Académique Documents
Professionnel Documents
Culture Documents
Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app. 101-111)
15b. [] 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 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.
NAME OF ORGANIZATION/ENTITY
Make-A-Wish Foundation of Western Pennsylvania (non-profit corporation)
3. 4. 5.
II. AGREEMENTS. (Reporting individual only; see pp. 14-16 of filing instructions.)
~] NONE (No reportable agreements.)
DATE PARTIES AND TERMS
Bloch, Alan N.
IlL NON-INVESTMENT INCOME. (Reporting individual and spouse; seepp. 17-24 of filing instructions.)
A. Filers Non-Investment Income ~ NONE ~o reportable non-investment income.)
DATE SOURCE AND TYPE
2. 3. 4.
B. Spouses Non-Investment Income - lf you were married during anyportion of the reporting year, complete this section.
(Dollar amount not required except for honoraria.)
~-]
SOURCE
Academy of Trial Lawyers of Allegheny County
DATES
10-6-2010 to 10-8-2010
LOCATION
Farmington, PA
PURPOSE
3. 4.
5.
Alan N.
V. GIFTS. ancludes those to spouse and dependent children; seepp. 28-31 of filing instructions.)
NONE (No reportable gifts.)
SOURCE
1. 2. 3. 4. 5.
DESCRIPTION
VALUE
VI. LIABILITIES. andudes those of spouse and dependent children; see pp. 32-33 of filing instructions.)
NONE (No reportable liabilities.)
CREDITOR
1. 2. 3. 4. 5.
DE S CRIPTION
VALUECODE
VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
NONE (No reportable income, assets, or transactions.)
A. Description of Assets (including trust assets) Place "(X)" after each asset exempt from prior disclosure B. Income during reporting period ~2) ~l) Amount Type (e.g., Code 1 div.. rent. (A-H) or into C. Gross value at end of reporting period (t) Value Code 2 (J-P) (2) Va ue Method Code 3 (Q-W) (t) Type (e g, buy, sell, redemption) D. Transactions during reporting period (2) (3) " (4) Date Value Gain mm/dd/yy Code 2 Code 1 (J-p) (A-H)
Pa. Horsham Township Sewer Authority Philadelphia Pa. Gas Works Bond (12th Series) Pa. State Higher Education Facility Bond Pa. State Higher Education Bond Montgomery County Bond Philadelphia IDA Airport Bond Philadelphia Authority Bond Pa. Turnpike Bond (Series B)
A A A A A A A A
Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest J K J J K K K T T T T T T T J T J J J J T T T T
J J
Redeemed 11/15/10
Redeemed 11/15/10 J
Lewistown Borough Water Authority Bond A Pine Richland School District Bond Sto-Rox School District Bond A A
Stroudsburg Penn Area School District Bond B Pa. State Higher Educ. Assistance Agency A A B B B
(B/E)
Harrisburg PA Parking Authority Bond Pa. Turnpike B/E OY Bond Pa. State Finance Auth. Beaver Cty. Bond Fairview School District Bond
i lnc0me Gain Codes: (See Columns B 1 and D4) 2. Value Codes (See Columns C I and D3) 3. Value Method Codes (See Column C2)
A --$1,000 or less F =$50,001 - $100,000 J =$15,000 or less N =$250,001 - $500,000 P3 =$25,000,001 - $50,000,000 Q =Appraisal U =Book Value
B =$1,001 - $2,500 G =$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 HI =$1,000,001 = $5,000,000 L =$50,001 - $100,000 P I =$1,000,00 i : $5,000,000 P4 =More than $50,000,000 S =Assessment w =Estimated
D =S5,001 - $15,000 : H2 =More than $5~000~000 M =$100~001 ~ $250;000 P2 =$5,000,001 - $25,000,000 T =Cash Market
E =$15,001- $50,000
VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; seepp. 34-60 of f!ling instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets (including trust assets)
Place "(X)" al~er each asset exempt from prior disclosure B. Income during reporting period (1) Amount Code I (A-H) (2) Type (e.g.. div.,rent, or int.) C, Gross value at end: of repoSing period (1) Value Code 2 (J-P) (2) D. Transactions during reporting period (5) Identity of buyer/seller (if private "aansaction)
