Professional Documents
Culture Documents
0312000)
5 C.F.R. Part 2634
Executive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORT Form Approved:
OMB No. 3209 - 0001
U.S. Offlce of Government Ethics
Date of Appointment, Candidacy, Election, Reporting Incumbent Calendar Year New Entrant, Termination Termination Date (IfAppJi-
orNominatlonfMonth Day. Year) Status
(Check Appropriate [gJ Covered by Report Nominee, or
Candidate
0 Filer D cabJe) (Month,Day, Year) Fee for Late Filing
Any individual who is required to file
01/20/2009 Boxes) 2009 this report and does so more than 30 days
1 1 1 1
after the date the report is required to be
Last Name First Name and Middle Initial
Reporting filed, or, if an extension is granted, more
Individual's Name Obama Saraek H. than 30 days after the last day of the
filing extension period, shall be subject
to a $200 fee.
Title of Position Department or Agency (If Applicable)
Position for Which
Filing President Reporting Periods
Incumbents: The reporting period is
Address (Number, Street, City, State, and ZIP Code) the preceding calendar year except Part
Telephone No. (Include Area Code)
Location of II of Schedule C and Part I of Schedule D
Present Office White House, 1600 Pennsylvania Ave. NW, Washington, D.C. 20500 202-456-1414 where you must also include the filing
(or forwarding address) year up to the date you file. Part II of
Schedule D is not applicable.
Title of Position(s) and Date(s) Held
Position(s) Held with the Federal
Government During the Preceding Termination Filers: The reporting
12 Months (If NOl Same as Above) period begins at the end of the period
covered by your previous filing and ends
at the date of tennination. Part II of
Name of Congressional Committee Considering Nomination Do You [ntend to Create a QJ.lalified Diversified Trust? Schedule D is not applicable.
Presidential Nominees Subject
to Senate Confirmation Not Applicable DYes 181~ Nominees, New Entrants and
Candidates for President and
Cert1fication Vice President:
Signature.¢-~rting Ind ,.,idual Date (Month, Day, Year)
I CERTIFY that the statements [have
(~)
Schedule A--The reporting period
made on this fonn and all attached
schedules are true. complete and correct
to the best of my knowledge. - S/p-//IO for income (BLOCK C) is the preceding
calendar year and the current calendar
year up to the date of tiling. Value assets
as of any date you choose that is within
Signature of Other Reviewer Date (Month, Day, Year)
Other Review 31 days of the date of filing.
(If desired by
~~ C/~ 5-1-'7-/0
agency)
Schedule B-Not applicable.
/? Schedule C, Part I (Liabilities)-The
Agency Ethics Official's Opinion Signature of Designated Agency Ethics Official/Reviewing Official Date (Month, Day, Year) reporting period is the preceding calendar
year and the current calendar year up to
~Ii.,~
On the basis of infonnation contained in this
report, I conclude that the filer is in compliance
with applicable laws and regulations (subject to
any comments in the box below).
..sIll/II 0 any date you choose that is Within 31 days
of the date of filing.
-JZ~J-. L ~/~
Use Only arrangements as of the date of filing.
J-/7-/o
Comments of Reviewing Officials (ff additional space is required, use the reverse side of this sheet)
- Schedule D -The reporting period is
the preceding two calendar years and
the current calendar year up to the date
of filing.
(Check box if filing extension granred & indicate number of days _ _ _ )
D
Agency Use Only
Assets and Income Valuation of Assets Income: type and amount. If "None (or less than $201)" is
at close of reporting period checked, no other entry is needed in Block C for that item.
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5
Vanguard 500 Index Fund (Retirement) (S)
X X X
* This category applies only if the asset/income is solely that of the filer's spouse or dependent children. If the asset/income is either that of the filer or jointly held
by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate,
Assets and Income Valuation of Assets Income: type and amount. If "None (or less than $201)" is
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1
U.S. Treasury Bills - SEP/lRA
X X X
2
U.S. Treasury Notes (J)
X X X
5
U.S. Treasury Bills (J)
X X X
6 Bright Directions College Savings 529 Plan (DC)
X X X
(Newborn to 8 yrs).
7
Bright Directions College Savings 529 Plan (DC)
(9 to 12 yrs).
X X X
8
Morgan Chase Private Client Asset Mgmt. X X
Checking Account (S)
q Final deferred
University of Chicago Hospitals, Chicago, IL (S)
compensation
distribution
* This category applies only if the asset/income is solely that of the filer's spouse or dependent children. If the assetlincome is either that of the filer or jointly held
by the filer wi th the spouse or dependent children, mark the other higher categories of value, as appropriate,
Assets and Income Valuationo f Assets Income: type and amount. If "None (or less than $201)" is
at close of reporting period checked, no other entry is needed in Block C for that item.
