P. 1
2001

2001

|Views: 9,978|Likes:
Published by Andrew Kaczynski

More info:

Published by: Andrew Kaczynski on Jul 17, 2012
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less

10/24/2013

pdf

text

original

}-

MASSACJ-l USETTS STATE ETHICS COMMlSSION STATEMENT OF FINANCIAL INTERESTS
FOR CALENDAR YEAR 2001
",

....

.

-

....

• , .... .,'.,

~,... , ~""-.
I ~

"

'..

:

"':
I ~.

i

~..

r-,

.;

..._'

(>

Please provide the requested information. As required by G.L. c. 26l\l3, the Financial Disclosure Law, you must answer all questions 10 the best of your knowledge. If your answer 10 any question is "none" or if any question is nOI applicable 10 you, check "Not Applicable". If you arc filing manually and extra space is needed 10 complete a response, attach additional pages, clearly noting to which question the information relates. 1: Reporting Data

Person Reponing: Address I: Address 2: City: State: Zip: Office Phone: Fax Number: Email: Name of spouse residing II1 your household: Name of dependent child(ren) residing in your household:
2: Candidate

W.

Romney '153 Alewife Brode Parkwao P.O. Box' 381091 Cambridge
M.i.tt

..., .

,

MA

02238 617-868-8683 617-868-1411
Ann Romney

o Not
Ben Ronmey

Applicable

o Not

Applicable

3: Positions Held This question indicates the reason you arc filirig and must be completed if you arc an ELECTED PUBLIC OfFICIAL or DESIGNATED PUBLIC EM PLOYEE. Identify each position you held or hold as an ELECTED PUBLIC OFFICIAL or DESIGNATED PUBLIC EMPLOYEE from January 1,2001 to the present and report AMOUNT or INCOME d enve d from cach1 nosition i 200! F A MOUNT categones see Instructions page 5. . . rom cac pOSlllOIl In 'or

1

1

Agency in which you serve(d) in 2001: Your Position: Start Dale: End Date if applicable: Amount of Income for 1001: -_.

...

_----_. __ .._--_ .... "_._-

Ji(N~lt I\ppli<:ahle

for 200.

.:;: Other

Go"cfnmcrH

ldentify
p8.r1,.tirnc

any other g_(}\:errln~enl child) ~n ~~nyfcdtr(~L
in 2001

F."JA!LY MEMBER (spouse or uncompensated,

Of

fun

0;

of Govcrnrnental
,
-------

..---.-.--.~"-~~:_-'- ..

Fn;i!v'

Position Held: iler or Immediate Fami Member: Income (Filer Only):
5: Employment and Other

-

--.-.---~

-

-..

-

..-.-~

..

- --~--

---~--'-----

Associations

with Businesses

and Non-Governmental

Entities

(Including

Non-

Profit Organizations)

.

Identify each BUSINESS with which you or anIMMEDIA TEFAMILY MEMBER (spouse Or dependent child) were associated in 2001 as an employee, Or as a partner, proprietor, officer, director,or in any similar managerial capacity, full or part-time, compensated or uncompensated.

Name of Business: 1------.---.- .. Address 1: Address 2:
City:

I

See Exhi.bi.t A - attached

Ll Not Applicable
.

.

r

,,

State: Zip: Position Held: Filer or Immediate Family Member:
Gross Income (Filer Only):
6: Business
Ownership/Equitv the EQUITY

-.

.~-- .. .....

~

Identify any BUSINESS, than I % during 2001.

of which you and/or an IMMEDIATE

F AMI LY MEMBER(S)

owned more

,
I

,.._,

Name of Business: Address 1: Address 2:
City: State:

See Exhibit B

-

l.Not Applicable r

attached

i

..