(2) (3) (4) (!) ..... Type (e.g~; Date Value [ Gain Value Method ..... buy~sell,: : mm/dd/yy Code 2 Code 1 Code 3 redemption) (J-P) (A-H) (Q-W)
Adams County Bond Dauphin County Bond Delaware Cty. IDA Sub. Water Authority Bond Mt. Lebanon School District Bond Lower Merion School District Bond
Altoona PANTS Series A Bond
A A A A A
B
J J J J J
K
T T T T T
T
All, Cty. Hosp. Dev. Auth. Bond (Mercy Hospital) Philadelphia PA Auth. (Series B) Bond Scranton PA Gen. Obligation (Series B) Bond Norristown School District Bond
Gateway School District Bond
B B A A
A
K K J J
J
T T T T
T
Meyersdale Area School District Scranton Penn School District Bond Economy Pa. Municipal Sewer Authority Abington School District Bond Pa. State Ref. Project (I st Series) Bond Fairview School District (Series B) Bond
A A A A A A
J J J J K J
T T T T T T
1~ Income Gain Codes: (See Columns B I and D4) 2. Value Codes (See Columns C I and D3) 3. Value Method Codes (See Column C2)
A =$1,000 or less F =$50,001 - $ 100,000 3 =$15,000 or less N =$250,001 - $500,000 P3 =$25,000,001 - $50,000,000 Q =Appraisal U =Book Value
B =$1,001 - $2~500 G =$] 00,001 - $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 H 1=$1,000~00 ! - $5;000,000 L =$50,001 - $I00,000 P 1 =$ 1,000,001 - $5,000~000 P4 =More than $50,000,000 S =Assessment W =Estimztcd
D =$5,001 - $15,000 H2 =More than $5,000,000 M =$I00,001 - $250,000 P2 =$5,000;001 - $25,000,000 T =Cash Market
E =$15,001 - $50,000
VII. INVESTMENTS and TRU S TS - income, valae, transactions (Includes those of sp ....
~-~ NONE (No reportable income, assets, or transactions.)
35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46.
Philadelphia Gas Works (5th Series) Ambridge Penn Area School District Plum Borough School District Garnet Valley School District Chestnut Ridge School District Iroquois School District Philadelphia Pa. School District Southeast Delco School District State Public School Building Authority State Public School Building Authority State Public School Building Authority Philadelphia Pa. School District
A A A A A A A A A B A B A A A B B
Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest Interest
J J J J J J J J J K J K J J K K K
T T T T T T T T T T T T T T T T T
47. Spring-Ford Area School District 48. 49. 50. 51. State Public School Building Authority Pa. State Higher Education Drexel University Philadelphia PA Water & Wastewater Series B Bond Aliquippa PA School District Bond
1. Income Gain Codes: (See Columns BI and I)4) 2. Value Codes (See Columns C I and D3) 3. Value Method Codes (See Column C2)
A =$1;000 or less F =$50,00 ] - $100,000 J =$I 5,000 or Jess N =$250,001 - $500,000 P3 =$25,000,001 - $50,000,000 Q =Appraisal U =Book Value
B =$1,001 - $2,500 G =$ 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 - $5,000 HI=$ ,000,00 -$5;000i000 L ~$50i001 - $100,000 Vl =Sl;000;001- $5,000,000 P4 =More than $50;000,000 S =Assessment W =Estimated
D =$5,001 - $15,000 H2=M0retha~$5;000;000 M =$100;001 ~ $250 000 P2 =$5;000i001 L $2~i000~000 T =Cash Market
E =$15,001 - $50,000
VII. INVESTMENTS and TRUSTS - ineo,~e, vatue, transactions (Includes those of spouse and dependent children; see pp. 34-60 of f!ling instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets Income during
(including trust assets) Place "(X)" after each asset exempt,from prior dise!osure
reporting period (1) (2) O) Amount "lZype (e.g.. Code l div., renL
(A-H) or int.)
of reporting period (2) El) (2~ (3) Type (e.g., Value Value buy, se|l~ Code2 Method
(J-P) Code3 ~edi~mp-d0il~
Identity of buyer/seller
(if private
transaction) 52. 53. 54. 55. 56. 57. 58. 59. 60.
