Joseph S Van Bokkelen Financial Disclosure Report for 2010

8/3/2019 Joseph S Van Bokkelen Financial Disclosure Report for 2010

http://slidepdf.com/reader/full/joseph-s-van-bokkelen-financial-disclosure-report-for-2010 1/18

Rev, 1/2011 IFINANCIAL DISCLOSURE REPORT

FOR CALENDAR YEAR 2010

Report Required by the Ethics

in Government Act of 1978(5 U.S .C. app. ,~,~ I01-111)

I. Person Repor t ing ( l a s t name , f i r s t , m idd le initial)

V a n B o kke l e n , J o s e p h S .

4. Tit le (Ar t ic le I I I judge~ ind ica te ac t ive or senior s ta tus ;magistrate judges indicate full- or part- t ime)

ac t i v e

7. Chambers or Office Address

Uni ted S la te s Cour thous e5 4 0 0 Fed er a l P l aza , Su i t e 4 2 0 0H a m m o n d , I n d i a n a 4 6 32 0

2. Cour t or Organizat ion

U S D i s t r i c t C o u r t

5a. Report Type (check appropriate lype)

] N o m i n a t i o n , D a t e

[] Initial [] Annual [] Final

5b. [] Amended Report

8.On the basis of the information contained in this Report and anymodifications pertaining thereto, it is, in my opinion, in compliance

w i t h a p p l i c a b l e l a w s a n d r e g u l a t i o n s .

3. Date of R e p o r t

05/15/2011

6 . R e p o r t i n g P e r i o d

01/01/2010

I2/31[2010

R e v i e w i n g O f f i c e r Date

I M P O R T A N T N O T E S : The instructions accompanying thls form must be followed Complete all parts,

checking the NONE box for each pa rt where you have no reportable informat ion. S ign on last pag~

I . P O S I T I O N S . m e p o r ~ n g individual only; seepp. 9- 13 of f i l ing instructions .)

~] (No rep ortable posi t ions.)O NE

POSITION

NAME OF ORGANIZATION/ENTITY

I I . A G R E E M E N T S . m e p o n i . u individual only; see pp. 14-16 of f i l ing instructions.)

~] (No reportable agreements . )ONE

DAT~ PARTIES AND TERM S

FINANCIAL DISCLOSURE REPORT

N a m e o f P e r s o n R e p o r t i n g

Van Bok kclen , Joseph S.

D a t e o f R e p o r t

05/15/2011

I I I . N O N - I N V E S T M E N T I N C O M E . t Reporan g ind i , ,iduo t and ~ po~e; see pp . t z -2 4 o f ~ l ing instructionsO

A. Filer’s Non-Investm ent Incom e

[] NONE non - inves tmen t income . )N o reportable

DATE SOURCE AND TYPE

INCOME( y o u r s , n o t s p o u s e ’ s )

B . S p o u s e ’ s N o n - I n v e s tm e n t I n c o m e - i f you were ma rried during any port ion of the report ing year, comp lete this sect lon~

(Dollar a mount not required except for honoraria.)

N O N E (No reportable non-investment income.)

1.2010

W e s t mi n s t e r P r e s b y t e r i a n C hu r ch ( S a l a r y)

I V . R E I M B U R S E M E N T S - transportation, lodging, food, entertainment.

(Includes those to spouse and dependent cbildrem see pp. 25-27 of filing instructions.)

NONE (No reportable reimbursements.)

SOURCE D A T E S LOCATION

PURPOSE ITEM S PAID OR PROVIDED

N a m e o f P e r s o n R e p o r t in g

Van B okkelen , Jos eph S .

Date o f Repor t

05/15/201 I

V . G I F T S . ( l n c l u d ~ t h o s e t o s p o ~ e a n d d e r e n d e n t c h i l d r e n : se e p p . 2 8 - 3 1 o f f i li n g i n ~ t r u c t i o n ~ . )

N O N E (No reportable gifts.)

SOURCE DESCRIPTION

V I . L I A B I L I T I E S . a n c l .d e ~ t h o . 4 s p o . . . . d d , ~ , e n d e n t children; see pp. 3 2 - 3 3 of filing instructlonsO

NONE (No reportable liabilities.)

CREDITOR DESCRIPTION

VALUECODE

FINANCIAL DISCLOSURE REPOR T

Van B okke lcn , Jo s eph S .

05/15/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - inco, .e , , ’ . lue, , ru.so . io ,~ ana.des those of spouse and dependent children: see pp. 3 4 - 6 0 o f f i l i n g i n s t r u c t i o n s . )

N O N E (No reportable income, assets, or transactions.)

