Brack_Robert_C
FNANCAL DSCLOSURE REPORT Page 2of6 Brack, Robert C. 05/06/2009 J 11. N 0 N-JNVESTMENT JN C 0 ME. (Reporting individual and spouse; see pp. J 7-14 of filing instructions.) A. Filer's Non-nvestment ncome [Z NONE (No reportable non-investment income.) SOURCE AND TYPE NCOME (yours, not spouse's). 2. 3. B. Spouse's Non-nvestment ncome - (Dollar amount not required except for honoraria.) f you were married during any portion of the reporting year, complete this section. D NONE (No reportable non-investment income.) SOURCE AND TYPE. 2008 Four-Lane Auto Sales, nc. 2. 3. JV. REMBURSEMENTS - transportation, lodging.food, entertainmenl (ncludes those to spouse and dependent children; see pp. 25-27 of filing instructions.) [Z NONE (No reportable reimbursements.) SOURCE DATES LOCATON PURPOSE TEMS PAD OR PROVDED
FNANCAL DSCLOSURE REPORT Page 3of6 Brack, Robert C. 05/06/2009 V. GFTS. (lncl11tles those to spouse anti dependent chiltlren; see pp. 28-31 offiling instructions.) D NONE (No reportable gifts.) SOURCE DESCRPTON VALUE. White Construction Co. Entry fee, shirt, shoes, hat, sleeve of balls, lunch & dinner (cont. on pg 6) $3300 2. 3. VJ. LABLTES. (lncl11tles those of spouse and dependent children; see pp. 32-33 of filing instmctions.) D NONE (No reportable liabilities.) CREDTOR DESCRPTON VALUE CODE. Southwest Visa Credit Card K 2. Robert Brack, P.A. Note from Shareholder K 3. Northwestern Mutual Loan L AAA Visa Credit Card K
.. FNANCAL DSCLOSURE REPORT Pag 4of6 Brack, Robert C. 05/06/2009 V. NVESTMENTS and TRUSTS -- income, value, transactions r1nc1udes those of spouse and dependent c/lilt1ren; see PP 14-60 of filing instructions.) 0 i NONE (No reportable income, assets, or transactions.) A. Description of Assets (including trust assets) Place "(X)" after each asset exempt from prior disclosure B. c. D. ncome during Gross value at end of Transactions during reporting period reporting period reporting period {) (2) (1) (2) () (2) (3) (4) (5) Amount Type (e.g., Value Value Type (e.g., Date Value Gain dentity of Code div., rent, Code 2 Method buy, sell, Month - Code 2 Code buyer/seller (A-H) or int.) (J-P) Code 3 redemption) Day (J-P) (A-H) (if private (Q-W) transaction). -Home - Ruidoso (1/2 interest) None K w 2. -Trust A nterest K T 3. New Mexico Bank & Trust - RA A nterest J T 6. 7. 8. 9. JO. J. J2. 13. J 1 ' 16. 17.. ncome Gain Codes: A =$1,000 or less B =Sl,OO! -S2,500 c =$2,501 - $5,000 D =$5,001 -Sl000 E=Sl 5,001-S50,000 (See Columns Bl and D4) F =$50,001 -$100,000 G=S00.001 - $1.000,000 HJ =$1,000,001 -$000.000 H2 =More than $5,000.000 2. Value Codes J =$15,000 or less K =$15,001 -$50,000 L =$50,001 - $100,000 M =$100,001 - $250,000 (See Columns Cl and D3) N =$250,001 -$500,000 0=$500,00 - $1,000,000 Pl =$1,000,001 -$5,000,000 P2 =$5,000,001 - $25,000,000 P3 =S25,000,001 - $50,000,000 P4 =More than $50,000.000 3. Value Method Codes Q =Appraisal R =Cost (Real Estate Only) S =Assessment T=Cash Market (See Column CZ) U =Book Value V=Other W =Estimated
FNANCAL DSCLOSURE REPORT Page 5of6 Brack, Robert C. 0510612009 V. ADDTONAL NFORMATON OR EXPLANATONS. (JntlicatepartofReport.) V. GFTS: all for annual charity golf tournament organized by White Construction Co., the general contractor building our new federal courthouse. attempted to pay for my entry fee; White Construction refused. made a $250 donation to the honored charity, Dell Children's Hospital, in lieu thereof.
FNANCAL DSCLOSURE REPORT Page.6of6 Brack, Robert C. 0510612009 X. CERTFCATON. J 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. further certify that earned income from outside employment and honoraria and the acceptan e 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 NOTE: ANY NDVDUAL WHO KNOWNGLY AND WLFULLY FALSFES OR FALS TO FLE THS REPORT MAY BE SUBJECT TO CVL AND CRMNAL SANCTONS (5 U.S.C. app. 104) FLNG NSTRUCTONS Mail signed original and 3 additional copies to: Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544