Professional Documents
Culture Documents
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1010
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Brinkema, Leonie M.
3. Date of Report
2. Court or Organization
6. Reporting Period
D
D
Sb.
lmtrnl
01/01/2011
Date
Nommat1on
[{]
Annual
05/10/2012
to
Final
12/31/2011
Amended Report
40 I Courthouse Square
Alexandria, VA 22314-5799
IMPORTANT NOTES: The instructions accompanying this form must be followed. Complete all parts,
checking the NONE box for each part where you have no reportable information. Insert signature on last page.
[{]
NAME OF ORGANIZATION/ENTITY
I.
2.
3.
4.
5.
II. AGREEMENTS.
[{]
I.
2.
3.
Date of Report
Brinkema, Leonie M.
05/10/2012
[{]
I.
2.
3.
4.
B.
Spouse's Non-Investment Income - If you were married during any portion of the reporting year, complete this section.
[{]
I.
2.
3.
4.
IV. REIMBURSEMENTS
--
[{]
I.
2.
3.
4.
5.
DATES
LOCATION
PURPOSE
V. GJFTS.
[Z]
NONE
Date of Report
Brinkema, Leonie M.
0511012012
(Includes those to spouse and dependent children; see pp. 28-31 offiling instructions.)
SOURCE
VALUE
I.
2.
3.
4.
5.
VJ. LJABJLJTJES.
[Z]
NONE
(Includes those ofspouse and dependent children; see pp. 32-33 offiling instmctions.)
CREDITOR
I.
2.
3.
4.
5.
DESCRIPTION
VALUE CODE
Date of Report
Brinkema, Leonie M.
05/10/2012
Page 4of6
NONE
-- income, value, transactions r1nc1udes those ofspo11se and dependent children; see PP 34-60 offiling instructions.)
c.
D.
Income during
reporting period
of reporting period
A.
Description of Assets
(including trust assets)
(1)
Amount
Code 1
(A-H)
"
(2)
Type (e.g.,
(1)
Value
(2)
Value
div., rent,
Code2
Method
buy, sell,
or int.)
(J-P)
Code 3
redemption)
(!)
Type(e.g.,
Value
(4)
Gain
(5)
Identity of
mmfddlyy Code2
(2)
Date
(3)
Code I
buyer/seller
(J-P)
(A-H)
( if private
transaction)
(Q-W)
I.
lnt./Div.
Mutual Fund
2.
Sold
12/12/11
(part)
Interest
Interest
3.
4.
Interest
5.
Interest
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
3. Value
D3)
B 41,001 -$2,500
c 42,501 - $5,000
F =$50.001
G =$100.001 -$1.000.000
HI
J=$15,000or lcss
K =$15,001 -$50.000
L =$50,001 -$100.000
M =$100.001 - $250.000
N =$250,00I - $500.000
0 =$500.001 - $1,000.000
Pl =$1.000,001 -$5,000,000
P 2=$5,000,001 -$25,000.000
-$100,000
Method Codes
=$1,000,001 -$5,000.000
P3 =$25.000.001 -$50.000.000
(See Column C 2)
D =$5,001 -$15.000
H2 =More than $5.000.000
A =$1.000or less
Q =Appraisal
S =Assessment
U =Book Value
V =Other
W=Estimatcd
T =Cash Market
E 415,001 -$50,000
Date of Report
Brinkema, Leonie M.
05/10/2012
(lndicate partofreport.)
..
Date of Report
Brinkema, Leonie M.
05/10/2012
IX. CERTIFICATION.
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 5 U.S.C. app. 501 et. seq., 5 U.S.C. 7353, and Judicial Conference regulations.
Signature:
s/ Leonie M. Brinkema
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILLFULLY FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL
AND CRIMINAL SANCTIONS (5 U.S.C. app. 104)