

Contin atio Sh t (if d d)

U I n ee I nee e
BLOCK A BLOCK B BLOCKC BLOCK 0 BLOCK E
Asset and/or Income Source Year-End Type Amount of Income Transaction
Value of Asset of Income
A B C 0 E F G H I J K L I II III IV V VI VII VIII IX X XI
SP, a C> ~ P,
a C>
a 0 C> ::) 8 s.
DC, a c5 a
a 0 0 a: 0
a C> Q) a §
C> a a 0 0 C> ~ 0 E
C> 0 a 0 ~ E 0
JT 0 0 0 0 g 8 .0 0 § en 0 0 0 8 0
0 8 C) c> 0 .0 Di ~ en ::) z t) 8 0 & ~ C)
0 0 III 0 a: ::J =~ 8 0 0 0 a
0 0 U) Z a 0
C) N 10 ~ I ~ III 0 10 a 0 W a
.0 to (fl (fl (fl I I § « 0 .0 t() W I 0
8 - (fl <n ~ en 0 0 o '0 q N .0 Ei) U)
Ifl I I I 0 0 C> 0 ~ (!) Q) Q) U) (fl I ;; 0
I I C> c5 en w w a. a. 0 U) I I 0
q I 0 0 8 0 0 a z _J ~ u: ~~ 0 I I I 0 0 ui
T"" 0 0 g m w w i! n, ~ C; C; 0
w C; 0 0 C) 0 a: ::J I C; c; 8 0 U)
Q) q 0 0 c> ci 0 0 .... 0 I- W 0:: w « Qj Q) ~ q 0 0 0 Qj
I 0_ q 0 z () c: I q ttl 0 q
c: tn 0 0 10 C) .0 Q> ;; ~ C- o 10 0
0 Eh Eh Vi tn Eh C\J t() Vi .0 N > W ~ « x ::) (5 0 (i) C\J (i) N ~ u; ~ u; ;;) >
z (/) (fl (fl U) I/) 0 0 a: o w 0 Z fA fA 0
~&(,/I'[l'7N~ - 5'¥'P :!fi«) l- X I--- X - K_ l- X
g- -- -- -
1- ¥!!! ... ~ u--'-l~lI-""u~1 "~IV~S - -- f--- X ,-- X -- -
X X -
~'_1l: llF $"~A~ ~,."o I- - f--- - - - -- I- m~SI - -
~M) ~11'N-r7«tff X -
-- -- i- - ,- - 1- :__ - -- rt!UfSr X
~ --'- X
-- tIt.'- Of.fA -.:rItA _. l- I-- ------ x
~~ CIJ«/. "S7t</~-ri4!A X ~11 /17 (?" 1"11 11t1 ~~ 11Y_ ~ ~t~ r/ ./ ~ nt ~I rY
gg_ (,.( I !J!'.:&.NC. ~ I' 6"~ -.:t:AA - X d_ - *
(ffrl'AI f!_AAlIv f)~ (A - -::eM X X - - -
-- - - 1- - ---- --
{)C; ~ SOOS_M 4*'~ J' K X -- -'-'- X
Oc, X - I- - X - I-- X f--- - ---_--
C/IIS__S_a.La (( (J()~JI ---- I- -- -- - -
OC I9).CA 'r'I ;4-0 - s tJ., fi{)1 - - -- ~- ----- --- ----- --- - _- X X r. _ - ,____ K
OC_ atV~ ~fNt.(J. s7tf.1'S - Xi -- -- - -_.
- ~ -
oc: ftL_C/HA~~i'rdSJeL __ X_ ~
- - -- --_----~
f)C L& ~()~~r Q~NR_.$ ____ n kU ~ 'It t:!t 6 ~ ~ urt-~ ~ ~ ~~ ~ !1'i ~ ~ t1J ,
tc x_ -- - -
~,.f1E as: S't4WIiI~Lg_tvI - ---1- - ~"SI_ f -- -,
Oc- ~I!F 0": ~,,£¥,,~ g.,,... ~ r~ff ---~--
- _J
I!_C_ 8c1YtJ COG'I£CTI(IfI) "rt<.J,frr - - -'g- - - ~ ~-
- - - ____, --
X_ I!J'()I-'i) C!l~Cif1tW' r~fT _ X
.W"i X -- --- ~ ----- ---- '-- -_-- - X -- -- - - ~ - ~_ - -- -- --- --
U~77t!CASf{~y- s-Lt£11'S' ,-- X'-- - K - -
~C_ ~fTL~~:- 5.4' $_r;,?'_ X -- K - - - - -
I- X kr I--- 1- --~---- ~-- :---' f-- -- -----
/2C ~L._-CLldl4-/J<_<!JI-f-i9SS-<CL_ I- .-_---- I-- 1- ----_._- I-- l- e- 1-
- - -- - - ------- This page may be copied if more space is required.

