Springmann_Theresa_L

Transcription

1 Springmann_Theresa_L

2 Page 2of6 Name of Person Reporting ill. NON-INESTMENT IN COME. (Reprt uuwz an spuse; see pp. n-24 of fting intrucns) A. Filer's Non-Investment Income [Z NONE (No reportable non-investment income.) SOURCE AN TYPE INCOME (your, not spouse's) I. B. Spouse's Non-Investment Income - (Dollar amount not required except for honoraria.) [Z NONE (No reportable non-investment income.) If you were man-d during any portn of the reortg year, completl this sectn. SOURCE AN TYPE I. IV. REIMBURSEMENTS -transportatwn, lodging,food, entertainmenl (Includes those to spouse and dependent children; see pp of filing instructions.) IZ NONE (No reportable reimbursements.) SOURCE DATES LOCATION PURPOSE ITEMS PAID OR PROVIED 1. 5.

3 Page 3of6 Name of Person Reporting V. GIFTS. (Jnclwk thosl to spouse and tkpendenl chilen; SLe pp of fi instructns.) l2 NONE (No reportable gifts:) SOURCE DESCRIPTION VALUE I. 5. VJ. LIABILITIES. (Include those of spouse and tkpendent chihen; see pp. 32-3J of fing inuctions) D NONE (No reportable liabilities.) CREDITOR DESCRIPTION VALUE CODE 1. Chase MasterCard Credit card J 5.

4 Page 4of6 Name of Person Reportng 05/13/2009 Vll. INSTMENTS and TRUSTS - D NONE (No reportable income, assets, or transactions.) income, vaue, 1ranctns (lnduae thos of spuse an deendt chil see pp. Juo of fi instructns) A. B. c. D. Desc ription of Assets Income during Gross value at en d of Transactions during reporting period (i ncluding trst assets) reportig period repor ting period (!) (2) (!) (2) (1) (2) (3) t Pl ace "(X)" after each asset Amount Type(e.g., Value Va lue Ty (e.g., D ate Value Gai n Identit y of exem p from prior disc losure Code I div., ret, Code2 Method buy, sell, Month- Code2 Code I buyer/seller (A-H) or int.) (J-P) Code 3 redemption) Day (J-P) (A-H) (if private (Q-W) trsaction) (4) (5) I. IR with IDS/ American Express - self A Dividend.M T IR with IDS/American Express A Dividend M T Annuity with IDS/American Express -- A Dividend K T IR - Keough rollover with IDS/ American A Dividend M T Express - self 5. T. Rowe Price Blue Chip Growth Fund.. A Dividend Closed 1108 K A - 6. United States Savings Bonds A Interest Redeemed 0108 J c K with American Funds Arcap and G None M T rowt America 8. SEP Plan - -Fidelity Asset Manager None M T Transferred 0708 K (to line 14) 9. SEP Plan - -Templeton Global Stock None K T Transferred Fund (to line 14) 10. Savings account with Chase Bank B Interest K T K Plan - -Met Life moderate asset A Dividend J T Transferred allocation fund (to line 14) KP!an--JanusFund A Dividend J T Transferred J (to line 14) 1 Estate of Reverend Francis Lazar B Int./Div. M T 1 T. Rowe Price Retirement 2020 Fund None M T Transferred (to line 15) 15. T. Rowe Price Summit Cash Reserves A Int./Div. L T I. Income Ga Codes: A =$1,000 or less B =$1,001 - $2,500 c =$2,501 - $5,000 D =$5,001 - $15,000 E-$15,001 - $50,000 (See Colums Bl and D4) F =$50,001 - $100,000 G =S!00,001 -$1,000,000 HI =$1,000,001-$5,000,000 H2 =More th $5,000,000 Value Codes J =$15,000 or!ess K 415,001 - $50,000 L 450,001- $100,000 M =$100,001 - $250,000 (See Columns Cl an D3) N =$250,001 - $500,000 0 =$500,001 - Sl,000,000 Pl =$1,000,001- $5,000,000 P2 =$5,000,001 - $25,000,000 PJ =$25,000,001 - $50,000,000 P4 =More than $50,000,000 Value Method Codes Q =Appraisal R =Cost (Real Es Only) S =Assesment T =Cash Market (See Column C2) U =Book Value V=Gther W=Esti

5 Page 5of6 Name of Person ReJ>rting 05/05/2009 VIII. ADDITIONAL INFORMATION OR EXPLANATIONS. {lndakpartofreprtj

6 Name of Person Reportng Pag 6of 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 certi that earned income from outside employment and honoraria and the acceptance of gi 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 retions. Signature NOTE: ANY INIVIUAL WHO KNOWIGLY AN WILFULLY FALSIFIS ORF AIS TO FIE THIS REPORT MAY BE SUBJECT TO CIVI AN CRAL SANCTIONS (5 U.S.C. app. 104) FILING INSTRUCTIONS Mail signed original and 3 additional copies to: Committee on Financial Disclosure Administrative Offce of the United States Courts Suite One Columbus Circle, N.E. Washington, D.C