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[oimerhy _H. Bisnoe es Q — Yocum STE T aa TM 4 PT ORY :[ unrreD STATES HOUSE OF REPRESENTATIVES a FINANCIAL DISCLOSURE STATEMENT FOR CALENDAR YEan ons | "mbes sores HAND DELVE?” D 7 cis ATIVE RESOURCE CENTER TMOG HAY 11 PH 2: 13 (nos\o a F802 & = teen atRepecoaies Bet —_—————— =e Tas ‘A $200 ponaity shall be assessed TaESGGae | asint anyone who fles more than er TD ween Sbayo me. PRELIMINARY INFORMATION — ANSWER EACH OF THESE QUESTIONS Tong pateomane vont eee [Deen open sams apo F Geese eaeaniar PRRs OA wns eae See amen aa ean ea aes et Reed ee tener gee aoe Rar Ter soan at a Sa ve ‘eponatl git roping yered es soaring ae (Fass inet onerise war OP yes, complete snd stach Schedule Vi. VL Dit you yur spun or dependent cid eave any "itt eats asa yee. complete and sitach Scheguse Vit ‘i your wy repre potins on arbor he (toot rhe Soren caendar yar? ifyecscomblot and aach Schedule VL © cate oy eae ee ea ta tel maton 1, iyo aay opt apanertanngaat Ifo comple and etch Schedule ‘eee en aaa a een 3g saneeetoepeay | pe ng EXCLUSION OF SPOUSE, DEPENDENT, OR TRUST INFORMATION — ANSWER EACH OF THESE QUESTIONS Each question in this part must be answered and the appropriate schedule attached for each “Yes” response. “TRUSTS_Detats garg “vale Bnd Tra approved he Commie on Sanda of Ofc Cantu an ofan be “cepted Ws eed bercose, Have yo enced Hr sep ea a uc testa ig yo, Your opuse of opened ck Yes| “Bl ‘ost fe testo cramp? "EXEMPTION Have you exclude Yom apo any chr esas, esr home, ransections or abies a poure odaprdnt cid boas thoy CERTIFICATION — THIS DOCUMENT MUST BE SIGNED BY THE REPORTING INDIVIDUAL AND DATED. wo] Eg] ‘This Financial Diglosure Statomont ia roquied by the Eth in Government Act of 1978, as amended. The Statement wil bo aval pen wtion application and wil bg relowed bythe Camiee on Standards of Oil Conduct rts Seignen, Any tndvcual wha knowingly and wily ses, ‘or who Knowingly and willy fast fe tis report may be subjoc to Gvl penales and erminal sanctions (S00 5 U.S.C, App. 4, §104 and 18USC.§ 100%), fo ay requesting parson Se CERTIFY tat the eatomente fad all attacnoa’ sched, orect to the bast of my knowledge and bse, ‘eg (8 an Bistor rn all List he souree, type, ans amount of earned income from any source (ther than the file's curent employment by the U.S. Government) ctaling $200 or are uring the preceding calendar yea Fora spout, st he souree ars out o ry hora tote soc fo eo spouse earedncome excoading $1,000, SCHEDULE | — EARNED INCOME Source For payments to charity in lew ot honoraria, use Sched. nae poo “SCHEDULE Ill — ASSETS AND “UNEARNED” INCOME ai00%a aioe occe 0x0 00K {Asset andlor Income Source Value ot Assot ype __dmountfincome ransacen sesame mers | con drat of Income rn ect a e aed a ae ree Check all columns that appiy. eens Leave bank if asset dd not enor ay ieee during fhe calendar year aera ‘Soa uhers youeve te uations! inormaton, sea'he stwctca | | lv: Yup! enn) uns i : i ‘ 1B Gorermont iremert organs FeESEe ‘QUALIFED aN TRUST “carr ane —= B60 #20001 = 100000 ca [elec Se Pc, | exampes| Sens ee 4 ar tekst re \r| Zire - CLEFF Mr] er vine Sos vowed |_|X L i