SCHEDULE IV - TRANSACTIONS

Report any purchase, sale, or exchange by you, your spouse, or Type
dependent child during the reporting year of any real property, of Transaction Date Amount of Transaction
stocks, bonds, commodities futures, or other securities when the
amount of the transaction exceeded $1,000. Include transactions B C D E F G H I J K
w w
that resulted in a loss. Do not report a transaction between you, en <!) 10 ..Lo 0
c( ~ ,1.0
your spouse, or your dependent child, or the purchase or sale of :J: (MO/DAYIYA) I §§ 10 ~O 88 0
o ,1.0 ..L8 ~O 5~ 88 00 0
W :J: C> - gg ci
your personal residence, unless it is rented out. 0:: o ,1.8 00 && _0
-' 00 00 C> 0 00 C> 0 0
:;) c( ~ 8C!- 00 °_0 cio 00 -0 8C!. :net
Q. (J) .00 011) 00 ~m
.11) 00 i5lm o _ - II) o§
~ ... r- on ~~ ~N on r- ~~ on N
fnfh EI) fn fnfn fh EI) fn fn
SP, DC, JT Asset
SP Example: I Mega Corporation Common Stock , X 10-12-99 X
--_-- ~F(J_~cr_s_~cA CQ_t<~ X-- --- '1'2--/6-'79 )( ----
$4,4/ £?/~tLL~ ---C4 'f?(lrV () S X 9-3tJ- 99 X
_T2G_ ~___r5Of._t65 M ~ CO?t/p,./ VjPNPJ' X I/-/S- 99 X
lX ~ -- f--- -_ r-- -
O!9"'rM c..... VJ4 ~K- 5CJ.lfl'Jt.-Q6T. I]gv/JJ /-/3-9? X
(JquFr Iv"~t-r~ ~cs ~~J?.5 ~ /-I"$-Pi Ix
C~"trt..£'N~,ytE:- '-:-0rV" -<:;;,Lr' ~t:if! X ~19"'III.(S D<
~c... e:a (;(rry:;t:/V~,w€ ~v~.- 5" ~ ?;i)t? X ~!../~t{) X
2)c..- 6__~ tr'L .:z-N'co,v1 e: ~wAd_" ~y!_/.5W ~ VIV~'t?US X
r----
c& a I it- _;:t:::'"M::JJ M c rtl M'~_:I--f? 5PtJ IX VAlllalS X
-- -


-

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SCHEDULE V - LIABILITIES

Ip·.·_6' .« I

--
Report liabilities of over $10,000 owed to anyone creditor at any time during the reporting period by you, your spouse, or dependent child. Mark the highest amount owed
during the year. Exclude: Any mortgage on your personal residence (unless it is rented out); loans secured by automobiles, household furniture, or appliances; and liabilities
owed to a spouse, or the child, parent, or sibling of you or your spouse. Report revolving charge accounts only if the balance at the close of the preceding calendar year
exceeded $10,000.
Amount of liability
SP, a c. D E F G H I ,J K
§§ 10 88 0
DC, Creditor Type of Liability .!.o 58 ,0 ..... 0 0
§§ I .!.8 o~ 00 0
o - §§ 0
JT ..... 0 00 ~~ ci8
00 get 00 00 00 0
00 00 gg ·0 00 ,-0
0.0 .00 08 00 o . .00 ~o
010 o _ _10
.......... ..... 10 ~w ..... N ~~ 10 ..... ..... 10 10 N ~~ o~
I/} (fl I/) (fl (fl Eo') Eo') <n (fl In (fl en
Example: .1 Firsl Bank of Wilmington, Delaware -t-
Mortgage on 123 Main St., Dover, Del. X SCHEDULE VI - GIFTS

Report the source, a brief description, and the value of all gifts totalling more than $260 received by you, your spouse, or a dependent child from any source during the year.
Exclude: Gifts from relatives, gifts of personal hospitality of an individual, local meals, and gifts to a spouse or dependent child that are totally independent of his or her relationship
to you. Gifts with a value of $100 or less need not be added towards the $260 disclosure threshold.
Note: The gift rule (House Rule 26, clause 5) prohibits gifts except as specifically provided in the rule.
Source Description Value
Example: I Mr. Joseph H. Smith, Any town, Anystate Silver Platter (determination on personal friendship received from Committee on Standards) $270


: Use additional sheets if more space is required.

SCHEDULE VII-TRAVEL PAYMENTS AND REIMBURSEMENTS

Identify the source and list travel itinerary, dates, and nature of expenses provided for travel and travel-related expenses totalling more than $260 received by you, your spouse, or a dependent child during the reporting period. Indicate whether a family member accompanied the traveler at the sponsor's expense, and the amount of time, if any, that was not at the sponsor's expense, Disclosure Is required regardless of whether the expenses were reimbursed or paid directly by the sponsor.

Exclude: Travel-related expenses provided by federal, state, and local governments, or by a foreign government required to be separately reported under the Foreign Gifts and Decorations Act (5 U.S.C. § 7342); political travel that Is required to be reported under the Federal Election Campaign Act; travel provided to a spouse or dependent child that is totally independent of his or her relationship to you.

Date(s)

Source

t------.---------------I-------~--·-- --- ...