61.
Mahanoy PA Sewer Authority Bond Mars PA School District Bond Greater Johnstown PA Water Bond Erie PA Water Authority Bond Altoona PA Area School District Bond Pa. State Turnpike Commission Bond
A A A A A A
K J
T T Redeemed 07101/10 J
J K J J
T T T T
West Mifflin PA Area School District Bond A Pa. State Higher Education Facility College & Univ. Bond Uniontown PA Area School District Bond
Erie PA Water Authority Water Bond
A A
A
J
J
T
T
62.
63.
A
A
Interest
Interest
J
K
T
T
Buy
Buy
01/11/10
01/11/10
J
K
New Kensington PA Sanitary Authority Bond Coatesville PA Area School District Bond Reading PA School District Bond North Versailles Township Sanitary Authority Bond lnterest-PNC Bank- Checking;~ ~ Pgh.
A A A A A
J J J J J
T T T T T
J J J
1 ~ Income Gain Codes: (See Columns B 1 and D4) 2. Value Codes (See Columns C I and D3) 3. Value Method Codes (See Column C2)
A =$1,000 or less F =$50,001 - $100.000 J =$15;000 or less N =$250,001 - $500,000 P3 =$25,000,001 - $50,000,000 Q =Appraisal U =Book Value
B =$1i001 ~ $2;500 G =$100100i - $1,0001000 K =$15~001 - $50,000 O =$500,001 : $1;000,000 R =Cost (Real Estate Only) V =Other
C=$2,501 - $5~000 HI =$ i000~00 ~ $~;000,000 L =$50 00i ~ $i00 000 : Pi =$i~000,00i ! $~i00~i00D ..... P4 =More than $50~0001000 S =Assess~efit W =Estimated
D =$5,001 -$15,000 H2 =Mor~ than $5~000,000 M =$100,001 ~ $250;000 P2 =$5,000i00]- $25,000,000 T =Cash Market
E =$15,001 $50,000
VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets (including trust assets) Income during
(2) (3) (4) Date: Value Gain mm/dd/yy Code 2 Code 1 (J~P) (A-H)
Vanguard Pa. Insured Tax Free Fund Pimco High Yield Fund Class A Bell South 7% preferred stock J.P. Morgan Chase 7% Shares Bond Fund of America American High Income Trust First Trust Preferred Income Series 38 Unit Trust Capital Income Builder Class A of American Funds Income Fund America, Inc. Class A of American Funds
B A A A A A A A A
K J
T T Redeemed 10/01/10 J
J J J J J J
1. Income Gain Codes: (See Columns B I and D4) 2. Valuc Codes (See Columns CI and D3) 3. Valuc Method Codes (See Column C2)
A =$L000 0r le~s F =$50,001 - $100,000 J =$15,000 or less N =$250,001 - $500,000 P3 =$25,000,001 - $50,000,000 Q =AppraisaI U =Book Value
B =$I,001 - $2,500 G =$100,001 - $1,000,000 K =$15,001 - $50,000 O =$500,001 - $1,000;000 R =Cost (Real Estate Only) V =Other
=$2,501 - $5,000 1 =$1,000,00 ~ - $51000i000 =$50,001 - $100,000 1 =$ !,000,001 - $5,000,000 P4 =More than $50,000,000 =Assessment W =Estimated
=$5,001 - $15,000 H2 =More than $5,000,000 M =$100,001 - $250,000 P2 =$5,000,001 - $25,000,000 =Cash Market
E =$15,001 - $50,000
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 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.SoC. 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)
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, NoE. Washington, D.C. 20544