A. B. C. D.

D e s c r ip t io n o f A s se t s I n c o m e d u r in g G r o ss v a lu e a t e n d T ra n s a c t io n s d u r in g re p o r tin g p e r io d

( i n c l u d i n g t r u s t a s s e t s ) r ~ o r t i n g p e r i o d o f r e p o r t i n g p e r i o d

l (I)(2 ) (I) (2) (I) (2) (3) (4) (5 )

Place "(X)" after each asset I A m o u n t T y p e ( e . g . , V a l u e V a l u e Type (e.g., Da te V a l u e G ain I d e n t i t y o f

e x e m p t f r o m p r i o r d i s c l o s u r ei Code I

d iv ., r e n t , C od e 2 M e tho d b u y, s e l l, m n ~ d d /y y C o d e 2 C o d e I b u y e r / s e l l e r

~ , ( A - H ) o r in t . ) ( J - P ) C o d e 3 r e d e m p t i o n ) (J -P ) ( A - H ) ( i f p r i v a t e

!( Q - W ) t r a n s a c t i o n )

Progress Energy A Dividend S o l d 07/10/10 K D

A T & T A Dividend J

B P L L C A D iv id e n d So ld 04124110 K A

Federated Capital Reserves A I n t e r e s t J T Bu y 10/29/10 J

C omm un i t y Ho sp R e t i r emen t A c c~ ’7~

-Fidelity Contra Grow th

-Fide l ity G rowth and Income

P r e s b y t e r i a n C h u r c h R e t ir e m e n t F u n d /

S p o u s e

-Fidelity Equity Incom e Fund

-Fidelity US Bond Ind ex

AXA Equitab le-Annuity Fund/Spouse

-EQ/Equity 500 Index

A Dividend K T

A Dividend J T

A Dividend

A Divid end J T

C ap i t a l Secu r i t ies ~ IR A

- P e r s hi n g P r i m e R e s e r v e s ( f o r m e r l y

Centenn ia l Money Mar ke t )

-MF S T R I1 Em er g ing G r owth Clas s A

A I n t e r e s t

A Dividend

Bu y 12/01/10

I . I n c o m e G ai n Co d es : A =$1.000 or less B -$1,001 - $2,500 C =$2.501 - $5,000 D =$5.001 - $15,000

(See Columns B ! and 134) F = $ 5 0 . 0 0 1 - $ 1 0 0 , O 0 0 G = $ 1 0 0 . 0 0 1 - $ I .O O O . ’ ~ O 0 I I I =$ 1.000.0~ | - $5.000.000 1 1 2 = M ~ r c t l ~ a r t . $ .5 . 0 0 0 . 0 0 0

2. Va lu e C o d c~ J = $15.000 o r Ic~s K - $1 5 .O I - $5 0 .0 0 0 L =$50.0~1 - $10~.0~) M =110~.0~1 - $250.000

IS~:e ColumnS CI and D3) N -$ 250.001 - $ 500.000 O :$ 500.001 - $ 1.0~ 0.000 PI =$1.00~.001 - $ 5.000.000 P2 =$5.000.001 - $25.000.000

P3 =$25.000.0OI - $ 50.0~0.0~1 P4 =More than $50.0(~.000

3. Value I ’dcthod Codes Q =Appraisal R =Cost t Rca l I :~ta tc Only) S = As s e s s me n t T =Cash F. larkct

( Sc ¢ Co l u m n C2) U B o o k V a l u e V = O ~ h t ’r W = E s t i ma t e d

E =$15.0(11 -$50,000

Van Bo kkelen, Joseph S.

05/1~/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - i , c o , , ,, v a t u , . , ~ Q , ~ , c a o , ~ a , a Q d e ~ t n o s , o f s p o u s ~ a , d dependent children; see pp. 3 4 - 6 0 o f f i l i n g i n s t r u c t i o n s . )

A. B. D.

D e s c r i p ti o n o f A s s e ts Income dur ing Transactions during reporting period

( i n c l u d i n g t rus t a s se t s ) r epor t i ng per iod

( x ) ( 2 )

i A m o u n t T y p e (e . g . ,C o d e I d i v . , r e n t ,

( A - H ) o r i n t . )

P l a c e " ( X ) " a f t e r e a c h a s s e t

exempt f r om pr ior d i s c los ure

G r o s s v a l u e a t en d

o f r e p o r t i n g p e r i o d

(I) (2)

V a l u e V a l u e

C o d e 2 M e t h o d

( J - P ) C o d e 3

( Q - W )

(I) (2) (3) (4) (5 )

Type (e.g., Da te V a l u e G ain I d e n t i t y o f

b uy , s e l l , m m ] d d / y y C o d e 2 C o d e I b uy e r / se l le r

r e d e m p t i o n ) ( J - P ) ( A - H ) ( i f p r i v a t e

t r a n s a c t i o n )

-MFS TR 11 Emer ging Gro wth Class B

-MFS Global Equity Fund Class A

-MFS Small Cap W orld Fund Class A

-First Energy Corp.