Owned r L~_~_~~_~~_---,(,-F_i l~er_O"",-n_1L.Y )'--:....L1 Percent
7: Transfer of Owner ship/Equity interests or 6) 'Nllh which you are associated which you 200:

ZI

:1

-

Identify any EQUITY in a BUSt NESS (reported Hl transferred 10 any iMMEDIATE Ff\M1LY MHABERS

Name or Descriouon of Ecuirv: _ : :·--·----·---~"~~~_,~_. ...:.,_~_. ~ ~~~_._..::.:._~c fans
_i_~

__ ."

••

~ __

~_~~~.~

c__

."
8; Leaves of Absence

Identify any BUSINESS with which you (not an IMMEDiATE FAMILY MEMBER) were previously associated and with which you had an understanding in 200 I with regard to employment at any time in the future, )[] N ot A.pp r bl e rca

"

Name of Business: Address 1: Address 2: City: State: Zip:

,

9; Gifts

Identify any GIFTS received

by you or an IMMEDIATE

FAMILY

MEMBER

during 2001,

EfN

0t

A~pp~ bl e I'ea l

Name of Source: Address of Source Address 1: Address 2: City: State: Zip: Affiliation (if appJ icable): Recipient: Value (Filer Only): Nature of Services or Other Consideration Given in Exchange:
]0; Honornrfa

Identify any HONORARIA

received
"

by you or an IMMEDIATE

FAM IL Y MEMBER

Name of Source: Address of Source Address 1: Address 2: City: State: Zip: Affiliation (if applicable): Recipient: Value (Filer Only): Nature of Services or Other Consideration Given in Exchange: )
'" _,'

during 200 I. ~ N ot A.ppuca bl e r

_·FfE'--

.'E

·'W'

.. _.-. JEu

I

·r..·

-;vp;

1

If

1'1:3 d9i

I

if

b

I

II

I

fji

L

""i" ;"".1!!aauDII'

J4: Creation

of Business and Charitable

Trusts

}

Each of the following Questions (I4-21) is concerned with a specific aspect of the interests held by you or an IMMEDIATE FAMILY MEMBER in a TRUST as of December 31, 2001. Please respond to each Question, including those which do not apply (by checking not applicable). Please review the instructions which detail what should be disclosed. .J Not Applicable

N8111e of Trust: Address I: Address 2: City: State:
Zip:

Mitt Romey 1996 Charitable c/o Ropes & Gray One International Place Boston MA

w.

Remainder

Unitrust

'.

Date Trust Created: Name of Grantor(s): Trustee(s): Beneficiaries: Percent of Equ,ity Owned (Filer Only): Income (Filer Only):
15: Business and Charitable

02110
June 25 1996 w. Mitt Romney * R. Bradford Malt. ·w. Mitt Romney

60,001 - 100 000

Trust Holdings

Respond to this question only if you 'or an lMMEDIA TE FAMILY MEMBER has a beneficial interest. Please disclose the creation of any trust(s) and then disclose the holdings in this Question. "1,,- N at A pplica ble

)

Name of Trust: Name' of Issuer: Description of Security: Real Estate Holding(s):
] 6: Fa mily Trusts

W. Mitt Romney 1996 Cbaritable
Federqted Funds Money Market Funds n/a

Remainder

Unitrust

Report all securities and other investments with a fair market value in excess of$I,OOO held in the TRUST(S) and beneficially owned by you and/or IMMEDIATE FAMILY MEMBERS as of December 31,2001, r 0 N ot Applica bl e

Benefici aries (Filer or Immediate Family Members only): Name of Issuer: Description of Security: Real Estate, Holding(s):

See Exhibit

E - attacbed

)

;'<Following the dea th of the survivor of W. 1'ti. t t Romney and Ann Romney the remainder of the funds held by the trust wi Ll. be distributed to a charitable organization to be designated by Mr. Romney. In the absence of such 2. designation the funds will go to the Churcb of Jesus Christ of Latter-Day Saints.

