1 r8 AOllO Re FINANCIAL DISCLOSUR REPORT Report Requir1 by the Ethics in Government Act of Calendar Year 2003 (5 U.S.C. app. ft ) _ l. Person Reporting (Last name, Firs11 ri1ame, Middle initial) 2. Court or Organization 3. Date of Report FITZPATRIC, DUROSS U. S. DISTRICT COURT, GEORGIA 5/X0/ Title (Article III Judges indicate active or senior stats; 5. ReportType (check appropriate ty) magistrah: judges indicate full or p111rttime) U. S. DISTRICT JUDGE (SENIOR) 0 Nomination, Dat 0 Inti (!1 Annual 0 Fi 6. Reporting Period 1/ to 112/31/ Chambers 1 r Offce Addres 8. On the basis of the information contained in this Report and any P. O. BOX I<l4 MACON, GA modifications pertining thereto, it is, in my opinion, in compliance ith applicable las and regulations. Revieing Offcer Date NOTES: The instructions accying this for must be folloed. Complete all par, checking tllle NONE box for each part e no reportble informtion. Sign on last page. I. POSITIONS. (Reporting iindividual only; see pp. 913 of filing instructions) D NOJ'. (No reportable positions.) POSITION NAM OF ORGANIZATIONIETIIY 1. PRESIDEN RICHLAND RESTORATION LEGUE, INC. II. AGREEMENTS. (Rc:lrting individual only; see pp of filing instructions) NONE (N reortale agreements.) PARTIES AN TE I.
2 . ' FINANCIAL DISCLOSURE REPORT Nam of Person Reporting Date: of Repo] FIZPATRC, DUROSS 5/10/2004. Ill. NONINESTiNT INCOME. (Reporting individual and spouse; see pp of filing instrctions) A. FiJer's Nonlnvestmen1t Income NONE (No reportable noninvestment income.) l. SOURCE AN TYE GROSS INCOME (your, not spuse'1;) B. Spo111se:'s NonInvestmemt J[neome (If you ere married durg any porton of the reortg ye, please complete th section. (dollar amount not required 1::cet for honoraa) NONE (No rertable noninvestment income.) SQUCE AN TYE l. N. REIIIBURSEMENTS trrtaion, lodging, food, entertinment. (Includes those to spouse and d :pendent children. See pp of instons.) NQ] E (No such reportle reimburements.) SOURCE DESCRON 1.
3 FINANCIAL DISCLOSUR REPORT Name ofpersonreportng Date of Report FITZPATRC, DUROSS 5/10/2004. V. GIFTS. (Includes those to.spouse and dependent childre. See pp of instructions.) NOJt'll (No such reorfo gifts.) DESCRIPION I. VI. LIAB][ITIS. (Includes those of spouse and dependent children. See pp of insctions.) 0 NONE (No reportable liabilities.) CRIQ DESCRIPTION 1. WES F' FARM LAND, EQUIMENT & PERONAL M 2. AGGEO:RGIA FARM CREDff ACA FAR 3. GEORGIA DEvEPMENT FARM LAD & EQUIMENT N AUTHO:Rfl....
4 FINANCJAL DISCLOSURE REPORT Name ofperson Reporting age 1 )f,_1 VII. INSTMENTS and TRSTS Date ofrepo,,..._ F I TR C D U R _ TZ _A _ I. o_ s_s.. _,s11012q( income, value, trions (includes thos ofthe spouse and dependent children. See pp offiing instr.ctions.) A. D cscription of Asse (in eluding trst assets) Pl ace "(X)" afer each asset ex frc1m prior disclosure B. Income dung reportg period (1) (2) Amout Typ (e.g. Code l div. re. or (AH) in) c. 0. Gros value at en of Traions during reporting period repg peod (1) (2) (1) If not exempt frm disclosur (2) (4) (5} Value Value Type (e.g. Dae: Value Ga Identity of Co2 Met buy, sell, Month Code2 buyer/seller (J P) Code3 meer, Day (J P) (if private (QW) remption) trns:attiou) (3) Codel (A H) DNON (No reportle income, assc:t or transactions) 1. Til[BE RINDTWIGGS COUNTY, GEORGIA None 0 2. PASTI fre & CROP LANDTWIGGS COUN, GEOR! GIA 3. FARM EQUIPMENT D Ret None M 4. STOCI< AGGEORGIA F ARM CREDIT ACA A Dividend J T S. VEHICLES None 6. COBB LESTONE SQUARE LIITD PARTh IERHI 7. CHECIG ACC<?UNT, SUNTRUST BAN B A Ret Inte J T s. c1mcig ACCOUNT, RJIVOLI BAN & TRUST A Intet J T 9. IRASA.LOMON SMI11I BARNEY E Intet N T Paral Mthly Monthly IR Rede distributions JO. RIVOLI BAN & TRUST STOC 11. TRl\ SAMERICA LI INS COMPANY LAND MA ANNU 12. emsan NA BAN DEPOSIT PROGRAM. 1. Income/Gain Codes: A = SI,000 or less B = $1,00J.$2,500 C =$2,501$5,000 D =$5,001$15,000 E =$115,001 $50,000 (See Columns Bl andd4) F = $50,001$100,000 G = $100,001Sl,OOO,OOO HI = $1,000,001$5,000,000 H2 =More than $5,000, Value CO s: J = $15,000 or less = $15,001$50,000 L = $50,001SIOO,OOO M = $!00,00J.$250,000 (See Colnns Cl and 03) N = $250,0C0$ = $500,001S!,OOO,OOO Pl = $1,000,001 $5,000,000 P2 $5.000,001$25,000,000 P3 = $25,000,001$50,000,000 P4 =$More th $50,000, Value Method Codes Q = Appraisal R =Cost (Real Estate Only) S = Assessment T =Caket (See Colnn C2) U =Book Value V =Other W = Eiiimated
5 FINANCIAL Dl:SClLOSURE REPORT Name of Person Reporting FIATR, DUROSS 5/10/2004. VIII. ADDICONAL INORMTION OR EXPLANATIONS (JndcaepaofRep<rt)
6 FIANCIAL DISCLOSURE REPORT Name of Person Reportng FITZPA TRC, DUROSS Dal po ;; 5/10/21:. IX. CERTCA TION. I certif that all information given above (including inormation pertg to my spouse and minor or dependent childreiri if any) is ac:curate, tre, and complete to the best of my knoledge and belief: and that any information lllot reported a ithhield because it met applicable statutoiry provisions permitting nondisclosure. I fur certify that eared income from outside emloyment and honoraria and the acceptace of gift hich have been reported are in compliance i the provisions of 5 U.S.C. 501 et seq., 5 U.S.C. 7353, and Judicial Conference regultions. Signature NOTE: ANY INDIVIUAL WHO NOWINGLY AND WILY FALSIFS OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CIVI AN CRIAL SANCTONS (5 U.S.C. app. 104) FILING INSTRUCTIONS Mai signed origi an 3 additional copies to: Committee on Fincial Disclosure Admtrative Offce of the United States Cour Suite 2301 One Columbus Cirle, N.E. Washington, D.C