AXA Equitable Annuity

-EQ/Marisco Focus

A Dividend J T

A Dividend S o l d 09/07/10

A Dividend K T

A Divid end J T Bu y ll/ll/10

A D i v i d e n d L T

-EQ/JP M organ Core Bond Fund

-EQ/Alliance Bem stein Quality Bon d

A Dividend K T

A Dividend L T

Capital Securities IRA

-MFS Growth Opp. Fund A

-MFS Mid Cap Fund A

-MFS Strategic growth Fund A

-MFS New Discovery Fund A

- American G eneral Fin. Corp. Incom eNotes

A Dividend

A I n t e r e s t

S o l d I 1/10/10 K A

S o l d 09/09/10 J A

S o l d I I/I 1/10 J A

S o l d 09/07/10 K A

T Bu y 10/26/10 J

I . I n c o m e G ai n Co d es : A =$1.000 or less B =$1,001 - $2.500 C =,$2.501 - $5,000 D = $ 5.001 - $ 15.000

( sec Co l u m n s B I a n d D 4 ) F = $ 5 0 . 0 0 1 - $ 1 0 0 . 0 0 0 G= $ 100.001 - $ 1.000.000 I I I =$ 1 .0 0 0 . 00 1 - $ 5 .0 0 0 . 00 0 1 1 2 =M o r e I ha n $ 5 . 00 0 .0 ~ O

2. Va lu e C o d es J = $15.0~O or Ices K =,$15.001 - $50.0~ L = $ 50.0~ 1 - $ 100.00~ M = $ 10~.0O I - $250.000

(s ee C olu mn s C I a nd D3 ) N $ 25 0.0O I - $5 00 .00 0 O = ’ $ 5 0 ’ 9 . 0 0 1 - $ 1 . 0 ~ O . 0 O O PI =$1,000.001 - $5.0OO.0(~ p2 =$5.000.0OI - $25.00~.000

P 3 = $ 2 5 . O 0 0 . 0 ~ 1 - ’ $ 5 0 . 0 0 0 . 0 0 0 P4 =More lhzn $50.000.000

3. Value Method Codes Q =Appraisal R -~o s ! (R e a l E . s la t e On l y) S = As s e s s me n t T =Cash Markc~

( See Co l u m n C2) U -Bo o k Va l u e V = O ~ h o " W = Esf i m a l c d

E =$15,001 - $50.000

N a m e o f P e r so n R e p o r t i n g

V a n B o k k e l e n , J o s e p h S .

05/15/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - i n c o ~ , e , ,’ a l . e , ~ a , ~ a a i o , ~ ( ln c l u d e ~ t h o s e o f s p o a s e a n d d e p e n d e n t children; see pp. 34-60 o f f i l i n g i n s t r u c t i o n s . )

A. B. C. D.

Des cr ipti on of As s et s Inco m e d uring Gro ss va lue a t en d Transactions during reporting period

(including trust assets) r epor t i ng per iod o f r e p o r t i n g p e r i o d

I (I) (2) (I) (2) (I ) (2) (3) (4) (5 )

P l a c e " ( X ) " a f t e r e a c h a s s e t I A m o u n t T y p e ( e . g ., Value V al u e T y p e ( e . g ., D a t e Value Gain I d e n t i t y o f

exempt f r om pr ior d i s c los ure I C o d e I d i v . , r e n t , C o d e 2 M e t ho d buy, se l l , m m / d d ~ Code 2 C o d e I buyer /se l le riA-H) o r i n t . ) ( J - P ) Code 3 r e d e m p t i o n ) ( J - P ) ( A-H) ( i f p r i v a t e

1( Q - W ) t r a n s a c t i o n )

-El i Li l ly Co. A D i v i d en d J T Bu y 1 1 / 1 5 / 1 0 J

-Loc kheed Mar t in Cor p . A D i v i d en d J T Bu y 1 1 / 1 5 / 1 0 J

- Bar c l ay’ s Bk PIc 6 .6 2 5 % Ser & Ad r A

- N a t io n a l W e s t m i n s t e r B K P L C S p o n s o r e d AA DR

- P e r s hi n g P r i m e R e s e r v e s A

Interes t J T Bu y 10/07/10 J

Interes t K T Bu y 12/01/10 K

C en t i e r Ban k A I n t e r e s t J T

F ide l i ty F und Cas h Res e r ves A Interes t J T

P eoples B ank

O c e a n a C o u n t y , Be n o n aT owns hip , Mic higan

A Interes t

A R e n t

So l d 07/08/10 A

I. I n co me Ga i n C o d e s :

( See Co l u m n s BI an d

2. V a l u e C o d e s

(S e e C o l u mrLs C I a n d D3 )