.'
20: Renlly Trusts: Purchase/Transfers of Properly (In Massachusetts Only) Report all transfers of REALTY TRUST property which occurred during 2001. Please note that you must report any Realty Trusts in Questions 17, 18 and 19 before answering Question 20. xo Not Applicable

)

Address of Property: Description of Property Held in Trust: Name and Address of Seller or Transferee:
21: Realty Trusts:

,

r

Sales/Transfers of Property (In Massachusetts Only) . Report all transfers of REALTY TRUST property which occurred during 200 I. ~ Not Anplicable

Address of Property: -Description of Property Held in Trust: Name and Address of Purchaser or Transferor:
22: Real Property Owned In Massachusetts

Identify ~ny real property in Massachusetts with an. assessed value in excess of $] ,000 in which you and/or ali IMMEDIATE FAMILY MEMBER held an INTEREST as of December 31,2001. Exclude out-of-state primary residence, and properties held for investment or rental purposes. r 0 N ot ApT>rca bl e

)

Address 1: Address 2: City: State: Zip: Description of Property: Person Holding Interest Record Owner(s): Assessed Value (Filer Only):
23: Investment and Rental Properties

171 Marsh Street Belmont NA
-

.

02478
Single fami Iv residence'
\

_grimcgy res idence
!

Ann Rorrmey

n/a

Identify any real property in Massachusetts or out-of-state including time-sharing arrangements, with an assessed value in excess of $] ,000, held for investment or rental purposes, in which you and/or an IMMEDlATE FAMILY MEMBER had a DIRECT OR TNDlRECT FINANCIAL TNTEREST as of December 31,2001. Properties held in a REALTY TRUST should be reported in Question 18. r9N lot Annlica b Ie

Address 1: Address 2:

City:
State: Zip: Description of Property: Person Holding Interest Record Owner(s): Assessed Value (Filer Only): Aggregate Net Income (Filer Only):

r=
\

E7IWR

S2ZiT3i

j-;_G.··

11

t

iB!

'dB 'nlhA'

'Iff

H,' ma-'Gf[ JI"l'l!!!"",urpi·

27: Mortgage

ReceivaiJle Information

Identify each parcel of real estate on which you and/or an IMMEDIATE FAMILY MEMBER held a mortgage and report the name and address of the issuer, i.e., the person obligated to you in 200 I, and the assessed value. D N 0 (A .pp nrca iJlc

Address 1: Address 2: City: Stale: Zip: Description of Property: Name of Issuer: Address 1: Address 2: City: State: Zip: :Assessed Value (Filer Only):
28: Other' Creditor

1350 Gentle

Bend Dr ive

Missouri Ci ty Texas 77489-4112 Residential Home Tirnotl"!y & Bet t_Y. Stamps 1350 Gentle Bend Drive Missouri Ci ty Texas 77489-4112 $60,000 - $100,000

Information

)

Identity each debt, loan or other liability in excess of $} ,000 owed by you and/or any IMMEDIATE FAMILY MEMBER on December 31,2001. You must report the loan collateral, which is the property (including insurance policies used to guarantee a loan) assigned to guarantee payment of funds. Certain personal and business loans are excluded. EXCLUDE: Ally liability of $1,000 or less; installment loans (cars, household effects, etc.); educational loans; medical and dental debts; credit card purchases (other than cash advances); support or alimony, obligations; debts owed 10 spouse or CLOSE RELATIVE or debts incurred in the ordinary course ofa BUSINESS. IXN ot App r bl c rca

Creditor Name: Address of Creditor Address 1: Address "2: City: State: Zip: Original Amount Borrowed (Filer Only): Amount Owed (Filer Only): Terms of Repayment Interest Rate: Year Due or
Terminated:

\

Loan Collateral:

)

.

r·... _,

.....

WVT'P'-a-

-- s;;=nsswor

72P'PW!WIIP7LHP

.,
Exhibit A - 5: Employment and Other Associations with Businesses and Non-Governmental Entities (Including Non-Profit Organizations)

),

Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer·Only): Name of Business: Address 1: , Address 2: City: State: Zip: Position Held: Filer or Immediate Family .Member: Gross Income . (Filer Only):

Salt Lake Organizing Committee 299 South Main Street Suite 1300 Salt Lake City

.

UT
84111 President Mitt Romney'
!

w,.

,

$20,001 - $40,000

Bain Capital Inc. 111 Huntington Avenue Boston MA 02199 Former Executive W. Mitt Romney Over $100,000
,

Bain Capital LLC I II Huntington Avenue Boston MA 02199 Former Executive W. Mitt Romney Over $100,000

)

118/448533.1

I

Exhibit A - 5: Employment and Other Associations with Businesses and Non-Governmental Entities (Including Non-Profit Organizations)

).

