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Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app. 101-111)
Nomination, [] Initial
5b. [] Amended Report 7. Chambers or Office Address On the basis of the information contained in this Report and any modificattens pertaining thereto, it is, In my opinion, in compliance with applicable laws and regulations. Reviewing Officer Date
IMPORTANT NO TES: The instructions accompanying this form must be followe~L Comvlele all parts,
checking the NONE box for each part where you have no reportable informatiom Sign on last pag~
(No reportablepositions.)
POSITION
NAME OF ORGANIZATION/ENTITY
2. 3. 4. 5.
Anderson, Stanlcv T.
III. NON-INVESTMENT INCOME. ~epo,ting i,di~iduol ond~ouse; see pp. 17-24 o/filing instructions.)
A. Filers Non-Investment Income
NONE
(No reportable
DATE
non-investment income.)
_SOURCE AND TYPE INCOME
(yours, not spouses)
2.
3. 4.
B. Spouses Non-Investment Income - zf you were married during any portion of the reporting ),ear, complete this section.
(Dollar amount not required except for honoraria.)
~~
NONE (No reportable non-investment income.) DATE SOURCE AND TYPE Self-employed clerical
1.2010 2. 3. 4.
NONE (No reportable reimbursements.) SOURCE DATES LOCATION PURPOSE ITEMS PAID OR PROVIDED
2.
3.
4. 5.
~
I. 2. 3. 4. 5.
VALUE
~-~
CREDITOR
1. 2. 3. 4, 5. First Bank Independent Bank Personnl Loan Personal Loan
DESCRIPTION.
VALUECODE K K
VII. INVESTMENTS and TRUSTS - ~,come. ~.~. ~,a.~actions (1,a,ae~ tho~, of spouse and dependent children; see pp. 34-60 of fillng instructions.)
NONE (No reportable income, assets, or transactions.)
Description ofAssets (including trust assets)
Place "(X)" after each asset exempt from prior disclosure
Income during reporting period O) Amount i Code l i (A-H) ~ (2) Type (e.g.. div., rent, or int.)
Gross value at end of reporting period O) Value Code 2 (J-P) (2) T (t) Type (e.g., Value buy, sell, Method Code 3 redemption) (Q-W)
(4) (2) ! (3) Date ] Value Gain mm/dd/yy [ Code 2 Code 1 (A-H) i (JP)
Interest
Interest
4. Voxwaro, Inc. 5. lntlGoldResources, Inc. 6, 7, 8. 9. 10. II. 12. 13. 14. 15. 16. 17. ING Financial Pars - Cash IRA Prudential Variable Annuity IRA Jackson Natl Life Variable Annuity IRA First Bank D A
None
None
None
J L L J
T T
I. Income Gain Codes: fSee Columns B I and D4) 2. Value Code~ (See Colutoas CI and D3) 3. Value Method Codes (S~ Co~m~n C2)
A =$l,0~O or tess F =SSO.001 - $ I00,000 J =$15,0~0 or less N =$250.~1 - $500,~ Q =App~isal U =Book Value
B =$1,001 - 12,500 O =$ I00.001 - S 1,000,000 K :$15,001 - $50.000 0 =$500,001 - S1.000,000 R ---Cost (Real Estate Only) V =Other
C =$2.501 - aS,000 H I =$ 1.000.001 - $ 5,000.000 L =$50,001 - $100,000 Pl =Sl.000,001 - $5,000.000 P4 ~More than $50,000,000 S =Assessment W =Esliffmted
19 =$5.601 - $1S.000 H2 =More than $5.000.000 M =$I00.001 - $250.000 P2 =$5.000.00l - $25.000,000 T =Cash Market
I certify that ali 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 eL 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)
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544