Mar.:2

- - -- - - - - - -

Aug. 6-13

Examples: _ ~~i<?a~o_ C_h~~b_er:_ o~ ~o_m~~r.ge _

Roycroft Corporation

Was a Family A tl t t

Point of Departure-Destlnatlon- Lodging? Food? Member Included? ny nne no a

Point of Return (YIN) (YIN) (YIN) sponsor's expense

N N

-- - _- - - - - -

y Y

Wash., D.C.-Chicago-Wash., D.C.

- - - - - - - - - -- - - - - - - - - - - - -

N

N

y

4 Days

Wash., D.C.-Los Angeles-Cleveland

f-~/.JltfW,., a~ F"'Orz. ~d/<{~ ~ cJv1" _ ~I'\ItUi ~~, ?,,~ SPtJN~S Cft.:~(j,.JG~tt.S.~ t{ __]_ __ '(_ ._. __ N_· ._1 __ "' __ . _

U"'CAu./CA-~" of NO. CA. f"'Q2_._/~~ __ lpAuY\~'¢.INc...s.C'A --:-SF,,('A-P'.r(~ __ y_ '1 N ._N~ _

CV~~o~"'dvt~ t',.~ __ .-:'!~"_!-~~__J,-~ ~:_C'!~R.4~r~'!~~_._'!.t_ __ ..... p_ N.__ tV _. _ _:_N _

'5IQw#lAi~ ~1.A($(.,lC4'/ PAKP{ S9r. U~Z1_ OHT"~,CA ... ~~~~~<~_-~~~ Y Y h tJ __ tL _

,¥tff:_rf2aA'fltJrJ <1F ~fJ~if~f$f/.SlY' ISo_tiL Wt4.J"N,().(_· -SCA1tt£,£,v,QrjJ - r~,__ _'I__~ -Y--- _ ____!tI~_!_ -f 1J/

CA~_fCP«lArgJ rt.qWJ~CA~ w.,... ~ A& v. _L. Po$. O<J .=_S'A,v&1Ic:-r; ',CA - RS. <A Y y tI AI

li_IfMII ~~U(JUf'A"/ 1'1\A::f'l . !J)~.j_-:L/_ rp.s. C.q -1.J()I{D~~iI$-qCA. __ Y V__ __ y_. ~_. _

---------- ._._------------1---_._--- ------.-------------- .--- --- ---.------ -------

-----·--------------1--------·- -------.~----------_f----I__.---I-------- .• ---------I

---------------

-_._._-- ---_._--.-_._------_ .. - ---._-- ---- --_._. --------- ----_._----

.. ~--.------.--- .. - .. --- ..... --'~--'- ------. . __ . ------- ------ -.-_ .. _ .. __ . _,-,,_-----,- --------_.--

This page may be copied if more space is required.

Ip·g·~oLI

SCHEDULE VIII - POSIT!ONS

Report all positions, compensated or uncompensated, held during the current calendar year as an officer, director, trustee of an organization, partner,
proprietor, representative, employee, or consultant of any corporation, firm, partnership, or other business enterprise, any nonprofit organization, any labor
organization, or any educational or other institution other than the United States.
Exclude: Positions held in any religious, social, fraternal, or political entities; positions solely of an honorary nature; and positions listed on Schedule I.
Position Name of Organization
j?tf-eS I tl evT -~~~t-~~~-- ;;;;_~_. CCO~AiY_tA-ff5:f?IS5/J~!fP 9t.1~/,/_~_l'f922
r-·---·- -. ---. - -. "--'- --- .... .. --~~---- .. --.--- _- -
r~{tJbWT ~#et.. Ctv'/ CIt:.... t" t£I s ~ I rIVC- .
---~-.----- -_ .. _--- _._----_._-- --.- .... ~-.----- ---- -.- - --- - --- ---, - - ... _- - --- -.---------. --~---- ----- .-----------~---- .. ----------.-- --------- - -- -_._- ---
-----_. --- -- ----------------_.--------_ . _._--_- - .. --------- __ ._---_- ._-- --_.- -- -----,----- -----_---_ ---------- .- ---------- ---

- -----_ .. - --.- - - -- - _-. __ ._-----_ .. -_._-- _- _--_ - _. - -.-.-.-- -- _---_ .. __ - -- --.-.--~----------.--------- ---------_- ----_~----.--_- .. --.
_.---- - .. -_._--- "-_ .. . - --- .- - ----, .. --- -.- -. --- -- ---- ----- _ ----- - -~---.-- -- ---_._-_- -------- ------ ----,-----------~~-.-------------- SCHEDULE IX - AGREEMENTS

' ..

Date

Terms of Agreement

Identify the date, parties to, and general terms of any agreement or arrangement with respect to: future employment; a leave of absence during the period of government service; continuation or deferral of payments by a former or current employer other than the U.S. Government; or continuing participation in an employee welfare or benefit plan maintained by a former employer.

Parties To

---_. -----------------_--------------

------.- -------- ---.----------~-.------

-.---.---- .. ----------------~--- -------------- --_-

GPO: 2000 62-753 (mac)

Use additional sheets if more space is required.