FOR CALENDAR YEAR 2010 (5 U.S.C. app )
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1 O Brien, Terrence L. AO I0 FINANCIAL DISCLOSURE REPORT Rev. 1/2011 FOR CALENDAR YEAR 2010 (5 U.S.C. app ) Report Required by the Ethics in Government Act of Person Reporting (last name, first, middle initial) Court or Organization O Brien, Terrence L. Tenth Circuit 05/14/2011 Title (Article Ill judges indicate active or senior status; 5a. Report Type (check appropriate type) 6. Reporting Period magistrate judges indicate full- or part-time) ] Nomination, Date 01/01/2010 U.S. Circuit Judge - Active [] Initial [] Annual [] Final to 12/31/2010 5b. [] Amended Report 7. Chambers or Office Address 8. On the basis of the information contained In this Report and any modifications pertaining thereto, it is, in my opinion, in ompliance U.S. Court of Appeals, Tenth Circuit with applicable laws and regulations CareyAve., Suite 200 Cheyenne, WY Reviewing Officer Date IMPORTANT NO TES: The instructions accompanying this form must be followetl Complete all parts, checking the NONE box for each part where you have no reportable informatiot~ Sign on last page. I. POSITI O N S. (Reporting individual only; see pp of filing instructions.) NONE (No reportable positions.) POSITION NAME OF ORGANIZATION/ENTITY II. AGREEMENTS. (Rcpo.i.g individual only; seepp of filing instructions.) ~] NONE (No reportable agreements.) DATE PARTIES AND TERMS
![Report Type (check appropriate type) 6. Reporting Period magistrate judges indicate full- or part-time) ] Nomination, Date 01/01/2010 U.S.](/docs-images/49/18234245/images/page_1.jpg "Circuit Judge - Active [] Initial [] Annual [] Final to 12/31/2010 5b. [] Amended Report 7. Chambers or Office Address 8.")
2 Page 2 of 8 O Brien, Terrence L. 05/14/2011 III. NON-INVESTMENT INCOME. (Rcpo.l.g individual andspouse; seepp of filing instructions.) A. Filer s Non-Investment Income ~ NONE (No reportable non-investment income.) DATE SOURCE AND TYPE INCOME (yours, not spouse s) I State of Wyoming - Judicial Retirement $50, B. Spouse s Non-Investment Income - If you were married during anyportion of the reporting year, complete this section. (Dollar amount not required except for honoraria.) NONE (No reportable non-investment income.) DATE SOURCE AND TYPE 1. IV. REIMBURSEMENTS - transportation, Iodglng, food, entertalnmen~ (Includes those to spouse and dependent children; see pp of filing instructions.) NONE (No reportable reimbursements.) SOURCE DATES LOCATION PURPOSE ITEMS PAID OR PROVIDED 1. 5.
3 Page 3 of 8 O Brlen, Terrence L. 05/14/2011 V. GIFTS. anauaes those to spouse ond dependent children; see pp of f!ling instructions.) D NONE (No reportable gifts.) SOURCE DESCRIPTION VALUE Wooden Chest April Brimmer Kunz $ Air Fare Cheyenne Vancover Cheyenne Marian Rochelle $ Alaska Tours April Brimmer Kunz $ Alaska Cruise Marian Rochelle $5, Metz- Lewis & Clark Book Marian Rochelle $2, Thomas Bronze (I/2 interest) Marian Rochelle $3, Misc Gifts April Brimmer Kunz $ Christmas & Birthday Gifis~ $ VI. LIABILITIES. (Includes those of spouse and dependent children; seepp of filing instructions.) NONE (No reportable liabilities.) CREDITOR DESCRIPTION VALUE CODE 1. 5.
