STATEMENT OF ECONOMIC INTERESTS

Transcription

1 STATEMENT OF ECOMIC INTERESTS NAME y / &, L, V ^i / Cdidte for -- Electio to this office? OFFICE OR POSITION HEL OR SOUGHT <?i ti vi / AGENCY/BUSINESS NAME PHONE AGENCY/BUSINESS ARESS CITY NAMES OF MEMBERS OF IMMEIATE FAMILY STATE VA ZIP J\E ITEMS 1 THROUG Retur Schedules oly if eeded to complete Sttemet. You my ttch dditiol expltory iformtio. Offices d irectorships. Are you or member of your immedite fmily pid officer or pid director of busiess? If yes, complete Schedule A Persol Libilities. o you or member of your immedite fmily owe more th $5,000 to y oe creditor icludig cotiget libilities? (Exclude debts to y govermet d los secured by recorded lies o properly t lest equl i vlue to the lo ) If yes, complete Schedule B Securities. o you or member of your immedite fmily, directly or idirectly, seprtely or together, ow securities vlued i excess of $5,000 ivested i oe busiess? Accout for mutul fuds, limited prterships d trusts. If yes, complete Schedule C Pymet for Tlks, Meetigs, d Publictios. urig the pst six moths did you receive i your cpcity s officer or employee of your gecy lodgig, trsporttio, moey, or ythig else of vlue with combied vlue exceedig $200 (i)for sigle tlk, meetig, or published work or (ii) for meetig, coferece, or evet where your ttedce t the meetig, coferece, or evet ws desiged to () educte you o issues relevt to your duties s officer or employee of your gecy or (b) ehce your kowledge d skills reltive to your duties s officer or employee of your gecy? If yes, complete Schedule Gifts. urig the pst six moths did busiess, govermet, or idividul other th reltive or persol fried (i) furish you or member of your immedite fmily with y gift or etertimet t sigle evet, d the vlue received exceeded $50 or (ii) furish you or member of your immedite fmily with gifts or etertimet i y combitio d the totl vlue received exceeded $100, d for which you or the member of your immedite fmily either pid or redered services i exchge? Accout for etertimet evets oly if the verge vlue per perso ttedig the evet exceeded $50. Accout for ll busiess etertimet (except if relted to the privte professio or occuptio of you or the member of your immedite fmily who received such busiess etertimet) eve if urelted to your officil duties. If yes, complete Schedule E Slry d Wges. List ech employer tht pys you or member of your immedite fmily slry or wges i exeess of $5,000 ully. (Exclude slte or locl govermet or dvisory gecies.) If o reportble slry or wges, check here [ _ [ Crf o P KS" I _ I.. I 1. i I._. I _ I Li4 _ I I 1

2 7 Busiess Iterests. I 1 Vrf o you or member of your immedite fmily, seprtely or together, operte your ow busiess, or ow or cotrol iterest i YFS excess of $5,000 i busiess'' If yes, complete Schedule F 8. Pymets for Represettio d Other Services. 8A id you represet, excludig ctivity defied s lobbyig i y busiesses before y stte govermetl gecies, excludig courts or judges, for which you received totl compestio durig the pst six moths i excess of $1,000, excludig YPS compestio for other services lo such busiesses d represettio cosistig solely of the filig of mdtory ppers d subsequet represettio regrdig the mdtory ppers? (Officers d employees of locl govermetl d dvisory gecies do T eed to swer this questio or complete Schedule G-l.) If yes, complete Schedule G-l 8B. Subject to the sme exceptios s i 8A, did persos with whom you hve close ficil ssocitio (prters, ssocites or others) represet, excludig ctivity defied s lobbyig i y busiesses before y stte govermetl gecy for YPS which totl compestio ws received durig the pst six moths i excess of $1,000? (Officers d employees of locl govermetl d dvisory gecies do T eed lo swer this questio or complete Schedule G-2.) If yes, complete Schedule G-2 8C. id you or persos with whom you hve close ficil ssocitio furish services to busiesses opertig i Virgii pursut to greemet betwee you d such busiesses, or betwee persos with whom you hve close ficil ssocitio d such YFS busiesses for which totl compestio i excess of $1,000 ws received durig the pst six moths? Services reported uder this provisio shll ot iclude services ivolvig the represettio of busiesses tht re reported uder item 8A or 8B. If yes, complete Schedule G-3 9. Rel Estte. 9A. Stle Officers d Employees.... o you or member of your immedite fmily hold iterest, icludig prtership iterest, vlued t more th $5,000 or I I I I more i rel property (other th your pricipl residece) for which you hve ot lredy listed the full ddress o Schedule F? YhS Accout for rel estte held i trust. If yes, complete Schedule H-l 9B. Locl Officers d Employees. Kr I l o you or member of your immedite fmily hold iterest, icludig prtership iterest, or optio, esemet, or ld I I cotrct, vlued t more th $5,000 i rel property (other th your pricipl residece) for which you hve ot lredy listed i the full ddress o Schedule F? Accout for rel estte held i trust. If yes, complete Schedule H Rel Estte Cotrcts with Govermetl Agecies o you or member of your immedite fmily hold iterest vlued t more th $5,000 i rel estte, icludig corporte, prtership, or trust iterest, optio, esemet, or ld cotrct, which rel estte is the subject of cotrct, whether pedig or completed withi the pst six moths, with govermetl gecy? If the rel estte cotrct provides for the lesig of the property to govermetl gecy, do you or member of your immedite fmily hold iterest i the rel estte vlued t more th $1,000? Accout for ll such cotrcts whether or ot your iterest is reported i Schedule F, H-l, or H-2. This requiremet to disclose iterest i lese does ot pply to iterest derived through owership iterest i busiess uless the owership exceeds three percet of the totl equity of the busiess. If yes, complete Schedule I Sttemets of Ecoomic Iterests re ope for public ispectio. AFFIRMATION BY ALL FILERS. I swer or ffirm tht the foregoig iformtio is full, true d correct to the best of my kowledge. fi/1 SIGNATURE OF FILER ATE

