A010 Rev.1/2006 FINANCIAL DISCLOSURE REPORT FOR CALENDAR YE 2005 Report Required by the Ethics in Govemmenl Act of 1978 (5 U.S.C. app. 101-111) 1. Person Reporting (las name, first, middle initial) Court or Organization Kahn,, Lawrence E Northern District of New York 05/09/2006 Title (Article Illjudges indicate active or senior status; Sa. Report Type (check appropriate type) magistrate judges indicate run- or part-time) D Nomination, Date District Judge - Active D Initial Annual Sb. )( Amended Report D Final 6. Reporting Period 01/01/2005 to 12/31/2005 7. Chambers or Office Address 8. On the basis or the information contained in this Report and 'any modifications pertaining thereto, it is, in my opinion, in compliance James T. Foley U.S. Courthouse with applicable laws and regulations. 445 Broadway - Room 424 Albany, New York 12207 Reviewing Officer Date IMPORT ANT NOTES: The instructions accompanying this form must be followed. Complete all parts, checking the NONE box for each part where you have no reportble information. Sign on last page. J, POSJTJ 0 NS. (Reporting individual only; see pp. 9-13 of instructions.) D NONE (No reportable positions.) POSITION NAME OF ORGANIZATION/ENTITY 1. Adjunct Professor Adjunct Professor II, AGREEMENTS. (Reporting individual only; set pp. 14-16 of instructions.) D NONE (No reportable agreements.) (: c=:i.-""" ;;a:.-..e 1'0 0 r'l w m (' rn - < rn 0 PARTIES AND TERMS 1. 1996 NYS & Local Employees Retirement System - Pension Benefits Post Retirement
Name of Person Reportng Page 2 of 6 Kahn,, Lawrence E 0510912006 Ill. N 0 N-INVESTMENT INC 0 ME. (Reporting individual and spouse; see pp. 17-24 of instructions.) A. Filer's Non-Investment Income D NONE (No reportable non-investment income.) SOURCE AND TYPE INCOME (yours, not spouse's) 1. 2005 $ 2,150 2005 Teaching $ 6,400 2005 NYS & Local Employees Retirement System - Annual Pension Benefit $ 62,173 2005 Key Bank National Association - Cancellation of Debt $ 15,000 B. Spouse'S Non-Investment Income - If you were married during any portion of the reporting year, complete this section. (Dollar amount not required except for lw1wraria.) [R NONE (No reportable non-investment income.) SOURCE AND TYPE 1. IV. REIMBURSEMENTS -- transportation, wdcing,food, e11ter1ainmen1. (Includes those to spouse and depe11de111 children See pp. 25 27 of instructions.) [R NONE (No reportable reimbursements.) SOURCE DESCRIPTION 1.
FIANCIAL DISCLOSURE REPORT Page 3 of 6 Kahn" Lawrence E 05/09/200 V. GIFTS, (Includes those to spouse and dependent children. See pp. 28-31 of instructions.) D NONE (No reportable gifts.) SOURCE DESCRIPTION VALUE I. Robert Mitchell Cash Gift $ 22,000 VJ, LIABILITIES. (lnc/jjdes those of spouse and dependent children. See pp. 32-34 of instructions.) D NONE (No reportable liabilities.) CREDITOR DESCRIPTION VALUE CODE 1. Home Equity Loan L Robert Mitchell Consolidation Loan. unsecured N 6. 7. 8. Unsecured Laon
Page 4 of 6 Kahn, Lawrence e 05/09/2006 AMtNIHcl VII. INVESTMENTS and TRUSTS -- income, value, transactions (inc1w1es those of the spouse and dependent children. see pp. 34-s7 of filing instructions) D NONE (No reportable income, assets, or transactions.) A. B. c. D. Description of Assets Income during Gross value at end of Trans<ictions during rcponing period (including trust assets) reporting period reporting period Place "(X)" after each asset exempt from prior disclosure (!) Amount Code I (A-H) Type (e.g. div., rent, or int.) ---- - (2) (!) (2) (I) If not excmpl from disclosure Value Value Type (e.g. (3) (4) (5) Code 2 Method buy, sell, Date Value Gain Identity of (J-Pj Code 3 merger, Month - Code 2 Code I buyer/seller (Q-W) redemption) Day (J-P) (A-H) (if private (2) transaction) 1. Escrow Account A Interest J T Anheuser Busch A Dividend T Gift 12/30 J Apple Computer A Dividend T Gift 12/30 J 6. 7. 8. 9. 10. 11. 1 1 1 1 16. 17. \ l. Income Gain Codes: A =$1,000 or Jess B =$1,001 $2,500 c =$2,501 - $5,000 D =$5,001 $15,000 E =$15,001 $50,000 (Sec Columns BJ and 04) F =$50,001 $100,000 G =$100,001 -$1,000,000 HJ =$1,000,001 - $5,000,000 H2 =More lhan $5,000,000 Value Codes J =$15,000 or less K =$15,001 $50,000 L =$50,001 - $100,000 M =$100,001 - $250,000 (Sec Columns Cl ;md 03) N =$250,001 $500,000 0 =$500,00J - $1,000,000 Pl =SJ,000,001 -$5,000,000 P2 =$5,000,001. $25,000,000 Value Method Codes P3 =$25,000,001 -$50,000,000 R =Cost (RC<l Estale Only) P4 =More than $50,000,000 T =Dsh Market (Sec Column C2) O=Appraisal Y=01her S =Assessmcn! U =Book Value W=Estimate<l
Page 5 of 6 Name of Person Reportng Kahn, Lawrence e VIII. ADDITIONAL INFORMATION OR EXPLANATIONS. (JndicatepartafRepart.) Investments in Anheuser Busch and' Apple Computer, reported in 2004 were transferred in December 2oos41 by gift. The value of the securities at the time of gift was under $15,000. There is no realized gain or loss on transfers by gift.
