OGEForrn278(Rev.
[2/2011)
ExecutiveBranchPersonnelPUBLICFINANCIALDISCLOSUREREPORT
5
C.F.R.
Part2634US.
Office
ofGovernmentEthics
FormApproved:OMBNo.
3.209-0001
DateofAppointment,Candidacy,Election,ReportingIncumbentCalendarYearNewEntrant,TerminationTermination
Date
(IfAppli-
FeeforLateFilingrNomination
(Month.Day,Yea~)
Status
~
Covered
by
ReportNominee,or
D
Filer
0
cable)(Month,DaY,Year)
01/20/2009
(CheckAppropriate
J
2011
I
Candidate
II
AnyindividualwhoisrequiredtofileBoxes)thisreportanddoes
so
morethan
30
daysLastNameFirstNameandMiddleInitialafterthedatethereportis
required
to
beReportingfiled,or,
if
anextension
is
granted,moreIndivid
ual
r
s
Name
Obarna
Barack
H.
than
30
daysafterthelastdayofthefilingextensionperiod,shallbesubjectTitleofPositionDepartmentorAgency
(IfAppIkable)
toa
$200
fee.PoSitionforWhichFilingPresidentReportingPeriodsIncumbents:ThereportingperiodisLocationofAddress
(Number,Street,City,State,andlIPCode)
TelephoneNo.
(IncludeAreaCode)
theprecedingcalendaryearexceptPart
II
ofSchedule
C
andPart
I
ofScheduleDPresentOfficeWhiteHouse,
1600
Pennsylvania
Ave,
NW,Washington,
D.C.20500202-456·1414
whereyoumustalsoincludethefiling(orforwardingaddress)yearuptothedateyoufile.Part
II
ofTitleofPosition(s)andDate(s)HeldScheduleD
is
notapplicable.Position(s)HeldwiththeFederalGovernmentDuringthePrecedingTermlnationFilers:Thereporting
12
Months
(IfNot
Same
asAbove)
periodbeginsattheendoftheperiodcoveredbyyourpreviousfiling
and
endsatthedateoftermination.Part
II
ofPresidentialNomineesSubjectNameofCongressionalCommitteeConsideringNominationDoYouIntendtoCreateaQualifiedDiversifiedTrust?ScheduleDisnotapplicable.
to
SenateConfirmationNotApplicable
DYes
~NO
Nominees,
New
EntrantsandCandidatesforPresidentandCertificationSignatu~Reportin!ilIndividualDate
(Month,Day,Year)
VicePresident:
T
CERTIFYhatthestatementsIhave
C~
ScheduleA--The
reporting
periodmade
on
thisformandallattached
S-)
y-i
chedulesare:true,complete
andcorrect
1
"Z-
forincome(BLOCK
C)
isthepreceding
tothe
best
of
myknowledge.calendaryearandthecurrentcalendaryearuptothedateoffiling.ValueassetsOtherReviewSignatureofOtherReviewerDate
(Month,Day,Year)
asofanydateyouchoosethatiswithin
(If
desiredby
(~d,
(~
31
daysofthedateoffiling.agency)
6-cF-/.2..
ScheduleB--Notapplicable.AgencyEthics
Official's
OpinionSignatureofDesignatedAgencyEthicsOfficial/ReviewingOfficialDate
(Month,Day,
Year)
ScheduleC,Part
I
(Liabilities)--Thereportingperiodistheprecedingcalendar
OnthebaSISof
information
containedinthis
~r-M.~a_
'i)'L_
year
and
thecurrentcalendaryearupto
report,
1
concludethatthefilerisincompliance
s-J
any
dateyouchoosethatiswithin
31
days
withapplicablelawsandregulations(subjectto
ofthedateoffiling.
anycommentsintheboxbelow).
OfficeofGovernmentEthicsSignature
»:
.4"
Date
(Month,pay,
Yey)
Schedule
C,
Part
II
(Agreementsor
e:-:
/L
5!ril!/.2_
Arrangernents)--ShowanyagreementsorUseOnlyarrangementsasofthedateoffiling.
I
/"
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+The
reportingperiodisCommentsofReviewing
Officials
(IfadditionalspaceIsrequired,usetherevers;side
of
thissheet)
theprecedingtwocalendaryearsandthecurrentcalendaryearuptothedate
0
offiling.
(Checkbox
if
filingextensiongranted
&
indicatenumber
of
days___)
AgencyUseOnly
D
OGE
UseOnly
(CheckboxifCOmments
are
continuedonthereverseside)
I
Supersedes
PriorEditions.
aGEForm278(Rev.12/2011)5C.F.RPart2634US.OfficeofGovernmentEthics
Reportinglndrvidual'sName
SCHEDULE
A
PageNumberObarna,BarackH.
2of8
AssetsandIncomeValuation
0
f
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If
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X
6
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aGEForm
278
(Rev.
12/2011)
5C.F.RPart2634U.S.OfficeofGovernmentEthicsReportingIndividual'sName
SCHEDULE
A
continued
PageNumberObama,BaraekH.
(Use
only
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needed)
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8
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*
Thiscategoryappliesonlyiftheasset/incomeissolelythatofthefiler'sspouseordependentchildren.Iftheasset/incomeiseitherthatofthefilerorjointlyheldbythefilerwiththespouseordependentchildren,marktheotherhighercategoriesofvalue,asappropriate.
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