4 Page 4 of 8 O Brien, Terrence L. 05/14/2011 VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; seepp of fillng instructions.) D NONE (No reportable income, assets, or transactions.) A. B. C. Description of Assets Income during Gross value at end (including trust assets) reporting period of reporting period (l) (2) (1) (2) (I) Place "(X)" after each asset Amount Type (e.g., Value Value Type (e.g., exempt from prior disclosure Code l div., rent, Code 2 Method buy, sell, (A-H) or int.) (J-P) Code 3 redemption) Transactions during reporting period (2) (3) (4) (5) Date Value Gain Identity of mm/dd/yy Code 2 Code 1 buyer/seller (J-P) (A-H) (if private transaction) 1. IRA# 1 Wy Defer Compt Artisan Mid Cap A Dividend Sold ARTMX IRA # 1 Wy Retire Acct Dreyfus Money A Dividend Sold Market Reserves IRA#1 WY Defer Comp Dodge & Cox Intl A Dividend Sold Stock Fund IRA#1 WYDefer Comp Perkins Mid Cap A Dividend Sold Value Fund 5. 1RA#1 WY Defer Comp Black Rock Russell A Dividend Sold 1000 Growth Index T 6. IRA #2 BA (TD Ameritrade - IRA) A Dividend Sold 7. IRA #2 CLX (TDA-IRA) A Dividend Sold 8. IRA #2 CVX (TDA-IRA) A Dividend Sold 9. IRA#2 DRYS (TDA_IRA) A Dividend Sold 10. IRA #2GR (TD-IRAA) A Dividend Sold 11. IRA#2 Cash Equivalent Account (TDA- A Interest L T IRA) 1 BKH (TDAmeritrade) A Dividend Sold 1 BA (TDA) A Dividend Sold 1 CAT (TDA) A Dividend Sold 15. GLW (TDA) A Dividend Sold 16. DD (TDA) A Dividend Sold 17. FCX (~fda) A Dividend Sold 12/27/10 K C Proceeds to Line 33 12/27/10 J A Proceeds to line 33 12/27/I 0 K A Proceeds to line 33 12/27/10 K D Proceeds to line33 12/27/10 K B Proceeds to Line 33 12/09/10 J A 12/09/10 J C 12/09/10 J A 12/09/10 J B Converted to Roth IRA 12/09/10 J C 12/09/10 L E 1. Income Gain Codes: A =$1,000 or less B =$1,001 - $2,500 C =$2,501 - $5,000 (See Columns B 1 and D4) F =$ 50,001 - $ G =$100,001 - $1,000,000 H 1 =$ 1,000,001 - $ 5,000,000 Value Codes J =$15,000 or less K =$15,001 - $50,000 L =$50,001 - $100,000 (See Columns C I and D3) N =$250,001 - $500,000 O =$500,001 - $1,000,000 PI =$1,000,001 - $5,000,000 P3 =$25, $50,000,000 P4 =More than $50,000,000 Value Method Codes Q =Appraisal R =Cost (Real Estate Only) S =Assessment (See Column C2) LI =Book Value V =Other W =Eslimatcd D =$5,001 - $15,000 E =$15,001- $50,000 H2 =M ore than $5,000,000 M =$ 100,001 - $250,000 P2 =$5,000,001 - $25,000,000 T =Cash Market
5 FINANCIAL DISCLOSURE REPORT Page 5 of 8 O Brien, Terrence L. 05/14/201 I VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; seepp of filing instructions.) D NO]qE(No reportable income, assets, or transactions.) A. B. C. Description of Assets Income during Gross value at end Transactions during reporting period (including trust assets) reporting period of reporting period O) (2) (0 (2) (1) (2) (3) (4) Place "(X)" after each assel Amount Type (e.g., Value Value Type (e.g., Date Value Gain Identity of exempt from prior disclosure Code 1 div.. rent, Code 2 Method buy, sell, mm/dd/yy Code 2 Code 1 buyer/seller (A-H) or int.) (J-P) Code 3 redemption) (J-P) (A-H) (if private (Q-W) transaction) 18. IBM ( IDA) A Dividend Sold 12/09/10! K E 19. JNJ (TDA) A Dividend Sold 12/09/10 K B 20. KMB (TDA) A Dividend Sold 12/09/10 J A 21. PEP ( IDA) A Dividend Sold 12/09/10 J A was PAS 2 RTP (TDA) A Dividend Sold 12/09/10 K E 2 JAVA (TDA) A Dividend Sold 01/28/10 J A 2 TRA ( IDA) A Dividend Sold 04/26/10 K D 25. TRN (TDA) A Dividend Sold 12/09/10 K C 26. UNP ( IDA) A Dividend Sold 27. VLO (TDA) A Dividend Sold 12/09/10 K B 28. CF (TDA) A Dividend Buy 04/16/10 J 29. CF (TDA) A Dividend Sold 12/09/10 J A 30. PTHAX (TDA) A Interest J T 31. ATCHX (TDA) A Interest J T was VKMHX 3 Cash Equivalent Account (TDA) A Interest N T Was CMFUZ 3 Roth IRA Fidelity