Name of Business: Address 1: 'Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only): Name of Business: Address 1: Address 2: City: State: Zi: Position Held: Filer or Immediate Family 'Member: Gross Income (Filer Only): Name of Business: Address 1: . Address 2: City: State: Zi : Position Held: Filer or Immediate Family Member: Gross Income (Filer Only):

BCIP Associates 111 Huntington Avenue Boston MA 02199 General Partner ( assive) W. Mitt Romney Over $100,000

I

j_
I

,
I

I

1

I

!

BeIP Associates II 111 Huntington Avenue Boston MA 02199 General Partner (passive) W. Mitt Romney Over $100,000

I

,

)

BCIP Associates III Cayn ran 111 Huntington Avenue Boston MA 02199
I

I

NI A

I

)

I This designation indicates that while Mr. Romney is listed as a gen eral partner of this entity and therefore, in theory, has management authority, in fact he plays no active role in t he management of this entity.

18/448533.1

2
-

"

Exhibit A - 5: Employment and Other Associations with Businesses and Non-Governmental Entities (Including Non-Profit Organizations) Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Immediate Family Member: Gross Income (Filer Only): BCIP Trust Associates 111 Huntington Avenue Boston, MA 02199 General Partner (passive) W. Mitt Romney Over $100,000
I

:
I
I

I

,

The Lifelike Company 3231 S. Platte River Dr. Englewood CO 80110 Board Member W. Mitt Romney $ 10,001 - $20,000L

I
!
r

,

Filer
"

or

)

I

Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only):

Marriott International Marriott Drive Washington D.C. 20058 Board Member W. Mitt Romney

I
,
I

i

,

N/AJ

r

2

The amount received was not wages, but rather interest on a loan. Mr. Romney did not receive any taxable income in 2001 but did receive stock options and deferred ~ompensation.

)

3

18/448533.1

3

!

I

Exhibit A - 5: Employment and Other Associations with Businesses and Non-Governmental Entities (Inc1uding Non-Profit Organizations) .

).

-

Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Position Held: . Filer or Immediate Family Member: Gross Income (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only):

Staples Inc. 500 Staples Drive Framingham MA 01702 Director W. Mitt Romney

;

N/A4
The Olympic Truce Foundation Chateau de Vidy 1007 Lausanne Switzerland Board Member W. Mitt Romney

,

)

N/A
The Points of Light Foundation 1400 I Street, NW Suite 800 Washington D.C. 20005 Director, Vice Chairman W. Mitt Romney

,

N/A

4
I )

Mr. Romney was granted stock options for his 2001 service 011 the Staples Board in March of2002 .. As these options had not vested at the time of Mr. Romney's resignation from the Board they were forfeited.

18/448533. I

4

,I
"

Exhibit A - 5: Employment and Other Associations with Businesses and Non-Governmental Entities (Including Non-Profit Organizations) ,

).

Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer On]y):
~

The Boy Scouts of America P.O. Box 152079 1325 West Walnut Hill Lane Irving TX 75038 Director W. Mitt Romney N/A

:
I

I
i

I

I I

Chamber of Commerce of Greater Salt Lake 175 East 400 Suite 600 Salt Lake City UT 84111 Board Member W. Mitt Romney NIA

I

:

I

I ,

i
I
I

)

I

I

Brigham Young University School of Management 730 TNRB Brigham Young University. Provo UT 84602-3113 National Advisory Council Member W. Mitt Romney N/A
~
-

I

f

:
!

:

I

)
18/448533.1

5

'IFIF---

U

---

T

-

I

-

--zaaas;g:;

11

t

! It

,~::

:'lIf IS'P'fll!d"5!till

!!!!,,''9t11

"'''IIR','''!'''! WI

"
i

Exhibit A - 5: Employment and Other Associations with Businesses and Non-Governmental Entities (Including Non-Profit Organizations) .'

I

.

!1

)

Name of Business: AddressI : Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only):

Olympic Aid P.O. Box 247 Salt Lake City

UT
84110 Co-Chair Ann Romney
N/A I
I I
I

United Way of Massachusetts Bay 245 Summer Street : Suite 1401 Boston MA 02210- 1121 Board Member Ann Romney
N/A

!
i

:
I

~
I
I

)

!

