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UNITED STATES HOUSE OF REPRESENTATIVES FORMA Page 1 of 8 HAND DELIVERED @ FINANCIAL DISCLOSURE STATEMENT FOR CALENDAR YEAR 2006 For use by Members, officers, and employees: ‘David Daniel Boren LEGISLATIVE RESOURCE CENTER rath) DO) MAY 15. PH 1:53 818 North David Lane Muskogee, OK 74403 202/225-2701 MOA vice op tue ‘Maing Daytine Telephone ois SE veg Member ofthe US. [i Officer Or Employing Office: ‘A $200 penalty shall House of Representatives Employee bo assessed against - 2 ——__ __] anyone who files Termination Date. more than 30 days @ ) Annual (May 15) |] Amendment [Termination aie PRELIMINARY INFORMATION -- ANSWER EACH OF THESE QUESTIONS Til you or your pou have “earned Toe ayo, your spouse dopant aa ace ny eporaale pn ‘ctor om any sure te feporng pea Yes yj No []) Yb Reporting peed te, sggraxing mrthun 308 andor terns Yes C] No KA ~tryes: completo and arach Sched : iffor, Comoto and attach Schedule Vi ‘id ary individual or organization make a donation 1 Sharyn lu Of pying Dia ye, your spouse, oa dependent id recsve any reportable eve or Youfora speech oppeerence, or aritein the repring ped? Yes [mo gy] Mis seinbirmmensferiavtinteroaring pod orthnore BANS” Yes No (] tyes, complete and attach Schedule . if yes, completa and attach Schedule Vi. “Be 6 ely por on bie a FSi fanaierhadany eerie wale Yee (2) No Conn eae ear wate ett sig cae na epee Yor (2 WoC) ve ZO Ifyes, complete and attach Schedule Ifyes, complete and attach Schedule VI. Di hey oe reno a oae iB UIT moo ie you, you spouse, or dependent hid purchese, sh or xchange hy ‘eportaleaastinatranseconexcancng $1,000 rig therepocing”” Yes Wj No (| % pevios? 1 _ yes. complete and attach Schedule V. Ityes, complete and attach Schedule IX id yu, your spcuse, oF a dependent cid have any roporable Tabity = Cseateesinsoekebe tvs anpel Yes % No []/ Each question in this part must be answered and the appropriate Ayes, complete and attach Schewule V ‘schedule attached for each "Yes" response. Yes C] No yj Trusts ‘proved bythe Committe cn Standards of Oficial Gonduct and crain other “excepted loud. Have you excluded from tis report dati of sucha tist benefiting you Your spouse, or dependent. Ye# C) NOW Exemptions-- Have you excluded from this report any other assets, “unearned income, transactions, or liabilities of @ spouse or dependent child because they meet al three tests for exemption? Yes (] Now CERTIFICATION — THIS DOCUMENT MUST BE SIGNED BY THE REPORTING INDIVIDUAL AND DATED This Financial Disclosure Statement is requred by the Ethics in Government Act of 1878, as arvended. The Statement wil be availabe (o any requesting person upon wien appitaton and wil be reviewed by the Commitee on Standards of Offical Conduct or ts designee. Ay individual who knowingly and wiulyfalsfes, or who knowingly and “fully Tals to fies repon may be subject o cul penatles and criminal sanctions (See 5 U.S.C. pp. 4,§ 104 and U.S.C. § 1001), Cerifcalion 7 ‘Date Worth, Day. Year) | CERTIFY thatthe statements 1 have made on ts form and al attached schedules ‘are true, complete and corect othe best of my knowedge ard belt SCHEDULE | - EARNED INCOME Name Davd Daniel Boren [mwas [List the source, type, and amount of earned Income from any source (other than the filers current employment by the U.S, Government) totaling $200 or more lduring 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 [s1,000. US House of Representatives Muskogee Women's Center Shady Grove Fertility Salary Spouse Salary Spouse salary $165,200 NIA NIA ‘SCHEDULE Ill - ASSETS AND "UNEARNED" INCOME, BLOCK A Assot and/or Income Source Identity (a) each asset held for investment or production of income with 2 fair market value excooding $1,000 atthe ond of the reporting period, ‘and (b) any other asset or source of Income which generated mora than ‘$200 in “uneamned!” income during the year. For rental property oF land, ‘Provide an address. Provide full names of any mutual funds, For a self directed IRA (Le., one where you have the power to select the specific Investments) provide information on each asset in the account that ‘exceeds the reporting threshold and the income earned forthe account. For an IRA or retirement plan that isnot self-directed, name the institution holding the account and provide its value atthe end of the ‘reporting period. For an active business that isnot publicly traded, In Block A state the nature ofthe business and its geographic location. For additional information, see instruction booklet for the reporting year Exclude: Your personal residence(s) (unless there is rental incom ‘any debt owed to you by your spouse, or by your or your spouse's child, parent, or sibling; any deposits totaling $5,000 or less in person: ‘savings accounts; any financlal Interest in or income derived from U.S, ‘Government retirement programs. {you so choose, you may indicate that an asset or income source is that of your spouse (SP) or dependant child (DC) or is jointly held (JT), in the optional column on the far loft. Value of Asset at close of reporting year, you use a Valuation method other than fair market value, please specify the method used. ifn asset was sold and is the value should be "None." Name David Daniel Boren BLOCK e Type of Income Ccheckal columns that ppl. Chock None" i steel cd not generate any incor ding the alent year. other than one ofthe listed Categories, speci the type of income by writing 2 bit description nis tock, (ror example Partnership neome or Parm income) Bot BLOCK D Amount of Income For retirement plans or ‘accounts that de not allow ‘you to choose specific Investments, you may write NA" for income, For all othor assets, indicato tha ‘category of income by ‘checking the appropriate ox below. Dividends, even ifreinvested, should be listed as income. Check "None" ito Income wat ‘earned. BLOCK E Transaction Indicate it assot had purchases (©), sates (8), or ‘exchanges (E) exceeding $1,000in reporting year. power authority, power supply | LOCL OK State Municipal systems bond $1,001 - $15,000 INTEREST $1 -$200 LOCL real estate in Ada, OK $1,001 - $15,000, RENT $1 - $200 | | | : fj LOCL-note recievable from JB $1,004 - $15,000) INTEREST $1 - $200 | Coleman Kingston, OK LOCL Interest in courage $15,001 - | Other: $2,501 - $5,000 special situation fund, LP $50,000 | Partnership “investment, Nashville, TN income ; : ie | LOCL Grand River Dam $1,001 - $15,000) INTEREST $1 - $200 Authority (OK Bonds) LOCL Federated Capital $1,001 - $15,000] DIVIDENDS $201 - $1,000 reserves money market fund