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3
Vanguard FTSE Social Index Fund (Retirement) X X
X
(S)
4
Vanguard FTSE Social Index Fund (Retirement) X
X X
(S)
5 Hawaiian Tax Free Trust Class A (Inheritance
X X X
from the Estate of Madelyn Dunham)
6 Dystel & Goderich, NY, NY - Book Royalties
X X
from Crown Publishing - Dreams from My Father
7
(Value not readily ascertainable)
8
Random House, NY, NY - Book Royalties - X X
Audacity of Hope
q
(Value not readily ascertainable)
* This category applies only if the asset/income is solely that of the filer's spouse or dependent children.
If the asset/income is either that of the filer or jointly held
by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate.
Assets and Income Valuationof Assets Income: type and amount. If "None (or less than $201)" is
at close of reporting period checked, no other entry is needed in Block C for that item.
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1 $225,000
Dystel & Goderich, NY, NY - Book Royalties Advance
from Crown Publishing - Dreams from My Father
2
(Abridged version for young adults) (Value not
readily ascertainable) - See Attachment B for
3
related information.
* This category applies only if the asset/income is solely that of the filer's spouse or dependent children. If the asset/income is either that of the filer or jointly held
by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate.
Part I: Transactions
Report any purchase, sale, or exchange Do not report a transaction involving NoneD
by you, your spouse, or dependent property used solely as your personal
children during the reporting period of any residence, or a transaction solely between Transaction Amount of Transaction (x)
you, your spouse, or dependent child. Type (x)
real property, stocks, bonds, commodity
futures, and other securities when the Check the "Certificate of divestiture" block Date
amount of the transaction exceeded $1,000. to indicate sales made pursuant to a (Mo.,
5: ~ Day, Yr.)
Include transactions that resulted in a loss. certificate of divestiture from OGE. '"
.J:;
!: ., '"x
1i
::J
a.
m
(j) uJ
Identification of Assets
I
Example Central Airlines Common x 2/1/99 x
Nobel Foundation, Stockholm, Sweden Nobel Medal and diploma (Value not readily ascertainable)
2
(Cash prize of 10 million Swedish kronor (approximately $1.4 million) has been donated to charity.)
Senator Edward Kennedy and Portuguese water dog named "80" $1,600
Part I: Transactions
Transaction Amount of Transaction (x)
Type (x)
2!OJ 8,
<:
OJ
Day, Yr.) ':'8 8c::. g~ 06 08 . . § §~
8· 00
88 88 80 80 ~ ~'C
8.Vl8. via ...>.,.,
~::J u10 68 VlO o.
-:(I
1
Vanguard 500 Index Fund (S) X 7/9/09 X
2
Hawaiian Tax-Free Trust Class A (Inheritance from the Estate of Madelyn Dunham) X 1/5/09 X
3
Bank Hawaii Corp. (Inheritance from the Estate of Madelyn Dunham) X 1/29/09 X
4
10
11
13
14
15
16
*This category applies only if the underlying asset is solely that of the filer's spouse or dependent children. If the underlying asset is either held
by the filer or jointly held by the filer with the spouse or dependent Children, use the other higher categories of value, as appropriate.
Prior Editions Cannot Be Used. OGEIAdobe Acrobat version 1.0.2 (l110 112004
SF 278 (Rev. 0312000)
5 C.F.R. Part 2634
U..
S Office of Government Ethics
Reporting Individual's Name Page Number
Obama, Saraek H. SCHEDULE C 8 of 9
*This category applies only if the liability is solely that of the fIler's spouse or dependent children. If the liability is that of the fIler or a joint liability of the filer
with the spouse or dependent children, mark the other higher categories, as appropriate.
Example
I
I Pursuant to partnership agreement, will receive lump sum payment of capital account & partnership share
calculated on service performed through 1/00.
General Assembly Defined Benefit Pension Plan (no further contributions by fonmer employer)
Doe Jones & Smith, Hometown, State
01/97
Mr. Henry G. Freeman Jr. died in 1917. His estate is administered by Wells Fargo
Bank, San Francisco, CA as Trustee. Mr. Freeman's will provided that upon the death of
the last to die of certain named relatives, certain charitable income interests would be
created and an annuity of $12,000 per year would be paid to each First Lady during her
husband's term as President.
ATTACHMENT B TO SCHEDULE A - ASSETS AND INCOME