,

I

Families First 97 Bishop Allen Drive Cambridge MA 02138 Honorary Board Member Ann Romney
N/A

I

,
I

I
,
I

:

i

,

I

)
-'

J 8/448533.1

6

I
,_'

Exhibit A - 5: Employment and Other Associations with Businesses and Non-Gov;ernmental Entities (Including Non-Profit Organizations) i
I

I

;I

).

I,
Name Of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer' Only): Name of Business: Address 1: Address 2: City: State: Zip: Position Held: Filer or Immediate Family Member: Gross Income (Filer Only): Best Friends Foundation 4455 Connecticut Avenue NW Washington DC 20008 National Council Member Ann Romney N/A
!

I
I
I

I

i

I
I I ,

I

i
i
i

!

Ann D. Romney and W. Mitt Romney Charitable Foundation Il c/o Goldman Sachs & Co. I 125 High Street, 1in Floor i I Boston I , MA I i 02110-2704 ! Trustees W. Mitt Romney and Ann Romney ;
I I "
I

;

I

I

I
I

)-

N/A
I
I

,

I

)
18/448533 _1

7

.'

!
Exhibit B - 6: Business Ownership/Equity

I

~I

).

Name of Business: Address 1: Address 2: City: State: ZiQ: Percent Owned (Filer Only):

American Energy Development 1980 Drilling Fund I 420 NW is" Street Suite 200 Oklahoma City

OK
73103 2.77%

Name of Business: Bain Capital Inc. Address 1: III Huntington Avenue Address 2: Cit~: Boston State: MA Zip: 02199 Percent Owned 100% (Filer Only): Name of Business: Address 1: Address 2: City: State: ZiQ: Percent Owned (Filer Only): Bain CaEital II, Inc. 111 Huntington A venue

,

,
,

I

1

I

;

I

I

)

Boston MA 02199 100%

Name of Business: Bain Capital Investors, Inc. Address 1: 111 Huntington Avenue Address 2: . City: Boston State: MA Zip: 02199 Percent Owned 100% (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Bain Capital Investors Y, Inc. 111 Huntington Avenue Boston MA 02199 100%

»

,

)

I. I

18/448534.1

I.

.

I
.: I

Exhibit B -,6: Business Ownership/Equity

II

OJ.
/

Name of Business: Address 1: Address 2: City: State: J Zip: P ercen t Own ed (Filer Only): Name of Business: Address 1: AddressZ: City: State: Zip: Percent Owned (Filer Only): Name of Business: ' Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only):

Bain Capital Investors VI, Inc. 111 Huntington Avenue Boston MA 02199 100%

Bain Capital NY, Inc. 111 Huntington Avenue Boston MA 02199 100%

Bain Capital Partners IV, Lp1 111 Huntington A venue Boston MA 02199 ]6.50%

J

Bain Capital Partners V, Lp1 111 Huntington Avenue Boston MA 02199 2.99%

I'

I I

)
./

Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only):

Bain Capital Partners VI, Lp1 111 Huntington Avenue Boston MA 02199 4.59%

18/448534.1

-2-

"

;\
I
I

Exhibit B - 6: Business Ownership/Equity

/J
/'

,

Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City; State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: P ercen tOwn ed (Filer Only):

Bain Capital Partners VII, LP' 111 Huntington Avenue Boston MA 02199 4.059%

Bain Capital Partners VII-E, LP' III Huntington Avenue
,

Boston MA 02199 2.10%

BaiJ1Capital Partners: A Califomia ,Lp1 111 Huntington Avenue Boston

)

MA
02199 23.46%

Bain Capital V Mezzanine Partners, LPI 111 Huntington Avenue Boston MA 02199 7.90%

i

I I

I

I
I

I,
\
I

I)
I

Name of Business: Bain Capital Venture Partners, LP' Address 1: 111 Huntington A venue Address 2: City: Boston State: MA Zip: 02199 Percent Owned 1.97% (Filer Only):

18/448534.1

-3-

"

Exhibit B - 6: Business Ownership/Equity
I I

).

Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer OnIyl: Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip_: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only):

Bain Venture Capital: A California Lpl 111 Huntington Avenue Boston MA' 02199 28.70%
r

I

I

:

I

Bain-GoCom Management, Inc. 1J I Huntington A venue Boston MA 02199 20%

,I
,
, I

I
I

:

BCIP Associates 11I Huntington Avenue Boston MA 02199 Various"

)

BCIP Associates I, LLC1 111 Huntington Avenue Boston MA 02199 5.49%

,

;

.BCIP Associates II III Huntington Avenue Boston

MA
02199 Various"

)
/'

18/448534.1

- 4-

,·,

Exhibit B - 6: Business Ownership/Equity

Name of Business: Address 1: Address 2: City: ) State': Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer OnlY):

BCIP Associates III Cayman 11 I Huntington Avenue Boston MA

z

02199
3.25%

BCIP Trust Associates, LP' 111 Huntington A venue
!

Boston I'v1A. 02199 Various"

-

BCP Service Corporation
111 Huntinzton Avenue Boston I'v1A. 02199 100%

')

Brookside Cc:lIl_itaIlnvestors,Inc. 111 Huntington A venue Boston MA 02199 100%

.'

r

.!

)
18/448534.1

Name of Business: Address 1: AddressZ; City: State: Zip: Percent Owned (Filer Only):

Brookside Capital Investors, LP' 111 Huntington Avenue Boston I'v1A.

02199 Various"

-5-

\'
I

I

Exhibit B - 6: Business Ownership/Equity

Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned . (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: , Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State:

Brookside Capital Partners, Inc. 111 Huntington A venue Boston MA 02199 100%

D3 Family Fund Lp 17017 NE21s' Street
l

Vancouver WA 98684 1.18%

Information Partners, Inc. 111 Huntington Avenue Boston MA 02199 100%

Intercontinental Real Estate Investment Fund I, LLC 1380 Soldiers Field Road Boston MA 01235 1.20%

MesoAmerica Fund I, Lpl Plaza Roble Edificio El Portico, Piso 2 Escazu Costa Rica 1.09%

,

I

Zip:
Percell t Own ed (Filer Only):

\)
18/448534.1

-6.I

Exhibit B - 6: Business Ownership/Equity

Name of Business: Address 1: Address 2: City: State: . Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only):

MS Commodity Investment Porfolio, LpJ 1221 Avenue of the Americas New York NY 10020 Various"

One Meadowbrook Associates 111 Huntington Avenue Boston MA 02199 2.34%

)

Name of Business: Sankaty Advisors, Inc. Address 1: 111 Huntington A venue Address 2: City: Boston State: MA' Zip: 02199 Percent Owned 100% (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only): Sankaty High Yield Asset Investors, LLC . 111 Huntington Avenue Boston MA 02199 1.15%

)

Sun MM·Partners, LpJ 5200 Town Center Circle Suite 470 Boca Raton FL 33486 3.13%

18/448534.1

-7 -

Exhibit B - 6: Business Ownership/Equity

)-

Name of Business: Address 1: Address 2: City: State: Zip: Percent Owned (Filer Only):

Sun Paper LP' 5200 Town Center Circle Suite 470 Boca Raton FL 33486 3.18%

I

;

I

i

Mr. Romney is a passive, limited partner in this partnership and has no management capacity.

,I
, I I

This is an investment partnership in which each partner's interest varies based on their interest in an individual investment made by the partnership.
ii

I
I

I

I

,I :I

!
:

I

I I I

)
/

I

I

,I

I

./

)

18/448534, I

-8-

\.
I.

Exhibit C - 12. State or Local Government

Securities
I

).