3. V a l u e M e t h o d C o d e s

( S e e C o h m m C 2 )

A -$1.000 or less

F =$50.001 - $100.000

J =$15.000 or less

N -$250.001 - $500.000

P3 = $ 2 5 . 0 0 ~ . 0 0 1 - $ 50. 0~ 1. 000

Q =Appraisal

U =Book Value

G = $1 0 0 . 0 0 1 - $1 , 0 0 0 . 0 0 0

K = $ 1 5 . 0 0 1 - $5 0 . 0 0 0

O = $ 5 0 0 . 00 1 - $1

R - - C o s t ( R c a l E s t a t e ~ n l y )

V = O t h e r

C =$2.501 - $5.0~0

L -$50.(X)1 - $100.0~0

p4 =More than $ 50.000.000

W = E s t i ma t e d

D =$5,001 - $15.000

112 =More Ihan $5.000.000

M =$10~.001 - $250.000

P2 =$5.000.001 - $25.000.~

T = Cash M ar kc l

E =$15.001- $50,000

Van Bokkelen, Joseph S.

05/15/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - i n c o , ~ e , v a ~ u e , t ~ a , ~ o ~ # o , ~ a n d ~ d ~ t h o s e o / s ~ , o . se o ~ d ~ e ~ , e ~ d e ~ t c h i t d , e ~ : s e e ~ , ~ ,. 3 4 - 6 0 of filing instructions.)

[~ ( N o r e p o r t a b le a s s e t s , o rONE i n c o m e . t r a n s a c t i o n s . )

D e s c r i p t i o n o f A s s e t s T r a n s a c t i o n s d u r i n g r e p o r t i n g p e r i o d

( in c lud in g t rus t a s se t s )

P l a c e " ( X )~ a f t e r e a c h a s s e t

e x e m p t f r o m p r i o r d i s c lo s u r e

I n c o m e d u r in g G ro s s v a lu e a t e n d

r e p o r t i n g p e r i o d o f r e p o r t i n g p e r i o d

( I ) ( 2 ) (l) (2) ( 1 ) (2) (3) (4) ( 5 )

A m o u n t T y p e ( e . g . , V a l u e V a l u e Type (e.g., D a t e V a l u e G ain I d e n t i t y o f

C o d e I d i v . , r e n t , C o d e 2 M e tho d b uy , s e l l , m m / d d / y y C o d e 2 C o d e I b uy e r / se l le r

( A - H ) o r in t . ) ( J - P ) C o d e 3 r e d e m p tio n ) ( J-P ) ( A - H ) ( i f p r i v a t e

(Q-W) t r a n s a c t i o n )

I. In co m e Gain C o d es : A -$ 1.000 o r le ss B = $ 1,001 - $ 2.500 C = $ 2.501 - $ 5.000 D =$5.001 - $15.0~O

( See Co l u m n s BI an d D 4) F = $ 50.0O I - $ 100.000 G = $ 100.001 - $1.000.000 I11 =$ 1,000.001 - $5.000.000 112 =More than $ 5.000.000

2. Value Codes J =$15.000 o~ less K = $ 15.0O I - $ 50.000 L = $ 50.0O I - $ 100.000 M =$100.001 . $ 250.000

( See Co l u m n s CI an d D 3) N =$250.0OI - $500.000 O = $50 0.00 1 - $1 .0 00 .0 00 P I = $1.0 00.0 01 - $5 .0 00 .0 0~ P2 =$5.000.001 - $25.000.000

P3 = $25.000.0OI - $50.090.000 P4 =More than $50.000.000

3. Value Method Codes Q =Appraisal R C o s t ( R e a l E s t a te O n l y ) S = As s cs s mc’m T = C ~ h M a r k e t

( See Co l u m n C2) U l~look Value V =O~hcr W = E s t i ma t e d

E = $1 5 . 0 0 1 - $5 0 . 0 0 0

P a g e 8 o f 9

Date o f Repor t

05/15/2011

VIII. ADDITIONAL INFORMATION OR EXPLANATIONS.

P a g e 9 o f 9

Name o f Pe r son Repor t ing

Date of Report

05/15/2011

IX . CERTIFICATION.

