aO 1o R,v.

I/2olo

I

I

FINANCIAL DISCLOSURE REPORT FOR CALENDAR YEAR 2009
2. Court or Organization U.S. District Court, D. Kansas 5a. Report Type (cheek appropriate ~pe) [] Nomination, Date [] Annual [] Final

Re~ort Requirea by in Government Act oft978 (5 u.s.c app. §~" lOl-llO ,
3, Date of Report 05/1112010 6. Reporting Period 01/01/2009 to 12/’31/2009

I, Person Reporting (last name, first, middle initial) Melgran, Eric F. 4. Title (Article III judges indicate active or senior status; magistrate judges indicate be!l- or part-time) U.S. DistrietJudge-Active

[] Initia!

5b. [] Amended Report 7. Chambers or Office Address Hon. Eric F. Melgren United States Courthouse 401 N. Market Wichita, Kans~ 67202 8. On the basis of the information contained in this Repor~ and any modJfieatio.ns pertaining thereto, it is, in my opinion, in compliance with applicable laws and regulations. Reviewing Officer

~

Date

IMPORTANT NOTES: The instructions accompanying this form must be followed. Complete all parts, checking the NONE box for each part where you have no reportable information. Sign on last page.

I. POSITIONS. r~epom~ ~na~via~t on~y; ,,e pp. 9-t ~ of fillng ~n~rr.¢tlon$.)
NONE (No reportable positions.) POSITION
I.
2. 3.

NAME OF ORGANIZATION!ENTITY

[~]

NONE (No reportable agreements.)
DATE PARTIES AND TERMS

FINANCIAL DISCLOSURE REPORT Page 2 of 6

I
!

Name of Person Reporting

Date of Report

o5~!

III. NON-INVESTMENT INCOME. (Repord,,glndi~id.oI.nds~,o.~e;
A. Filer’s Non-Investment Income
~-] NONE (No reportable non-investment income.)

DATE
I.

SOURCE AND TYPE

INCOME
(yours, not spouse’s)

B. Spouse’s Non-Investment Income - If you were married de,ring any pardon of the repordng year, complete this section.
(Dollar amount not required except for honoraria.)

D

NONE (No reportable non-investment
DATE SOURCE AND TYPt~
West Evangelical Free Church, salary

1. 2009

IV. REIMBURSEMENTS (Includes those to spouse and dependent children; see pp. 2J-27 of filing instructions.)

D

NONE (No reportable reimbursements.) SOURCE DATE~
4129109 - 5102/09

LOCATION
Lake of the Ozarks, MO

PURPOSE
Kansas City Metropolitan Bar Association Conference

ITEMS PAID OR PROVIDED
Transportation, lodging, meals, conference registration

I.

Kansas Bench/Bar fund

FINANCIAL DISCLOSURE REPORT Page 3 of 6

[~ameofPer,on Report|llg Melgren, Eric F. [

DateofRepor~ 05/11/20

~-]

NONE (No reportable gifts.)

~S_O_U_] g_C~
I. 2. 3. 4. 5.

DESCRIPTION

VALUE

VI. LIABILITIES. a,a,d,,
[’--] NONE (No reportable liabilities.) CREDITOR !. 2. 3. 4. 5, DOE Student Loan DESCRIPTION VALUE CODE K

FINANCIAL DISCLOSURE REPORT

~ame of
Melgren, Eric F. 05/1112010

Page 4 of 6

VII. INVESTMENTS and TRUSTS - i ........ lue, transactions (Includes those of spouse and dependent children see pp. 34-60 of f!lb!g instructions.)
NONE (No reportable income, assets, or transactions.)

A.
Description of Assets (ineIoding trust assets) Place "(X)" after each asset (I) ]Amount ] (A-H)

~.
Income during reporting period (.2) Type (e.g., or int.)

i
i ! [ I

C.
Gross value at end of reporting period

[

O.
Transactions during reporting period (5) Identity of (if private

[ (l) I (2) T (l) ! i2~--~ ........ (4) [ Value i Valae [ Type (e.g,: i Date I Value I Ga n ~ (J’P) ! Code 3 redemption) (J-P) (A-H)

I

1.
2. 3. 4. 5. ! 6. 7. 8.

Bank of America IRA (cash eqv)
Axa Equitable Variable Life Insurance Vanguard Total Bond Market Index Investment Vanguard LifeStrategy Conservative Orowtl Vanguard Windsor !1 Fund American Funds EuroPac R4 Vanguard Lil~Strategy Moderate Growth Vanguard LifeStrategy Growth Fund

None
None None None None None None None

J
J J K J J K L

T
T T T T T T T

11. 12. 13. 14. t5. 16,

t. ]ncome Gain Cod~: (S~.. Columns HI and D4) 2. Val,ae Cod~s (~c Columns C 1 alld D3) 3. Value ,%.lcthod Cones (See Column C2)

A =$1.000 or less /-" =S50,001 - $100,0(M) J =$15.000 Or less N =$250,001 - $500.009 P] =$25.0(M),001 - $50~000,000 Q ~Appl’aisal U =Bt~k Value

B --$1,001 - $2,500 O =$100,001 - $1.000,000 K =$15.001 - $50.000 O ,,$500,001 - $1.000.000 ’ R =Cost (Real Estate Only) V --Other

C =$2,501 - $5.000 111 ,,St 3k~0,00t - $5,0¢0.01~9 L =$50,001 - $100,000 P I =$1.6~),001 - $5,000,000 P4 =More than $50,000,000 S =Assessment W -Estimated

D =$5,001 - $15.000 H2 =More than $5,000.(~O0 M =$100,00l - $250,000 P2 =$5,000~001 - $25,000,~ T =Cash Market

E =$15,001 . $50,000

FINANCIAL DISCLOSURE REPORT Page 5 o f 6

N~me ot eer~o~ n,po~n~
Melgren, Eric F.

]
I

pat, or mp0~
05/I !/2010

[

VIII. ADDITIONAL INFORMATION OR EXPLANATIONS. a,a~,~,~,to.,a~o,,~

FINANCIAL DISCLOSURE REPORT [ Melgren’ Eric F.

Date of Report

Page 6 of 6 IX. CERTIFICATION.

O~/l 1/2010

I certify that all information given above (including information pertaining to my spouse and minor or dependent children, if any) is accurate, true, and complete to the best of my knowledge and belief, and that any information not reported was withheld because it met applicable statatory provisions permitting non-disclosure. I further certify that earned income from outside employment and honoraria and the acceptance of gifts which have been reported are in compliance with the provisions of 5 U.S,C. app. § 501 et. seq,, 5 U.S.C. § 7353, and Judicial Conference regulations.

NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C, app. § 104)

FILING INSTRUCTIONS Mail signed original and 3 additional copies to: Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C, 20544

Sign up to vote on this title
UsefulNot useful