You are on page 1of 4
UNITED STATES HOUSE OF REPRESENTATIVES 2007 FINANCIAL DISCLOSURE STATEMENT FORM A. Ww ; revue menvor ns, andonobees | HAND DELIVERED Nal Klercrombi € \S0Q Lon Filler roar altho US. Status AER] tome comsresenaties bit T. Did you or your spouse have ‘eamed" income (eg, salaries oF age) of $200 or more fram any source intro reporting perio? yes, complete and attach Schedule |. 1, id any individual or organization make a donation to charity in lieu of paying you for & speech, appearance, or article inthe Faporting period? ifyes, complete and attach Schedule I IL Did you, your spouse, or a dependent chid receive “unearned” income of more than $200 in the reporting period or hold any Teporiabe asset worth more than $1,000 atthe end ofthe period? iyos, complete and attach Schedule lil IV. Did you, your spouse, or dependent child purchase, ol, Sf exchange any reporabie assem 2 ancacton exceeding $1000 auting the reporting pe ityes, completo and attach Schedule V. \. Di you, your spouse, oa dependent child have any reportable Tilt fate than $10,600) ring I pore porad?| yes, complete and attach Schedule RESOURCE CENTER (202) 22.6 -2724 TOIMAY 21 PH 3:18 we Dating Topo oi she SLEAK cc nGUSE YG REPRESEMTATNES A $200 penalty shall be assessed against anyone who files more than VE Didyeu- your spouse, ora dependent chi easve any Tapert itn th oportng palo 6 aggregaing mate than $905 and not cthenwise exempt)? yes, complete and altach Schedule VI Vi ou, your soa, oa depen cid ace any No [SX], parable ave orremburcemant or ravaln torah pero (more more tan 3398 from an soe)” | fives, Complete and atiach Schedule VIL Mi Giises elev etabe poate cna sens of] a aaaanas saree Ce ee ee 1X, Did you have any reportable agreement or arrangement wih an outside entty? ifyes, complete and attach Schedule I. ch question in this part must be answered and the apprep late schedule attached for each “Yes” response. ‘TRUSTS—Details regarding “Qualified Blind Trusts” approved by the Committee on Standards of Oficial Conduct and certain other “excepted trusts" need not be disclosed. Have you excluded from this report details of such a trust benefiting you, your spouse, or dependent chid? EXEMPTION—Have you excluded from this report any other assets, “unearned income, transactions, or lailties of a spouse or dependent child because they ‘meet all three tosts for exemption? This Financial Disciost ‘upon written application and will be reviewed by tr 35 amended. The Statement will be available to any requesting person Conduct or its designee. Any individual who knowingly and wilfully falsities, ‘or who knowingly and wilfully fails to file this report may be subject to civil penalties and criminal sanctions (See 5 U.S.C. app. 4, §104 and 18 U.S.C. § 1001). TU CERTIFY that the statements | have made on this form id all attached schedules are true, complete and [III ect to the best of my knowiedge and belief. SCHEDULE | — EARNED INCOME List the source, type, and amount of earned income from any source (other than the filer's current employment by the U.S. Government) totalling $200 or ‘more during the preceding calendar year. For a spouse, list the source and amount of any honoraria; list only the source for other spouse earned income exceeding $1,000. State of Hawai Research Corporation of tne University oF Hawes For payments to charity in liou of honoraria, use Schedule I. L SCHEDULE Ill — ASSETS AND “UNEARNED” INCOME rere Neil Abercrombie. BLOCK A Lock B BLOCK C Lock 9 Asset and/or Income Source Value of Asset Type Amount of Income Identity (@) each asset hele for investment | al close of reporting year of Income For retirement plans or accounts that ‘orproduction olincome wih afar nance valve | aTeduiehineined | | cease chiGare ba {do not allow you fo choose specie exceeding $1,000 atthe end of te reporing |! You use a valuatio "eck all columns that apply. | frvestments, you may write NA’ for Period, ard (o) any ather asset or source of | other than fair market value, | Check-None" asset ckd not | income For al olner aesets, nde ‘Reome which generated more than $200 in | ease specty the method used the category of income by checking neared income during the year Fer rental ‘generate any income ducing | tne saregery churcome wy cneching property o land prove amaderass Pronde | an asset was sold ands ncuded | ty eatondar your, {he appropriate box below: Dividends, fanares. 2 any mutual tunes. Fer @ se | only because it generated income, as income. Check "None® it no Power to golect ine specie investments), | the value should be “None income was recoived. Provide intormation on each saat in the Eceount that excoods ho reporting tesa, Sa the income eared forthe account For ath Eee ohremont pan that isnot salirectad, fe natin Rad scour ad provide te value at the end of the reporting n Berod. Foran ace tusnens ate not possely as wv Faded, in Block A state tre name ot the Business the nature of tha business: and ts | [geographic locaton For adstiona formation, See the Instruction booklet lor the reporting year Exclude: Your persona! residence(s) (unless {hare is rental income), any dobt owed to ye by your spouse, 0” by your oF your spe chia, parent, oF sili? any deposits totaling ‘35.000 or ess in personal savings accounts {ny financial nteest in or ome Geri Om G3. Government rouromon. programs, if you se choose, you may indicate that an ‘asset or income source Ie that ol your spouse (SP) or dapendent chitd (0G) or ie joirty hols (GP), nthe optional columa on the far let EXCEPTEDIBLIND TRUST | -s100.00% - $250,000 ‘CAPITAL GAINS [_oMDENDS ‘1,500,001 ~ $5,000,000 ‘ver $5,000,000, NONE SP] Mepa Gor. Stock ‘Simon & Schuster | isteanar Pash XY acon For additional assets and unearned income, use next page.