PRINCE GEORGE,S COTINTY, MAR].

LAND
F'rI,{ANCIAL Drs cLosuRE STATEME|{T THIS FINANICIAL DISCLOSURE STATEMENT IS REQUIRED BY THE PRNCE GEORGE'S COUNTY CODE OF ETHICS 52-294. TITE STATEMENT CONSISTS OF THIS COVER SHEET, THE SCHEDULE SUMMARY ANID ALL APPROPRIATE SCHEDULES.

REPORTING PERIOD: January

L,Z) ( 0

through December 31,

70 / ?

RUs
(First)

L,en
(Middle lnitial)

'{(^ / /a
ast Name)

(Present Home or Work Add

'orlr1^1a

: Street, City, State an

ehe,Jenl

il4>
ip Code)

LO

735

3or

(Current Work/Office Telephone Number)

2\- 4/3
F A

&rfrz 6

a udH
A

A.
n-

DEPARTMENT/AGENCY ANID POSITION (JOB TITLE)

t . --

FOR

Cot)n
B.

DEPA'RTMENT/AGENCYAND POSITION CURRENTLY HELD (IF DIFFERENT FROM "A"):

C. PREVIOUS YEAR/PERIOD FOR V/HICH SIMILAR STATEMENT FILED:

D. DATE oF APPOINTMENT (IF AppoNTED To posrrroN rN

TToRTTNG

vEAR)

, t z/t
I

E. DATE OF DEPARTURE FROM COTINTY

SERVICE (IF

APPLICABLE),

M 'T

YOU MUST CHECK EVERY trTEM ON THE SCHEDUTE SUMMARY EITHER,,YES,, OR,NO,,. ATTACH APPROPRTATE SCHEDULE OT{LY IF BLOCK HAS BEEN MARKED "YES'' ON THE SCHEDULE SUMMARY.

OATH OR AFFIRIVIATIOI\
true and correct.

I do solemnly declare and affirm under the penalties of perjury that the contents of the attached document are

PGC Form No . 4169 (Revised

Updated

2l0l)

2l20ll

FINANCIAL DISCLOSURE STATEMEI{T youRNAME

- SCHEDULE SUMMARY
REpoRTTNGyEAR:

r?erclr,r"^n L . W,JA,q W
NO

;/o

YOU MUST COMPLETE EVERYITEM ON THIS PAGE.

A.

YES

Interests in ReaI Property. You * owned or paid rent for real property located inside and outside of Maryland (including leasehold interests in oil, g&S, or other mineral royalty or lease). (If "Yestt, complete a Schedule A for each property owned or rented.) fnterest in Corporations. You * owned stock or equity interest in a corporation. (If "Yes", complete Schedule B.)

t/ t/

Interests in Business Entities (Other Than Corporations) Doing Business with the County. You * owned part or all of any business entity doing business with the County. (tf t'Yest', complete Schedule C.)

'

D.

Gifts from Persons Doing Business with the County. You received, or directed to be given to another, a gift or gifts in excess of $25 in value, or a series of gifts totaling $ 100 or more in value, from, or on behalf of, an individual or business entity doing business with the County. (Gifts from spouse, children or parents need not be disclosed.) (tf ttYes", complete Schedule D.)
Offices, Directorships and Salaried Employment in Business Entities Doing Business with the Counfy. You or your spouse or dependent child held an office, directorship, or salaried employment with a corporation or other business entity doing business with the County. (If ttYes", complete Schedule E.) Indebtedness to Persons Doing Business with County. You or your spouse owned money or properlf to an individual or business entity doing business with the County. (tf "Yes", complete Schedule F.)

l/

G\
H.

,qg

,/

Members of Immedi rteFamily Employed by t8. County. Your spouse or dependent child was employed by the County during the reportittg period, (tf ttYes", complete Schedule G.)

,."'

Other Sources of Earned Income. You held salaried employment during the reporting period, other than with the County; andlor you, you spouse, or your dependent child earned income during the reporting period from a business entity of which you, your spouse, or your' dependent child was sole or parti.al owner. (If "Yes", complete Schedule H.) Contributiorsr Receipts and Expenses Associated with a Testimonial. You were given one or more testimonials during the reporting period. fft "Yestt, complete Schedule I for each testimonial.)
.

I.

4 ,/

J.

Interests and Information Disclosed. You wish to disclose additional interests "ther and information regarding your financial affairs. (If "Yes", complete Schedule J.)

* Include any interest held by: (1) a spouse or child if you directly or indirectly controlled the interest at any time during the reporting year; (2) any business entity in which you had a 30o/o or greater ownership or equity interest during the reporting year; or (3) a trust or estate in which you held reversionary interest, were a beneficiaryr or were a settler in the reporting year this does not include IRS 401 and 501 qualified trusts). t2-2
Updated

2l20ll

SCHEDULE A PROPERTY OWNED OR RENTED

AME,?rah

ev^ L- (Ul4r, T

REPoRTTNGyEAR:

List every piece of real estate Qocated inside and outside of Maryland) which you OWI\ED* OR PAID RENT FOR (including oil, gts, mineral leases) AT AI{Y TIME during the reportiog period. Complete a separate Schedule A ou owned or naid rent for. for each Dro

REI{TED

OWNED/

ADDREss' 3-fO8
(Street)

CLteuer-l
(City)
(Counfy) County

fur,)
(State)

OR

Lot

Block

Liber

Folio

IF YOU OWNED THE PROPERTY. COMPLETE THE FOLLOWING:

AS OF L2I3L OF REPORTING YEAR: Mortgase Balance:

3 50, o oo - 0 ?

Mortgage Holde

,r' lt0/{S(41:
, ([

THROUGHOUT THE REPORTING YEAR:

FutI Name(s) of Every Person(s) Owning Properfy with You

'<l-^ iSeVe"t t-

Other Uen(s) Amount:

Lien Holder:

IF YOU ACOUIRED PROPERTY DURING THE REPORTING YEAR:

Date Transferred:

How Transferred: Sold Other

/ I

Gift

/ (Specify:

Name of Every Person from Whom Properfy Acquired

Your Percentage of Ownership:

Amount Paid for Property:

Your Share of Cost of Property:

OR, if Gift, Fair Market Value:

IF YOU SOLD OR GAVE THE PROPERTY TO SOMEONE DURHNG THE REPORTING YEAR:
Amount You Received:

Full Name of Every Person who BoughtlReceived Property:

Date Transferred:

How Transferred: SoId Other / / (Specify:

/ I

Gitt

*Include any interest held by: (1) a spouse or child if you directly or indirectly controlled the interest at any time during the reporting year; (2) any business entity in which you had a30"/o or greater ownership or equity interest during the reporting year; or (3) a trust or estate in which you held reversionary interest, were a beneficiary, or were a settler in the reporting year (this does not include IRS 401 and 501 ualified trusts). 12-294
Updated 2/2011