3 Sttemet of Ecoomic Iterests SCHEULE C SECURITIES NAME: OFFICE OR POSITION HEL OR ^SOUGHT: G 1 4?M "SECURITIES'' INCLUES stocks, bods, mutul fuds, "SECURITIES" ECLUES certifictes of deposit, moey limited prterships, d commodity futures cotrcts. mrket fuds, uity cotrcts, d isurce policies. Idetify ech busiess or Virgii govermetl etity i which you or member of your immedite fmily, directly or idirectly, seprtely or together, ow securities vlued i excess of $5,000. Nme ech issuer d type of security idividully. o ot list U.S. Bods or other govermet securities ot issued by the Commowelth of Virgii or its uthorities, gecies, or locl govermets. o ot list orgiztios tht do ot do busiess i this Commowelth, but most mjor busiesses coduct busiess i Virgii. Accout for securities held i trust. If o reportble securities, check here NAME OF ISSUER TYPE OF SECURITY (STOCKS, BONS, MUTUAL FUNS, ETC.) 5,001 to 50,000 CHECK ONE 50,001 to 250,000 More th 250,000 ( se-e_ <\~ir c-ls) i^e 4- ) o

4 PORTFOLIO APPRAISAL TIMOTHY AN BETH LOVAIN CONSOLIATE INVESTMENTS Nme of Issuer VANGUAR SPECIALIZE PORTFOLIOS IVIEN A FIELITY LOW PRICE STOCK FUN T ROWE PRICE MI-CAP GROWTH INTERNATIONAL GROWTH AN INCOME FUN CLASS NEW PERSPECTIVE FUN CLASS F-2 NEW WORL FUN CLASS F-2 SMALL-CAP WORL FUN CLASS F-2 AMCAP FUN CLASS F 2 AMERICAN MUTUAL FUN CLASS F-2 FIELITY CONTRA FUN FUNAMENTAL INVESTORS CLASS F-2 THE GROWTH FUN OF AMERICA CLASS F-2 THE NEW ECOMY FUN CLASS F-2 VANGUAR EQUITY INCOME FUN AMIRAL SHARES WASHINGTON MUTUAL INVESTORS FUN CLASS F-2 AMERICAN BALANCE FUN CLASS F-2 T ROWE PRICE CAPITAL APPRECIATION THE INCOME FUN OF AMERICA CLASS F-2 PIMCO ALL ASSET ALL AUTHORITY FUN INSTITU T ROWE PRICE REAL ESTATE AMERICAN HIGH INCOME TRUST CLASS F-2 FIELITY STRATEGIC INCOME FUN AMERICAN HIGH INCOME MUNICIPAL BON FUN C THE TA-EEMPT FUN OF VIRGINIA CLASS F-2 Federted Tresury MMkt Pershig Govermet MMkt Type of Etity Ivestmet Co, Type of Security ETF Mutuf Fud $1 - $50,000

5 $50,001 - $250,000 $250,000+ x

6 Sttemet of Ecoomic Iterests SCHEULE H-2 REAL ESTATE LOCAL OFFICERS AN EMPLOYEES ONLY NAME: OFFICE OR POSITION HEL OR SOUGHT: List rel estte other th your pricipl residece i which you or member of your immedite fmily holds iterest, icludig prtership iterest or optio, esemet, or ld cotrct, vlued t more th $5,000. Ech prcel shll be listed idividully. Also list the mes of y co-owers of such property, if pplicble. LIST EACH LOCATION (STATE, AN COUNTY OR CITY) WHERE YOU OWN REAL ESTATE ESCRIBE THE TYPE OF REAL ESTATE YOU OWN IN EACH LOCATION (BUSINESS, RECREATIONAL, APARTMENT, COMMERCIAL, OPEN LAN, ETC.) IF THE REAL ESTATE IS OWNE OR RECORE IN A NAME OTHER THAN YOUR OWN, LIST THAT NAME, LIST THE NAMES OF ANY CO-OWNERS, IF APPLICABLE N o y ^ h ^ t h e // rj o ^ v\j, \*J A> T e cve-b/ &^oj _ 16