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LEGISLATIVE RESOURCE CENTER UNITED STATES HOUSE OF REPRESENTATIVES FORMA Page 1 0f6 MOTMAY IS. AMI: 07 FINANCIAL DISCLOSURE STATEMENT FOR CALENDAR YEAR 2006 ; For use by Members, officers, and employees inated Fe cc US. HOUSE OF REF meSENves JERRY F. COSTELLO (Fal Nane) 2608 PROTOURDR BELLEVILLE, IL 62220 WEIN Dg fa08-t17 DELIVERED 7 (Office Use Oniy) ‘A$200 penalty shail be assessed against anyone who files more than 30 days late. (Walling Adsress) fyi Member of the U.S. State: IL House of Representative pistict 49 Status Termination Date: Annual (May 15) |] Amendment — |) Termination PRELIMINARY INFORMATION -- ANSWER EACH OF THESE QUESTIONS Did you or your spouse have “earned tncome [eg taaies or foes) 200 Tg, Bid you your spouse, ova dependent cli receive any reporabe GTA ‘ormore tom any source n te reporting period Yes {J No []] V+ tereportng period (i.e, aggregating more than $305 and not otherdse | eee? HHyes, complete and attach Schedule | ityes, complete and attach Schedule Vi. id any individual or organization make a donaon io charity in Heu oT payiog| Did you, your spouse, or & dependent child receive any reporabla aval you tor a speech, appearance, oracle nthe reprtingperod? Yes [No gy) Vi sibirstments or woetin ih rporing peed wert mor man 0S"” Yes] No] tyes, complote and attach Schedule I, tyes, complete and sttach Schedule Vil. _ ‘Dd you, your spouse, ora dependent child receive “unearned Income of reportable positions on or befor he date of ling inthe ‘more tan 3200 1n the reporting period oral anyreportable assetwort — Yes No [| Wil Yes C] No ‘more tan $10 atte ent ofthe pelod? {yes complete and attach Schedule i. your spouse, or dependant child purchase, sll or exchange any ssoion exceeding $1000 uring ereportng” Yes f¥) No C] Yes [J No tote) rate orig peas Yes @% No C3] Each question in this part must be answered and the ete and attach Schedule V_ appropriate schedule attached for each "Yes otal regarding “Qualified Bind Truss” approved by the Commitigon Standards of Oficial Gonduct and corn othr vercopled ‘tusts" need not be disclosed. Have you excluded from this report detalls of such a trust benefiting you, your spouse, or dependant chile? Have you excluded from this report any other assets, “unearned” income, transactions, or lables of a spouse or dependent child because they meet al threo tests for exemption? ‘Statement willbe avalable to any requesting person upon writin vidual who knowingly and willy false, of wno knowingly and 304 and U.S.C. § 1009). | CERTIFY thatthe statements { have made on this form and al attached schedules | EP Legh lacie, cara od comet ou bat fy ce a ee CAZ -SCHEDULE I - EARNED INCOME Name JERRY F. COSTELLO i Page 2of 6 mh [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 Jduring 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. BOARD ST. CLAIR COUNTY EDUCATION COOP | SPOUSE SALARY | NIA SCHEDULE III - ASSETS AND "UNEARNED" INCOME BLOCK A Asset and/or Income Source ‘dentif (a} each asset held for investment or production of income with 2 fale market value exceeding $1,000 atthe end of the roporting period, ‘and (b) any other asset or source of income which generated more than mnearned" income during the year. For rental property or land, n address. Provide full names of any mutual funds. For a self ‘one where you have the power to select the specific ide information on each asset in the account that ‘exceeds the reporting threshold and the income earned for the account. For an IRA or retirement plan that is not selfdirected, name the institution holding the account and provide its value at the end of the ‘reporting period. For an active business that is not publicly traded, in Block A state the nature ofthe business and its geographic location. For additional information, see Instruction booklet forthe reporting yar. 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 las in personal ‘savings accounts; any financial interest In or income derived from U.S. Government retirement programs. Ifyou so choose, you may indicate that an asset or income source Is that of your spouse (SP) or dependent child (OC) or is jointly held (JT), in the optional column on the fa lot. Year-End Value of Asset at close of reporting year. Ifyou use a Valuation method Type of Income Check all columns that apaly. Check "None" if asset aid nt generate any Income during the alender year. other ‘thor than fair market | tran one ofthe listed value plosse epecty | categories, specify the the method used. if an | type of income by writing asset was sold ancis | abrietdescrpton in ins included only because | block. (For example: itis generated inceme, | partnership neome or Farm income) ‘BLOCKD. Amount of Income For retirement plans or accounts that do not allow you to choose specitic Investments, you may write SMA" for income. For all other assets, indicate the category of income by cchecking the appropriate ox below. Dividends, even reinvested, should be listed as income. Check "None" if no Income was eames. BLOCK E Transaction’ Indicate if asset had purchases (P), sales (8), oF ‘exchanges (€) exceeding $1,000 in reporting year. | WEST POINTE BANCORP, None | DIVIDENDS/CAP | $50,001 - $100,000 |S INC. STOCK-IRA | ITAL GAINS sP WEST POINTE BANCORP, None DIVIDENDS/CAP | $50,001 - $100,000 |S INC, STOCK-IRA ITAL GAINS PUTNAM INTERNATIONAL- $1,001 - DIVIDENDS $1 - $200 | NEW OPPORTUNITY FD-CL- $15,000 | AIRA - ae sP PUTNAM INTERNATIONAL- $1,001 - | DIVIDENDS $1 - $200 NEW OPPORTUNITY FD-CL- $15,000 | A-IRA : iH | LORD ABBET MID CAPITAL $1,001 - DIVIDENDS $201 - $1,000 | VALUE FD-CL-B-IRA $15,000 SP _| LORD ABBET MID CAPITAL $1,001 - DIVIDENDS $201 - $1,000 | VALUE FD-CL-B-IRA | $15,000