Investments A lnt./div. M T Buy 01/03/11 M 3 BRKB(Fidelity Investments) A Dividend Sold 12/09/10 K A I. Income Gain Codes: A =$1,000 or less B =$1,001 - $2,500 C =$2,501 - $5,000 D =$5,001 - $15,000 E =$15,001 - $50,000 (See Columns B I and D4) F =$50,001 o $100,000 G =$ 100,001 - $ 1,000,000 H I =$1,000,001 - $5,000,000 H2 =More than $5,000,000 Value Codes J =$15,000 or less K =$15,001 - $50,000 L =$50,001 - $ 100,000 M =$100,001 - $250,000 (See Columns C I and D3) N =$250,001 - $500,000 O =$500,001 - $ 1,000,000 P 1 =$ 1,000,001 - $5,000,000 P2 =$5,000,001 - $25,000,000 P3 =$25,000,001 - $50,000,000 P4 -More than $50,000,000 Value Method Codes Q =Appraisal R =Cost (Real Estate Only) S =Assessment T =Cash Market (See Column C2) U =Book Value V =Other W =Estimated
6 Page 6 of 8 O Brien, Terrence L. 05/14/2011 VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; see pp of fillng instructions.) NONE (No reportable income, assets, or transactions.) A. B C. D. Description of Assets Income during Gross value at end Transactions during reporting period (including trust assets) reporting period of reporting period (l) (2) (t) (2) (l) (21 (3) (4) (5) Place "(X)" after each asset Amount Type (e.g., Value Value Type (e.g., Date Value Gain Identity of exempt from prior disclosure Code 1 div., rent, Code 2 Method buy, sell, mm/dd/yy Code 2 Code I buyer/seller (A-H) or int.) (J-P) Code 3 redemption) (J-P) (A-H) (if private (Q-W) transaction) 35. IBDRY (Fid) A Dividend Sold 12/09/10 J A 36. BA(Fid) A Dividend Sold 12/09/10 J A 37. FH1GX (Fid) A Dividend L T 38. FTEXX Money Market Account (Fid) A Interest M T 39. Transamerica Annuity #1 A Interest K T was Pacific Fidelity Life 40. Transamerica Annuity #2 A Interest K T was PFL Transamerica Annuity #3 41. A Interest K T was PFL 4 Promissory Note from~... D Interest N T Buy 05119/10 4 First Interstate Bank Gillette WY Cash Equiv Acct A Interest M T 4 USAA Fed Savings Bank, San Antonio, TX Cash Equiv Acct A Interest M T 45. First NB, Buffalo, WY Cash Equiv Acct A Interest J T 46. American NB, Cheyenne, WY Cash Equiv A Interest L T Acct Closed Acct 47. U S Coins None J T 48. U.S. Bonds A Interest J T I. Income Gain Codes: A =$1,000 or less B =$1,001 - $2,500 C =$2,501 - $5,000 D =$5,001 - $15,000 E =$15,001- $50,000 (See Columns B 1 and D4) F =$ 50,001 - $ 100,000 G =$100,001 - $ 1,000,000 H 1 ~$1,000,001 - $5,000,000 H2 =More than $ 5,000,000 Value Codes J =$15,000 or less K =$15,001 - $50,000 L =$50,001 - $100,000 M =$100,001 - $250,000 (See Columns CI and D3) N =$ $500,000 O =$500,001 - $1,000,000 P1 =$1,000,001 - $5,000,000 P2 =$5,000,001 - $25,000,000 P3 -$25,000,001 - $50.000,000 P4 =More than $50,000,000 Value Method Codes Q =Appraisal R =Cost (Real Estate Only) S =Assessment T =Cash Market (Sce Column C2) U =Book Value V =Other W =Estimated
7 FINANCIAL DISCLOSURE REPORT Page 7 of 8 O Brien, Terrence L. 05/14/2011 VIII. ADDITIONAL INFORMATION OR EXPLANATIONS. (lndicate part of report.) Section VII - I converted my State of Wyoming IRA (lines!-5) to a Roth IRA with Fidelity Investments (line 33). The SOW issued a check on 12/27/2010 but it did not reach Fidelity for credit to the Roth IRA account until 01/03/2011
8 Page 8 of 8 O Brien, Terrence L. 05/14/2011 IX. CERTIFICATION. 1 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 statutory 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. Signature: S/Terrence L. O Brien NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FALLS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. 104) Committee on Financial Disclosure Administrative Office of the United States Courts Suite One Columbus Circle, N.E. Washington, D.C
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