I c e r t if y t ha t a l l i n f o r m a t i o n g i v e n a b o v e ( i n c l u d i n g i n f o r m a t i o n p e r t a i n i n g t o m y s p o u s e a n d m i n o r o r d e p e n d e n t c h i ld r e n , i f a n y ) is

a c c u r a t e , tr u e , a n d c o m p l e t e t o t h e b e s t o f m y k n o w l e d g e a n d b e l i e f , a n d t h a t a n y i n f o r m a t i o n n o t r e p o r t e d ~ v a s w i t hh e l d b e c a u s e i t m e t a p p l i c a b l e s t a t u to r yp r o v i s i o n s p e r m i t ti n g n o n - d i s c l o s u r e .

I f u r t he r c e r t i fy t h a t e a r n e d i n c o m e f r o m o u t s i d e e m p l o y m e n t a n d h o n o r a r i a a n d t h e a c c e p t a n c e o f g i f t s w h ic h h a v e b e e n r e p o r t e d a r e i nc o m p l i a n c e w i t h th e p r o ~ s i o n s o f 5 U . S .C . a p p . § 5 0 1 e t . s e q . , 5 U . S . C . § 7 3 5 3 , a n d J u d i c i a l C o n f e r e n c e r e g u l a t io n s .

Signature: S] Joseph S. Van Bokk elen

N O T E : A N Y I N D IV I D U A L W H O K N O W I N G L Y A N D W I L F U L L Y F A L S I F IE S O R F A L L S T O F I L E T H I S R E P O R T M A Y B E S U B J E C T T O C I V I LA N D C R I M I N A L S A N C T I O N S ( 5 U . S .C . a p p . § 1 0 4)

C o m m i tt e e o n F i n a n c ia l D i s c lo s u r eA d m i n i s tr a t iv e O f f ic e o f t h e U n i t e d S t a te s C o u r t sSui te 2- 301O n e C o l u m b u s C i r c l e , N . E .W a s h i n g t o n , D . C . 2 0 5 4 4

Rev. 1/2011

FOR CALENDAR Y EAR 2010

Report Required by the Ethics

in Government Act o f 1978(5 U.S .C. app. ,~ ,~ 101-111)

I. Person R epor t ing ( las t name, f i r s t , middle in i t ia l )

V an B okke l en , J os eph S .

4. Tit le (Art ic le I I I judges ind ica te ac t ive o r sen io r s ta tus;magistrate judges indicate full- or part- time)

act ive

7. Chambers o r Office Address

Uni t e d S t a t e s Cour t house

5400 Federal Plaza, Suile 4200H ammond, Ind i ana 4 6 3 2 0

2. Cour t or Organization

US Distr ict Cour~

3. Date of Report

05/15/201 I

5a. Report Type (check appropriate q,’pe)

] N o m i n a t i o n , D a t e

[] Initial [] Annual [] Final

5b. [] Amended Report

8.On the basis of the information contained in this Report and any

modifications pertaining thereto, it is, in my opinion, in compliance

nith applicable laws and regulations.

6.Repor t ing Per iod

01/01/2010

12/31/2010

Reviewing Office r D a l e

I M P O R T A N T N O T E S : The instructions accompanying this form must be followed Complete ali parts,

checking the NONE bo x for each part where you ha ve no reportable information. Sign on last pag~

I. P O S I T I O N S . t R e ~ , o r , in g i n d i v id u o l o n l y ; s e e ~ , p . 9 - 1 3 of filing instructions.)

V~ N O N E (No reportable positions.)

POSITION

NAME OF ORGANIZATION/ENTITY

I I . A G R E E M E N T S . ~ R e ~ , o . i n g individual only; see pp. 14-16 of filing instructions.)

1-~ NONE (No reportable agreements.)

DATE PARTIES AND TERM S

N a m e o f P e r s o n R e p o r t in g

Van Bokke l en , Joseph S .

05/15/201 I

I I I . N O N - I N V E S T M E N T I N C O M E . tgepo~ingi, di,’iduala,dspo,~e;se, pp. 17-24offilinginstructionsO

A. Filer’s N o n - In v e s t m e n t I n c o m e

~] NONE non- inves tmen t income. )N o reportable

INCOME

( y o u r s , n o t s p o u s e ’ s )

B . S p o u s e ’s N o n - I n v e s t m e n t In c o m e - t f y o . were married during any portion of the reporting year, complete this section.

(Do llar amount no t requ ired excep t fo r honoraria . )

D (No reportable income.)ONE non-investment

1. 2010 W e s t m i n s t e r P r e s b y t e r ia n C h u r c h ( S a l a r y )

I V . R E I M B U R S E M E N T S -transportation, Iodglng, food, entertainment.

