0-10 Rev. 112004 Report Required by the Ethics FINNCIL DISCLOSURE REPORT in Government ct of 1978 FOR CLENDR YER 2004 (5 U.S.C. app. 101-111) l. Person Reporting (Last name, First name, Middle initial) 2. Court or Organization 3. Date of Report United States District Court 4. Title (rticle ill Judges indicate active or senior status; 5. ReportType (check appropriate type) 6. Reporting Period magistrate judges indicate full- or part-time) ctive Q Nomiation, Date 1/1/2004 Q Initial @nnual Q Final to 12/31/2004 7. Chambers or Office ddress 8. On the basis of the information contained in this Report and any modifications pertaining thereto, it is, in my opinion, in compliance P. 0. Box 2421 with applicable laws and regulations. Roanoke, V 24010-2421 Reviewing Officer Date IMPORTNT NOTES: The instructions accompanying this form must be followed. Complete all parts, checking the NONE box for each part I. POSITIONS. (Reporting individual only; see pp. 9-13 of filing instructions) 0 NONE - (No reportable positions.) POSITION NME OF ORGNIZTION/ENTITY l. Member Bd. Of Visitors Wake Forest University School of Law 2. II. GREEMENTS. (Reporting individual only; see pp. 14-16 offiling instructions) NONE - (No reportable agreements.) PRTIES ND TERMS l.,..,... _..., ; j ' ; i
FINNCIL DISCLOSURE REPORT Name of Person Reporting Date of Report III. NON-INSTMNT INCOM. (Reporting individual and spouse; see pp. 17-24 of filing instructions). Filer's Non-Investment Income NONE - (No reportable non-investment income.) SOURCE ND TYPE GROSS INCOME (yours, not spouse's) 1. B. Spouse's Non-Investment Income - (If you were married during any portion of the reporting year, please complete this section. Dollar amount not required except for honoraria.) 0 NONE - (No reportable non-investment income.) SOURCE ND TYPE 1. 2004 Roanoke City School Board Teaching Salary N. REIMURSEMENTS -- transportation, lodging, food, entertainment. (Includes those to spouse and dependent children. See pp. 25-27 of instructions.) NONE - (No such reportable reimbursements.) SOURCE DESCRIPTION I.
FINNCIL DISCLOSURE REPORT Name of Person Reporting Date of Report V. GIFTS. (Includes those to spouse and dependent children. See pp. 28-31 of instructions.) NONE - (No such reportable gifts.) SOURCE DESCRJPTION 1. VI. LIBILITIES. (Includes those of spouse and dependent children. See pp. 32-34 of instructions.) 0 NONE - (No reportable liabilities.) CREDITOR 1. merican Express Revolving Charge DESCRlPTION VLUE CODE
FINNCIL DISCLOSURE REPORT Page 1of3 Name of Person Reporting Date of Report VII. 1NESTMENTS and TRUSTS - income, value, trnscations (includes those of the spouse and dependent children. See pp. 34-57 of filing instructions.). B. c. D. Income during Gross value at end of Transactions during reporting period Description ofssets reporting period reporting period (including trt assets) (1) (2) (1) (2) (1) (2) Ifnot exempt from disclosure (4) (3) (5 ) Place "(X)" aftr each asset exempt Type (e.g. mount Type (e.g. Value Value Date: Value Gain Identity of from prior disclosure buy, sell, Code I div. rent or Code 2 Method Month- Code2 Code I buyer/seller merger, (-H) int.) (J-P) Code 3 Day (J-P) (-H ) (if private (Q-W) redemption) transaction) DNONE (No reportble income, assets, or transactions) I. The New Economy Fund Shares in Mutual Fund Dividend M T 2. Treasury Securities c Interest L T 3. Treasury Securites Series Q D Interest L T 4. Condominium, Myrtle Beach,SC c Rent Sell 11/9 M G Bluewaters Condos, Inc. 5. Checking & Savings ccts. First Citizens Bank Interest J T 6. Sun Life ssurance Co. of Canada, Policy Interest J T 7. First Citizens Bank Checking cct. Roanoke Interest J T 8. Capital World Growth & Income Fund, Shares c Dividend M T 9. Smallcap World Fund, Shares Dividend M T 10. Savings ccount First Citizens Bank Interest J T 11. Capital World Growth & Income Fund, Shares c Dividend M T 12. Smallcap World Fund, Shares c Dividend M T 13. Vodafone/irtouch Stock Dividend Sell 10/26 J 14. Motorola, Inc. Stock Dividend Sell 5/28 J 15. nderson & Strudwick, Inc. (Brokerage cct.) None Closed 5/28 16. T&T, Stock None Sell 115 J 17. Vodafone/irtouch Stock Dividend Sell 1/8 J 18. Coming, Inc. Stock None J T Part Sell 7/30 J I. Income/Gain Coes: =$1,000 or less B = $1,001-$2,SOO c = $2,501-$5,000 D =$5,001-$15,000 E = $15,001-$50,000 (See Columns Bl and D4) F = $50;001-$100,000 G = $100,QOl,$1,QOO;OQO.. -Jn =$l;ooo,001-$s,ooo,ooo H2 =More than $5,000,000 2. Value Codes: = $15,000 or less K = $15,001-$50,QOO L "'$50,00 t-$100;000 M = $100,001-$250,000 (See Col1U1ms C 1 and D3) N = $250,000-$500,000 0 = $500,001-$l;Q00;000 PI "" $\;000,001-$5,000,000 PZ = $5,000,001-$25,000,000 P3 =$25,000,001-$50,000,000 P4 =$Mote thn $50;000,000 3. Value Method Codes Q =ppraisal R = Cost (Real Estate Only) s =ssessment T = Cash/Market (See.Column C2) u =Book Value v =Other w = Estiniated
