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UNITED STATES HOUSE OF REPRESENTATIVES | : rHUNALoe.0SURE SUTEUEN Fon cLeNDAR ane | Hots seeodHAND DELIVERE! V cosa seats cen VRGINIA ANN Fax — 7006 JUN 1 ANIL: 19 503 Cannon tovSE oFFICE BuDAG 202-228-2041 SeREE OF We ene Sia ie ss SESE es YL WASHINGTON DC 2057S" Otica Use Ory) OO gD meta Bie = 720 pony sal essen) | aoe —— | eae . 8 = —— Secret PRELIMINARY INFORMATION — ANSWER EAGH OF THESE QUESTIONS CES ene ee eaR aca Frtcomitn ty Uc we) Ld | Sista O » Cone By remem errr : FRESE sen earn “OS sae Dd Ol iSoummenticren rani Biugieeceaperoee Se Sram, IK) L) meee veD Petter sents ee aaron a Eeareeeenen ee vee] mo] PRESS msm ~O »& iret temen aaa Each queston his part must bo angyered anda inca aa ovtaaa Yer[] "BE appropriate schedule tached foreach "Yeo" respon EXCLUSION OF SPOUSE, DEPENDENT, OR TRUST INFORMATION — ANSWER EAGH OF THESE QUESTIONS LLL) Beery nh sty on ee re i pane —— wo CERTIFICATION — THIS DOCUMENT MUST BE SIGNED BY THE REPORTING INDIVIDUAL AND DATED This Financial Disclosure Slaton i requ bythe Ebics in Governvan Ato 1978, as mane. The Silomert wil bo avalablo loan roqasing pean ‘pon witlan appeaton ad wil a rviewed by tie Cruse on Standard f Osa Canduat orl desigoe Ay inaiel wo kroingy ane wal esos, ‘ot wn krowigly aed wily fa oto ths Yoport may ba sudo to cvs penalos and emia sanction (Se88 USC, APB 4, $108 4nd USS §1001L TTGERTIFY at te salopars (have made on tue form Snctencterinymeme wei” | Yaa foe bltslo6 ‘SCHEDULE lll — ASSETS AND “UNEARNED” INCOME. ane VIRGINIA Fok. Joos 2 ot | W you use a valuation motod ther than fair market value, [hase specie motion ures. Type ot income creckatleunas wat ope. | Amount of Income Pransaction| each |), 288). =] __ fe { | : H : Bi i ees B ! ia ale | TTT ey Fe To drystal Dew Regie Tl Kr! pr ered, [5 FA Be p=[pebe SCHEDULE ll — ASSETS AND “UNEARNED” INCOME = eer Continuation Sheet (it needed) VIRGIN Foe ‘Asset andior Income Source ee ‘Amount of Income [ransacto &| al 4 a devant to Do0% 1 fetmos zl ‘Tus page may be copied more space rogues.