( Includes those to spouse and dependent ch i ld ren, " see pp . 25 -27 o f f i l ing instruct ions.)

~] (No repor tab le re imbursem en ts .)ONE

SOURCE DATES LOCATION PURPOSE ITEM S PAID OR PROV IDED

Van B okkelen , Joseph S.

05/15/2011

V . G I F T S . (Includ~ those to spouse and dependent children; see pp. 28-31 of filing instructions)

N O N E (No reportable gifts.)

SOURCE DESCRIPT|ON

V I . L I A B I L I T I E S . a n c l u d e s t h o s e o /s p o u s e . h a l d e p e n d e n , children; see pp . 3 2 - 3 3 o f f i l i n g instructions.)

N O N E (]go reportable liabilities.)

CREDITOR DESCRIPTION

VALUECODE

of 9 Iame o f Pe rson Report ing

Date of R e p o r t

05/15/201 I

V 1 1 . I N V E S T M E N T S a n d T R U S T S - i. e o m e , ,’ a l .e , ~ a .s o e t io ~ a n c t u d - - t * o s e o f s p o u s e u n d dependent children; see p p . 3 4 - 6 0 of filing i n s t r u c t i o n ~ )

A. B. C. D .D e s c r i p ti o n o f A s s e t s Income during G r o s s v a lu e a t e n d T r a n s a c t i o n s d u r i n g r e p o t ’ li n g p e r i o d

( i n c l u d i n g t r u s t a s s e t s ) ~poning pe r iod o f r e p o r l in g p e r i o d

! (I) (2) (I) (2) (I) (2) (3) (4) (5 )

P l a c e " ( X ) " a f te r e a c h a s s e t ] A m o u n t T y p e ( e . g . , Value Value T y p e ( e .g . , D a t e V a l u e G a i n I d e n t i t y o f

e x e m p t f ro m p r i o r d is c l o s u r e i Code I d i v . , r e n t , C o d e 2 M e th o d b u y , s e l l, m m / dd /y y C o d e 2 C o d e I b u y e r / s e l l e r

! (A-H)o r i n t . ) ( J - P ) C o d e 3 r e d e m p t i o n ) ( J - P ) ( A - H ) ( i f p r i v a t e

i( Q - W ) t r a n s a c t i o n )

P r o g r e s s E n e r g y A D i v i d e n d S o l d 07110/10 K D

A T & T A D i v i d e n d J

B P L L C A D i v i d e n d So l d 04/24/10 K A

Federa t ed Capi t a l Res e rv es A Interest J T Bu y 10/29110 J

Com m uni t y Hosp . Re t i r e m e n t Ac c

-Fidel i ty Contra Growth Dividend K

- F ide l it y Growth and Incom e A D i v i d e n d J

P res by te r i an Ch u rch Re t i rement Fu nd/

-F i de l it y Eq u i t y Inc om e F und D i v i d e n d

- F ide l it y US Bond Index

AXA Eq ui t a b l e -Annu t y F un

- EQ/Equ i ty 5 0 0 Index

D i v i d e n d

C a p i t a l S e c u r i t i e s ~ " ’ Y ~ ~ . ~ ~ I R A

- P e rs h ing P r ime Res e rv es ( fo rmer ly

Ce n t e nn i a l Mone y M a rke t)

- M FS TR I I Em erg ing Growth Clas s A

Interest K

D iv idend K

Bu y 12/01/10

I. Incom e G ain C odes: A -$ 1.000 or less B -$ 1,001 - $2 ,500 C = 52.501 - $5,000 D = $5.0O I - $15.000

(See Colum ns B I and 134 ) F -$ 50.001 - $ 100.000 G =$ 100.001 - $ 1.000.000 I l I = $1.000.001 - $5,000.000 1 1 2 = M o r e t h a n $ 5 . 0 0 0 .0 0 0

2. Value Codes J -515.000 or less K :515,001 - 550.000 L =$50,001 - $100.000 M =$ 100.001 - $250.000

( See C olu mns C I and D 3) N =$250.001 - 5500.000 O =$500.001 - $I.000.000 P I =$ 1 .0 00 .0 01 - $ 5. 00 0. 00 0 P 2 =$ 5.0 00 .0 01 - $ 25 .0 00 .0 00

P3 =$25.000.001 - $ 50.0~0.000 P4 =M ore t i tan $50,000.000

3 . V a l ue M et h o d Co d es Q =Appraisal R -~Sost tReal Estate Only) S = Assessm en t T - - C~h Ma rk e t

~S ce Co l um n C2 ) U -Book Valu e V =O~hcr W = E s t i m a ted

E = $ 1 5 , 0 O I - $ 5 0 . 0 0 0

Date of R e p o r t

05/15/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - i n c o m e , v o t u e , ~ a ~ a e t lo ~ a n e t a d ~ s t h o ~ o f s p o ~ o n a d e p ~ n a e n t children; s e e p p . 3 4 - 6 0 of filing instruction~)

N O N E (N o reportable income, assets, or transactions.)

