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UNITED STATES HOUSE OF REPRESENTATIVES ] a FINANCIAL DISCLOSURE STATEMENT FOR CALENDAR YEAR 2005 | f%# by Mantes orces sn enya AND DELIVERED SLAVE RESOURCE CENTER |_Romner rose aber A Rar ——————] one HAY 1S AM 9: ST OST OFFICE BOK 523 (2902) 225-4896 POST CRIS BOR 328) asa susipne gem oo ——— fecbesDhnves EMEWILE, MaRWA 35565-0323 i hares Ag Filor [x] Monberof he US, Bian, SAE ‘Ofcerr Employing Ot: Status | Mouse of Representatives. istic 4TH — Employee A $200 ponaity belt assessed Fy] “tnt enpore ane tes ere nae [ss a 19 es [Tn ROR | gues one PRELIMINARY INFORMATION — ANSWER EACH OF THESE QUESTIONS i, Ds ag ee spoes havo eame cone ag. mares =) of $200 or more from any aoutes tho pseb cose yee, compte and attach Schedule L Wate yaragans aaeann Say | SAue a eteecnatare aeeasan N fom deca ves] nol — [fe ch Seer meri Wh io oan eel orange x Pavel fc ope Fa two mor ru S008 fom are ses Pa A aay ee We er ree ar a a Tt Sez wert ters cao eee eres etter Yo] mL) etarmamamrne _compiets and attach Schedul — [ire . 1, Diya hae ay eparata mreenent or arargaran [| fierce seme ves[] Each question in this part must be answered and the [2] appropriate schedule atch ‘each “Yes” response. EXCLUSION OF SPOUSE, DEPENDENT, OR TRUST INFORMATION — ANSWER EACH OF THESE QUESTIONS USE theese teleeeentssemesmencomeameee EPR en enna aainnieme ewer en ora HO SSE TON ey teen poy bran, ethene, ear ita eo pr altoaln by “ [Reno net veel] wef] [CERTIFICATION — THIS DOCUMENT MUST BE SIGNED BY THE REPORTING INDIVIDUAL AND DATED pon won appar actuate Fears by te Ets n Govermvant Ato 1878 as amended. Th Satomont wl be aval to ay ronoving row the irae ane arte reve by We Conmfioe on Standards of Oil Cond! ote Sesnee fay inal no heosogh ok ea SSE eer aw ale Hh 8 repr ay be subject oc peal and chminal sanction (See S USC top keh On a PORE Ft =a eas oe [Sea oar [ Stoner ~~ Sr Ct Rn lB ~ 1 ora et Earatn ~~~ =~ For payments to charty in eu of nonorai, use Schedule