Name of Issuer ' Commonwealth of Massachusetts'' North Andover University of Lowell Bldg. Authority Lowell, Massachusetts University of Mass. Bldg. Authority Hopkinton, Massachusetts

Descriptiou of Security Municipal Bonds Municipal Bonds Municipal Bonds Municipal Bonds Municipal Bonds Municipal Bonds

Income (Filer Only) NIA N/A

I
I

I
I
I

N/A N/A N/A N/A

I I I

I

I

I

I

I

I

II

)

)

l The bonds listed in this response are held in a managed investment account listed in Response No. 13. , Mrs. Romney plays 'no role in selecting the holdings of this account. This response reflects the holdings of the account as of December 31,2001. , 2 This account holds numerous types of bonds issued by the Commonwealth of Massachusetts for a variety of purposes, including without limitation, General Obligations, Housing Finance, Water Resources Authority, META, and Water Pollution.

, .'

II
I

:I
I

I
I

)t:1

I

to e
n>

I

,I
, I

~ .... .... o

I
I

=

f-4 W

)

o
til

tJj

tJj·z

I

8" ?
;:t>

§is;:
?
~
o

I

~

I

I
I I

I
I

I

I

)

-'

"

,

.
>-rj

:1
I

I

')
r:

s: _.
e-t-

'<

r?. X ...... ......
......

t--< ~ >-0
C1l

s:
.-+

t;
>-<

::T
Pl

r~ e-: X ~ X .-+ ...... .-+ ...... C1l
>-;:I

t; ~
(1)

:=
C/J
'"1 (1) (1)

2,_.
CIJ
'"1 (1) (1)

::T

(1)

l:!"

>< e-: >< ::r
.-+

r ~ ...... .~ >-0 ...... ~ ...... :=, til C1l .-+
::T
(/) .-+
(1)

~

......

.-+

en ......
~ ~ C1l 2..
tTl
.-+
'"1 (1)

--en ....
'"1 (1)

2C1l

2,_.

a .g. '9.
.... >o
0

>-0'0 0 0 l.IJ C/J PJ 0 ::+--() () ::; 0..

M ~
I:r' 0"

~

g

C1l

a

0..

tTl

e.
C1l

~

....

(1)

~

....
2-

.-+

'"1 (1) (1)

§
PJ

(1)

~

~ c ::; '"1 ;:; Pl (l)
til .-+
e-t(1)

....

o~

§.
til

I-tj >-0 >-0,. Pl o ::T til ~ ;:; ;:; >-;:I (l) C1l

..... v;;S § 2- 2- r CIJ
.-+

(1)

a

c;
,0
VJ

... _. .....
til

.....
U)

~
C1l

....
~
(1)

m tr.l

....
Pl C1l

on

....
U)

2tTl

2tTl
Pl

....erQ

8-

...... ......

'"1 til

,_.
'I:J

~ (l) ~
Pl C1l

t--< vO

0 0

10

'8"'
'"1

(l) '"1

a PJ

= ..... o· =
I-"

,

I

;:;

W

~
C/J
()

o
(1)

IJ.J
til
f')

~

s::: o
o

S
s:::

~
erQ
(1)

2>-rj

Pl

;:;

Pl

~
(JQ

Pl

;:;
C1l

Pl

~
Pl
(1)

;:;

Pl

;:;

Pl

g;
Pl

~

0

.-+

$:: $:: ~ 0 Pl
;:; ;:;
C1l

erQ

erQ

erQ ~~

0..

13

;:;
() (")

0..

o
3

S ::J n' o

>....
::l

c

0

;:;

(l)

a

....
U)

...... ;:; <
(1)

0..
>-<

;:;
U)

< C1l
(1)

...... < (l)
;:;
U)

0..

.-+

....

;:;
.-+

a

;:;
i-'

e--t-

en

o
"0

a c::

0..

;:;

c

'Tj

0..

;:;

s:::

'Tj

::l P-

c

'Tj

a

C1l

'Tj

a
::l

(l)

a

....
s:::

...... ;:; -< C1l

0..

...... ;:; <
(1)

0..

(l)

erQ erQ
0.. ~ ...... 0.. Pl ;:; ~ :r,- < < (l) C1l
'"1 (1)

Pl

~
C1l

~ §'
Pl
(J~

.= ., ....
.-;. VJ

t;.

0..
I-i

;:;

VJ

;:;

(l)

S
.....
s:::
0..

.....