Descrip t ion o f Assets T r a n s a c t i o n s d u r i n g r e p o r t i n g p e r i o d

(including t r u s t a s s e t s )

P l a c e " ( X ) " a f t e r e a c h a s s e t

exempt from prior disclosure

I n c o m e d u r in g G r o s s v a l u e a t en d

r e p o r t i n g p e r i o d o f r e p o r t i n g p e r i o d

(I) (2) (1) (2) (I) (2) (3) (4) (5 )

A m o u n t Type (e.g., V a lu e V a lu e T y p e ( e .g . , D at e V a l u e G a i n I d e n t i t y o f

C o d e I d i v . , r e n t , C o d e 2 M e t ho d b u y , s e l l , m m / d d / y y C o d e 2 C o d e I b u y e r / s e l l e r

( A - H ) or i n t . ) ( J - P ) C o d e 3 r e d e m pt i o n ) ( J - P ) ( A - I t ) ( i f pr iva t e

( Q - W ) t r a n s a c t i o n )

-M FS TR II Emer ging Growt h Class B

-MFS Global Equity Fund Class A

-MFS Small Cap W orld Fund Class A

-First Energy Corp.

AXA Equitable Annuity

-EQ/Ma risco Focus

A Div idend J T

A Dividend S o l d 09/07/10

A Dividend K T

A Dividend J T Buy I 1/11/10

A Dividend L T

-EQ/JP Morgan Core Bond Fund

-EQ/Alliance Bernste in Q uality Bond

A Dividend K T

A Dividend L T

Capital Securities IRA

-MFS Growth Opp. Fund A

-MFS Mid Cap Fund A

-MFS Strategic growth Fund A

-MFS New Discovery Fund A

- American General Fin. Corp. Income

A Dividend

A I n t e r e s t

S o l d I 1/10/10 K A

S o l d 09/09/10 J A

S o l d I I/11/10 J A

S o l d 09/07/10 K A

T Buy 10/26/10 J

I . I nc ome Gain C odes : A -$1 ,000 o r Icss B = $1 ,001 - $2.500 C = $2.501 - $5,000 D =$5.001 - $15,000

( S ee Co l um n s B 1 an d D 4 ) F =$50.001 - $ 100.000 G =$100.001 - $ 1.000.000 I I I = $ 1 . 0 0 0 . 0 0 1 - $ 5 . 0 O O . 0 0 0 1 1 2 = M o r e t h a r t $ 5 .0 O O . 0 O O

2. Va lue C o d es J = $15.000 o r le ss K = $15.001 - $50.000 L = $50.001 - $100.00~ M =$10~ .001 . $250.000

IS¢ c C olu mns C I and D 3) N =$250.001 - $500.000 O =$500.001 - $1.0~0.000 PI =$1.000.0~1 - $5.1~0.000 P2 =SS.0~0.001 - $25.000.000

P3 =$25,000.001 - $50,000,000 P 4 = M o r e t h an $ 5 0 , 0 O O . 0 0 0

3. Value M c~ ho d Cod es Q = A ppraisal R ’ ~ ’ o s~ I Rea l E s t a t e O n l y ) S = Assessm en t T ~ a s h M a r k e t

( See C olu mn C 2) U = B o o k V a l ue V - Olh e r W = E st i m a ted

E =$15.001 - $50,000

05/15/2011

Vl l . I N V E S T M E N T S a n d T R U S T S - income, vMue, transactions (Includes those of spouse and dependent children; seepp. 34-60 of filing instructlong)

NONE (No reportable income, assets, or transactions.)