FINNCIL DISCLOSURE REPORT Page 2of3 Name of Person Reporting Date of Report VII. INSTMENTS and TRUSTS -- income, value, trnscations (includes those of the spouse and dependent children. See pp. 34-57 of filing instructions.). B. c. D. Income durng Gross value at end of Transactions during reporting period Description of ssets reportng period reporting period (including trt assets) Ifnot ex.empt frm disclosure (2) (!) (2) (3) (4) (5) (!) (2) Place "(X)" after each asset ex.empt mount Type (e.g. Value Value Type (e.g. Date: Value Gain Identity of from prior disclosure Code I div. rent or Code 2 Method buy, sell, Month- Code 2 Code I buyer/seller (!) (-H) int) (J-P) Code 3 merger, Day (J-P) (-H) (if private (Q-W) redemption) transaction) 19. Corning, Inc. Stock None Sell 10/26 J 20. Pepsico, Inc. Stock Dividend Part Sell 4/20 J 21. Sun Microsystems, Stock None Part Sell 7/30 J 22. nderson & Strudwick, Inc. (Brokerage ccount) None J T 23. T&T, Stock None Sell 1/8 J 24. nderson & Strudwick, Inc. (Brokerage cct.) Interest Closed 1/8 25. Lucent Technologies, Inc. None Sell 5/28 J 26. Lucent Technologies, Inc. None J T 27. Lucent Technologies, Inc. None Sell 1/8 J 28. NCR Corp. None Sell 5/28 J 29. Quest Diagnostic, Inc. None See VIII 30. Quest Diagnostic, Inc. None Sell 1/8 J 31. vaya, Inc. None Sell 5/28 J 32. First Citizens IR: 33. Europacific Growth Fund Dividend J T 34. Growth Fund of merica Dividend J T 35. Hartford Small Co. Dividend Sell 8/3 J 36. Hartford Stock Fund Dividend J T 1. Income/Gain Codes: = $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 ColunBI and D4) F = $50,001-$100,0QO G = $100;001-$1,0(){,00( l' ='$1\0QO;OOl-$$,000,000 m =:More thn $5,000,000 2. Value Codes: = $15,000 or less K =$15;001-$S<i;Qdo L = $5,!)001.$,J00,000 M = $100,001-$250,000 (See Colums Cl and D3) N = $250,000-$500;000 0 = $500,001"$1,0:0;00Q. PL "'$1;000,001-$5,000;ooo P2 = $5;000,001-$25,000,000 P3 = $25,000,001-$50,000,000 P4 = $More thn $50,000;000 3. Value Method Codes Q =ppraisal R = Cost (ReJ1l Estate Qnl) s = Ssessment T =Cash/arket (See Column C2) u =Book Value v =Other w = Eitimated
. FINNCIL DISCLOSURE REPORT Name of Person Reporting Date of Report VIII. DDITIONL JNORMTION OR EXPLNTIONS (Indicate part of Report) l. Quest Diagnostic, Inc. listed on Line 43 of 2003 Report as a Part Sell should have been listed as a sale of all shares. 2. nderson & Strudwick, Inc. listed on lines 15 and 24 of this report and lliance Berstein Capital Reserve listed on line 43 were closed this year. They were brokerage accounts for transfer of funds and had no value. 3. Pershing Goverment cct. (Money Market cct.) listed on line 38 of this report was transferred to Dreyfus Government Cash Management Inv. on 10/26/04. No income on this account.
FINNCIL DISCLOSURE REPORT Name of Person Reporting Date of Report 511012005 lx. CERTIFICTION. I certify that all inrmation given above (including information pertaining to my spouse and minor or dependent children, if any) is accurate, tre, and complete to the best of my knowledge and belief, and that any information not reported was withheld be ause it met applicable statutory provisions permitting non-disclosure. I fuer certify that eared income from outside employment and honoraria and the acceptance of gift which have been reported are in compliance with the provisions of 5 U.S.C. 501 et. seq., 5 U.S.C. 7353, and Judicial Conference regulations. NOTE: NY INDIVIUL WHO KNOWINGLY ND WILFULLY FLSIFIES OR F ILS TO FILE THIS REPORT MY BE SUBJECT TO CIVIL N CRIMINL SNCTIONS (5 U.S.C. app. 104) FILING INSTRUCTIONS Mail signed original and 3 additional copies to: Committee on Financial Disclosure dmistrative Offce of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544.