'"rj

vv.>

;:; C1l (1) ;:; 0.. ..... ;:;

s:::

>;rj

aa

U)

.... ....
til

-c
(1)

VJ

.....

c,

;:;'

.0

tTJ

'<

E. .....
'"rj C

;:; ;:; 0.. 0..

c s:::

'Tj '"rj

....

'"rj

....
::l

(l)

a

~

= 0..
S
til

I

I

= -e
VJ

1

I

(Il VJ .-;.

;:; 0..

s:::

.= ...

)

;:;
vU)

0..

o 0

§
0

;:;

OJ
e--t-

til

0

·z
:2
'"1

(l)

?
'~

0

Z :2
(1)

0

>-<

?' Z >-<

?' Z >-<

'"1

0

.....::

F
.....::

Z C1l :2 >-< 0

Z

?' Z
.....::

'"1

Z :2 >-< 0,
(1)

?' Z >-<

'"1

Z :2 >-< 0
(1)

:2 :2 >-< >-< ?00
U)

.... 0

0

OJ Z Z
(1) (1)

'I:J

S'
(")

'"1

~

v~

ZZ
.....:: .....::

F-

? Z
'---<

0

....
C1l

o ~ o ~ :::;: ..... 0 ;:; 0.. ~

;:;

OJ''-''' C1l Pl

til

:<

a
C1l

~c

g
~
0

>S

_.
Pl

'< ;:; ._., >:::h o

0
(1)

S ;:;

'-<

~ (1)

a ;:;
'<
C1l

~

0

~
'<
C1l

>S

>S
0
(1)

0

~

a ;:;
'<

~

>g§ s s ss g g gS
~

§
~
;:;
(1)

~

0

~ ~
(1)

0

'<

(1)

'-< '<'-<

(1)

(1)

'<

)

'"1'<

,I
•J

'I'
Exhibit E - Question 16: Family Trusts Beneficiaries (Filer Ben Romney

).

of Immediate
Family Members Only):
I

Name of Issuer: Description Security: Real Estate Holdings:

Trust Account Managed by Raymond James Associates, Inc. Stocks, Heritage Cash Trust Money Market Fund

·I
II

I

of

i

I I

I

N/A

·I iI
I I

I

i

I

1

I I

:I
!
I

)

:I

}

! Stocks held as of 12/3110 I are: Abbott Labs, Amgen Incorporated, Chevron Texaco Corporation, Exxon Mobil Corporation, International Business Machines, Maytag Corporation, Pfizer Incorporated, Procter & Gamble Company, Qwest Communications.

!8/.:149485.!

i

I

~J

I

i!Uj
1

Exhibit F ~ 14: Creation of Business and Charitable Trusts Name of Trust:
,

I

)

Ann D. Romney and W. Mitt Romney Charitable Foundation II 171 Marsh Street

Address 1: Address 2: City: State: Zip: Date Trust Created: Name of Grantor(s): Trustee(s): Beneficiaries:
r-,

Belmont MA 02478 December 29, 1999 Ann D. Romneyand W. Mitt Romney

Ann D. Romney and W. Mitt Romney The Church of Jesus Christ of Latter-day Saints, Weber State University NIA
,

Percent of Equity Owned (Filer Only):

)

Income:

N/A

15: Business and Charitable Trust Holdings Name of Trust: AIm D. Romney and W. Mitt Romney Charitable Foundation Goldman Sachs Managed Investment Account Common Stocks', Money Market funds:'
N/A

Name ofIssuer: Description of Security: Real Estate Holdings:

J Abbot Laboratories, American International Group, Inc., Automatic Data Processing lnc, Cisco Systems, Inc., Citigroup Incorporated, Dell Computer Corporation, Emerson Electric Co., Federal Home Loan Mtg. Corp., General Electric Co., Home Depot lnc., International Business Machines, Linear Technology Corp., Maxim Integrated Products Inc., MBNA Corp., Medtronic Inc., Merck & Co. Inc., Northern Trust Corp., Omnicorn Group, Oracle Corporation, PepsiCo Inc., Phizer Inc., Safeway Inc., Wal Mart Stores Inc.

)

2

Goldman Sachs Institutional Li. Assets Federal Portfolio.

__

I

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->