Page 6 of 6 Kahn,, Lawrence E 051091200 IX. CERTIFICATION. I certify that all information given ab-ove (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 gills 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 INDIVIDUAL GLY AND WILFULLY FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. 104) FILING INSTRUCTIONS 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
Report Required by the Ethics AOIO in Government Act of 1978 Rev. 1/2006 FOR CALENDAR YEAR 2005 (5 U.S.C. app. 101-111) 1. Person Reporting Oast name, first, middle initial) Court or Organization Kahn,, Lawrence E Northern District of New York 05/09/2006 Title (Article III judges indicate active or senior status; magistrate judges indicate full- or part-time) District Judge - Active Sa. Report Type (check appropriate type) D Nomination, Date D Initial Annual D Final 6. Reporting Period 01/01/2005 to 12/31/2005 7. Chambers or Office Address James T. Foley U.S. Courthouse 445 Broadway - Room 424 Albany, New York 12207 Sb. D Amended Report 8. On the basis of the information contained in this Report and any modifications pertaining thereto, it is, in my opinion, in compliance with applicable laws and regulations. Reviewing Officer Date 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. Sign on last page. I. POSITI 0 NS. (Reporting individual only; see pp. 9-13 of instructions.) D NONE (No reportable positions.) POSITION NAME OF ORGANIZATION/ENTITY 1. Adjunct Professor Adjunct Professor n II. AGREEMENTS. (Reporting individual only; see pp.14-16 of instructions.) D NONE (No reportable agreements.) PARTIES AND TERMS 1. 1996 NYS & Local Employees Retirement System - Pension Benefits Post Retirement LJ COPY
Page 2 of 6 Kahn,, Lawrence E 0510912006 III. N 0 N-INVESTMENT IN CO ME. (Reporti11g individual and spouse; see pp. 17-24 of instructions.) A. Filer's Non-Investment Income D NONE (No reportable non-investment income.) SOURCE AND TYPE INCOME (yours, not spouse's) 1. 2005 $ 2,150 2005 $ 6,400 2005 NYS & Local Employees Retirement System - Annual Pension Benefit $ 62,173 2005 Key Bank National Association - Cancellation of Debt $ 15,000 B. Spouse's Non-Investment Income - If you were married during any portion of the reporting year, complete this section. (Dollar amount not required except for honoraria.) (E NONE (No reportable non-investment income.) SOURCE AND TYPE 1. IV, REIMBURSEMENTS tra11sportatio11, /odging,food, entertainment. (Includes those to spouse and dependent children. See pp. 25-27 of instructions.) (E NONE (No reportable reimbursements.) SOURCE DESCRIPTION 1.
Page 3 of 6 Kahn,, Lawrence E 05/09/2006 V. GIFTS. (Includes those to spouse and dependent children. See pp. 28-31 of instructions.) D NONE (No reportable gifts.) SOURCE 1. Robert Mitchell Cash Gift DESCRIPTION VALUE $ 22,000 VI. LIABILITIES. (Includes those of spouse and dependent children. See pp. 32-34 of instructions.) D NONE (No reportable liabilities.) CREDITOR DESCRIPTION VALUE CODE 1. Home Equity Loan L Robert Mitchell Consolidation Loan - unsecured N 6. 7. Unsecured Laon
-- FINANCIAL DISCLOSURE REPORT Page 4 of 6 Kahn,, Lawrence E 05/09/2006 VII. INVESTMENTS and TRUSTS income, value, transactions (includes those of the spouse and dependent children. see PP 34-57 of filing instructions) D NONE (No reportable income, assets, or transactions.) I A. B. c. D. Description of Assets Income during Gross value at end of Transactions during reporting period (including trust assets) reporting period reporting period Place 11(X)" after each asset exempt from prior disclosure --- (!) (2) (!) (2) (!) Amount Type (e.g. Value Code I div., rent, Code 2 (A-H) or int.) (J-P) Value Method Code 3 (Q-W) Type (e.g. buy, sell, merger, redemption) (2) Date Month- Day If not exempt from disclosure (3) (4) (5) Value Gain Identity of Code 2 Code I buyer/seller (J-P) (A-H) (if private transaction) -1 I! ---; i - -- --- 1. Escrow Accoun! j\ortgage II A Interest J T 6. 7. 8. 9. 10. 11. 1 1 1 1 16. 17. 1. Income Gain 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 (Sec Columns Bl and D4) F =$50,001 - $100,000 G =$100,001 - $1,000,000 HI =$1,000,001 - $5,000,000 H2 =More than $5,000,000 Value Codes J =$15,000 or Jess K =$15,001 - $50,000 L =$50,001 - $100,000 M =$100,001 - $250,000 (See Columns Cl and 03) N =$250,001 - $500,000 0 =$500,001 - $1,000,000 Pl =$1,000,001 $5,000,000 P2 =$5,000,001 - $25,000,000 Value Method Q1dcs P3 =$25,000,001 $50,000,000 R =Cost (Real Estate Only) P4 :::More than $50,000,000 T =Cash Market (Sec Column C2) O=Appraisal Y=Othcr S =Assessment U =Book Value W=Estimated
Name or Person Reporting Date or Report Page 5 of 6 Kahn,, Lawrence E 05/09/2006 VIII. ADDITIONAL INFORMATION OR EXPLANATIONS. (lndicale partofreporl.)
Page 6 of 6 Kahn,, Lawrence E 05/09/2006 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 1 I LJ COPY FILING INSTRUCTIONS 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