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UNITED STATES HOUSE OF REPRESENTATIVES 2007 FINANCIAL DISCLOSURE STATEMENT | | rorusby Montes, ccs, and empoyees HAN NIT) FORMA DELIVERED Borbora Culoin 224) belmmt Road. Casper Wy 82604 ; ran ‘Oficer oF BOQ 225-2311 Dayne Teper: x a @ poornay-9 PSH (tes Use Oniy) Employing Office | rematen rnson Da ‘A $200 penalty shall be assessed against anyone who files more than 30 days late, Employee T, Di you of you spouse have “eamed? income (og salares or 7 spouse, or a dependent cid receive any tof a nae sur te oping eto ‘orale ght ego sled sapegaing ne 5, complete and atiach Schedule | an $08 ss natainerce examen an Hey a if yes, complete and attach Schedule VI. 1 Oid any individual or orgarzation make a donation to chain VI. Dig you. your spouse, ora dependent child eceive any lieu ol paying you for a speech, appearance, or article in the reportable travel or eimbureements fr travel inthe Teporttg reporting pared? fess two ovo tan 8808 For one Sura)? I?yes, complete and attach Schedule i. ives, complete and attach Schoduie Vil Ul, Ded you, your spouse, or a dependent child reeive unsamed™ income of rare tan 200 n fhe Teporeng penod er eld ary ‘opontabe ase! worth more tan $1 OOO athe endo he pevoc? {Pfes: complete and atach Schedule i TW. Dd you, your spouse, or dependent chid purchase, sl ‘or excrungo any reportable aster na rareagion exceeang 81 Seb dung te poring pened? it'yes, complete and attack Scedule 1V. Vid you, your spouse, ora dependent chid have any reporable isbty (mor tant $10,900) ring the ropartng ood? tfyes, complete and attach Schedule EXCLUSION OF SPOUSE, DEPENDENT, OR TRUST INFORMATION — ANSWER EACH OF THESE QUESTIONS ve] “KX EXEWPTION Hae ev xeon is mot ary eas, eae rane razon abies fs pu esa cba Pe CMO aac ve[] “R CERTIFICATION — THIS DOCUMENT MUST BE SIGNED BY THE REPORTING INDIVIDUAL AND DATED. This Financial Disclosure Statement is required by the Ethics in Government Act of “978, as amended. The Statement will be avallable to any requesting person upon written application and will be reviewed by the Committee on Standards of Official Conduct or its designee. Any individual who knowingly and wilfully falsfies ‘of 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) Vi Did you ves] of ~O »& veDd “L] ve] oR] Each question in this part must be answered and the appropriate schedule attached for each “Yes” response. VI, Oye hl any epoabl pions on reo he i tn ener ifs core a sh Shei vn, 1X, Bid you nave any rporabie agreement or rangoment wih an outside ently? IW yes, complete and attach Schedule IX. ‘TRUSTS—Details regarding “Quaiied Blind Trusts’ approved by the Committee on Standards of Oficial Conduct and certain other “excepted trusis” need not be disclosed. Have you excluded from this report details of such a trust benaliting you, your spouse, or dependent child? | CERTIFY that the statements | have made on this form nd all attached schedules are trus, complete and rect to the best of my knowledge and bale. SCHEDULE | — EARNED INCOME List the source, type, and amount of eared 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 he source and amount of any honoraria; ist only the source for other spouse earned income exceeding $1,000. Amount Spouse Spooch ‘Spouse Salary For payments to charity in lieu of honoraria, use Schedule i. SCHEDULE Ill — ASSETS AND “UNEARNED” INCOME BLocKA BLOCK 8 Lock ¢ Block 9 BLOCK E Asset andior Income Source Value of Asset Type Amount of Income ransaction| Identity (a) each asset nels tor investment | at close of reporting year of Income For retiement plans or accounts that [Indicate ithe or production of income wih afar market value {do not allow you to choose specitc |asset nad ‘exceeding $1,000 at the end of the rer Mf you use a valuation method | Check all columns that apply. | investments, you may write "NA" for Tease Ported, arid 1b) any other ascet or source of | other than fair market value, | check None" it asset did not | income. For al other assets, indicate [Purchases (P), freon which gonrated more tan $200 10 i the catogery of come by checking [ales (8), ar “Unearnod? ineame during the year For rental | Please spediy the method used. generate any income during | ne sarrgertus bos below wicones [aes ®) avery or land rove an aasress Provde | than asset was sold andis ncuded | fr euendar year the appropriate box Below Dwcores. Hoxchanges () {ulrames of any mutual ands Fox ase | only because it generated income, fs income. ‘Check “None” it no [exceeding Power foie ie spectic vestments), | the value should be “None income was received. 1009 in Provice information on ean nasor in ive resorting year. Sceount that exceeds tne oporting threanota reporting yo ang te income earned for he account Fora {Ra orretvernt plan that sot sel crecod, hone hing fhe Secon a provi ite value a! the ond of the report Poned: Foran active business hat snot pabley ||8/C/0)€/F GI E/s) K |e fraged, in Block A siate the name Of the Bsns ena of the bushacs, sed ts yaprictscaton For adeonalésrmaion, ee"tno intructon Booklet for to reporting year | Exclude: Your personel residence(s) (unless theve fs rental income); any debt omed fo you by your spouse, or by your or your spouse's ‘hie, parent, oF sing! eny deposits totaling '$5,000 fr less in personal savings accounts: ‘ny financial interest In ox income dered trom U7 Goverment retirement programs ef afm} av] vj ve vn vin ox x |x | 81,001 - 82.500 ‘Over 5,600,008 » 7 i ' ‘$1,000,001 ~ $5,000,000, If you £0 choose, you may indicate that an Asset or income souree tat of your spouse (SP) or depenaert ela (0G) oF & joy held (01), the optional column on the far tft “001 ~ $80,000 '$5:000,001 ~ $25,000,000 ‘$25,000,001 - $50,000,000 ‘ver $50,000,000 | NONE EXCEPTEDIBLIND TRUST $50,001 — $100,000, ‘$100,001 $250,000 ‘$250,001 - $500,000 "$600,001 — $1,000,000 ‘$100,007 — $7,000,000 "51,000,001 - $5,000,000 8 EI a a $1 $1,000 ‘5,001 = $15,000 CAPITAL GAINS DIVIDENDS None RENT INTEREST Tone ‘51-200 ‘$201 = $1,005 81 5 2 & 6 x SP, [P| mega Cor. Sto 0¢, | Exampies:| | Seron 8 Schust inde a tt tarkef Pach KY scr x x Grey Walf Inc | Glo 4 Kline | | Tdentix eed le | [Medco | tft tt Merck | | x | z Foyates > |x PFizec x | For additional assets and unearned income, use next page.