.

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FINANCIAL DISCLOSURE REPORT

FOR CALENDAR YEAR 2009
2. Courl or Organizali,an U.S District Courl 5a. lieporl Type. [check appropriate lypc)

Report Req.ited by the Ethic.,

in Uovcrnownl Act q[ 1978

I. Persen Rcporling [last name firsI, middle ini~ialJ Burgess. Timolhy M. 4. Tille (Article Ill judges indicate active or senior slatug: ,naRi~tstc judge,; indicate full- or pard-dine) U.S. District Judge

3. D~1r 05.q 412(l I[) 6. R~porllng Period 01/~HI2009 1213

Nomination,

Da~c ~ Annual

~ lai,,al

5b. ~ Amc~cd Report

U.S. O~slrict Court 222 W 7d~ Ave Box 33 Anchorage, A K 99513

~itl, ~ppl~bk Isws ~.d r~g~lalio,,~, Re~iewi.g Officer l)=lc

IMPORTANT NO TES: rl, e instr.ction~ accompa.ying this for.t .,ust be follo,,ed. Co,,q,/ete alt part~,
checking the IVONE box fi*r each part .,here you have .o reportable i.formation. Sig. on last page.

I. POSITIONS. ~,~,,,,i,,g NONE (No reportable positions.)

POSITION
I.

NAME OF OR~A NIZATION,q:.NTIIY

NONE (No reporlab/e agreemenls.) I)ATE PARTIES AND TERMS

Burgess, Timothy M.

FINANCIAL DISCLOSURE REPORT Page 2 of 6

Burgess, Timo~hy 51.

05/IAQ010

I I!. NON-INVESTMENT INCOME. tR.,,,.,,,,~. ;.u;~,u,,., ~.d.,~ .....

A. Fliers Non-Investment Income NONE (No reportable non-investment income.) DATE
I t0-09

: s~,. ,:-:~ ,.t.,.g ; ......... ,,;,,,~.~

SOURCE A ND TYPE
Al~k~ Pennanenl Fund Dividend

] NCOM
(yours, not spouseS) $

2 3. 4.

B. Spouses Non-Investment hlcome - If y,~u .~ere married during atU, pl,rtiot~ o] rite reportink,.veur, e/mpl~te this sec6on.
(Dullor ~mouat t~ot requhed ~cept for honororla.)

~
I. 2009 2. 10-09 3.

N ONE ~0 reportable non-investment income.) DATg Slate o[ Alaska. salad, Al~kska Permanent Fund Dividend SOURCE AND TYPE

IV. REIMBURSEMENTS ........

~ .......i,,,,. ~,,,~,,,,~,1~,,~. ........ ; ........

NONE (No reportable reimburseme~ts) ~

1

DATE~

LOCATION

PLg{POSE

/TEM~ PAID OR PRQV1 DE D

2 3.
4.

FINANCIAL DISCLOSURE REPORT Page 3 of 6

r~ ..... flenon I~,porlinl:

Burgess. ~lmothy M.

05114,2010

V. GIFTS. a,,,~,,u..,. ,~,..,. ,o w,,,,,~ ,.a a.~,..a~., chi/d, en; .~eepl,. 25-3I ,,filling ins ..... NONE (No reportahle g~l?s.) DESCRIPTION
1 2. 3.
4.

..................................

VI. LIABILITIES. a..;.a., ,~,o,,,,f.v, ~ NONE (No r~7)ortable liabilities..) CREDIt-OR

1. Credil Union One 2. Bank of An~erlca 3. 4. 5 Credit Card Crcgi! C~rd

DESCRIPTION

VALUE CODE
K K

FINANCIAL DISCLOSURE REPORT

Page 4 of 6

Burgess, Timothy M.

051141201

NONE (No reportable income, a6"xet., or tran.~actionx.)

Description of Assets I Gross vaiue at er}d of

income during

"1 rans~cl~nns du~ m~ rcpo~in~ pcri~l

[b~cl~ding trust amcts) Place "{X)" alter each asset cxcmp~ from prior disclosure

~ reposing period Amount , Ty~ Code I I div., renl. (A-fi) . orint)

reporting ~riod

:.

Code 2 (J-P)

Method Code3

bu~.selL ~edcmp~=on)

MonthDay

] Ct)dc 2 ~ U-P)

Code ~ I (AdD

buyer/seller [if private"

1. 2. 3. 4.

T Rowe Price 529 Plan C, T Rowe Price C oilege Svgs Plan # I T Rowe Price 529 Plan C, T. Rt~we Price College Svgs Plan if2 T Rowe Price 529 Plan C. T Rowe Price C ol~ege Svgs Plan #3 Alaska Public Employees Retirement Sysl e~n 401 (k)

None None None None N T

Distributed Dis~ributed D=stabuted

03/09 03/09 03/09

J ) J

A A A

l0

13.

PageFINANC1AL5 of 6 DISCLOS URE REPORT

a,~rge,,, Timothy M.

!1

05/14]2~110

FINANCIAL DISCLOSURE REPORT

~ ...... ..... Reporting fP

DaleofRtpor,

Page 6 of 6
IX. CERT! FICATION.

Burge~s, Timothy ~.

05!~4,20~ 0

I cerlify thai all information g yen above (including inlormation pertaining to my spouse anti minor or dependenl cbihlren, it an}) is accurate, Irue, and complele Io the besl of my knowledge and helief, and that any iufurn~alion not reported eras wilhheld because it m~2l appllcahlc stalulorv provisious pcrmitling nnn-disclosure. I further certify that earned income frnm outside employmen! and honoraria and Ihe acceplance ol gills ~vbich have bccn reporled are iu compliance wilh the provisions of 5 [/.S.C. app. 501 el. seq., 5 U.S.C. 7353, and Judicial Confereoce regnlaliuns.

SignI NOTE: ANY INDIVIDIIAL WHO KNOWINGLY AND WILFULLY AND CRI511IS/AL SANCTIONS (5 U.S.C. app. 104)

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FILING fNSTRU(;TIONS Mail signed original and 3/.lditional copies m: Committee on Financial Disclosure Administrative Office of the Uniied Stales Courts Suite 2-301 One Cohlmbus Circle, N.E. Washinglon, D.C. 20544