D e s c r i p t i o n o f A s s e t s I n c o m e d u r i n g

( i n c l u d i n g t r u s t a s s e ~ ) r e p o r t i n g p e r i o d

(1) (2)

Place "(X)" after each asset ! A m o u n t T y p e ( e . g .,

e x e m p t f r o m p r i o r d i s c lo s u r e [ Code I d i v . , r e n t ,

( A - H ) or i n t . )

G r o s s v a l u e a t e n d

o f r e p o r t i n g p e r i o d

O) (2)

V a l u e V a l u e

C o d e 2 M e t ho d

( J - P ) C o d e 3

T r a n s a c t i o n s d u r i n g r e p o r t i n g p e r i o d

(I ) (2) (3) (4} (5 )

T y p e ( e . g . , D a t e Value Gain I d e n t i t y o f

buy, se l l , m m/ddh/y Code 2 C ode I buyer /se l ler

r e d e m p t io n ) ( J - P ) (A-H) ( i f p r i v a t e

3 5 . - E l i L i l ly C o . A Dividend J Buy 11115/10 J

36 . -Lockheed Ma ~ inCorp. A Dividend J Bu y 11/15/10 J

37 . -Barclay’s Bk PIc 6.625% Ser & Adr A I n t e r e s t J Bu y 1 0 / 0 7 / 1 0 J

38 . -National W estminster B K PLC SponsoredADR

3 9. -Pe r sh in g Pr ime Res e rv e s

I n t e r e s t J

I n t e r e s t K

Bu y 10/07/10 J

Bu y 12/01/10 K

C e n t ie r B a n k

Fidelity Fund Cash Reserves

Peoples Bank

Oceana County, BenonaTownship, Michigan

I n t e r e s t

R e n t

So ld 07/08 /1 0 A

I. I n co m e G a i n Co d es :

( See C olu mns BI and 1 ) 4)

2. V al ue Co d es

( S c c C o l u m n s C I a n d D 3 )

3 . V a l u c M e t h o d C o d c s

( S c c Column C2)

A =$ 1 .000or l es s

F =$50.001- $100,000

J =$ 1 5.000or l es s

N =$250,001- $500.000

P3 = $25.000.001- $ 50.000.000

Q =Appraisal

U = B o o k V a l ue

B =$ 1 ,001 - $ 2 , 5 0 0

G =$100.001 - $1.000,000

K =$15.001 - $50.0(~

R =C os ( ( R eal Es t a t e O n l y )

V = ~ h e r

C =$2,501 - $5.000

I I I = $ 1 . 0 0 0 , 0 0 1 - $ 5 . 0 0 0 . 0 0 0

L -$50.001 - $100,000

PI =$l.000,001 - $5.000.000

P4 =More Ihan $50.0(~.000

s -A s s c s s menl

W -Es t imated

D =$5,0~1 - $15,000

1 1 2 = M o r e t h an

M =$100.091 - $250.000

P2 =$5.000.001 - $25,000.0~)

T -~Tash Markcl

E =$15,001- $50,000

N a m e a f P e r s o n R e p o r t in g

Van Bokke l en , Joseph S .

05/15/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - i n c o m e , v a l u e , tr a n s a c t io n s a n c t u d ~ t h o , e o l , p o n s e a n d d e p e n a e n , children; see pp. 3 4 - 6 0 of f i l ing ins truct ions~)

NONE (No reportable income, assets, or transactions.)

D e s c r i p t i o n o f A s s e t s I n c o m e d u r i n g

( in c l u d i n g t ~ s t a s s e t s ) r e p o r t i n g l ~ f i o d

(0 (2)Place "(X)" after each asset i A m o u n t T y p ~ ( e . g . ,

e x e m p t f r o m p r i o r d i s c lo s u r e i Code I d i v . , r e n t ,

~ ( A - I I } or i n t . )

G r o s s v a l u e a t e n d

of re~rting period

(I) (2)

V a l u e V a l u e

C o d e 2 M e t h o d

( J - P ) C o d e 3

O)T Y T ~ (e.g. ,

buy, se l l ,

r e d e m p t io n )

T r a n s a c t i o n s d u r i n g r e p o r t i n g p e r i o d

(2) (3) (4) (5 )

D a t e Value Gain I d e n t i t y o f

m m / d d ~ ’ y Code 2 C ode I buyer /se l ler

( J - P ) (A-H) ( i f p r i v a t e

I . I nc ome Gain C odes : A = $1 ,000 or less B = $1 ,001 - $2.500 C = $2,501 - $5.000 D =$5.001. $15,000

( See C olu mns B I and D 4) F = $50.001 - $ 100,000 G = $100.001 - $1.0~0.000 I I I =$ 1.000.0~ I - $5.000.000 112 = M ore than

2. Vahlc Codes J =$15.0~0 ~ Ic~s K =$1 5.001 - S50.00~ L =$50.001 - $100.0~1 M ~$100.0~1 - $250.000

( See C olu mns C I and D 3) N = $250,001 - $ 500.000 O =$50~ .001 - $ 1.000.000 P i = $ 1. 00 0. 00 1 - $ 5, 00 0. 00 0 P 2 = $ 5.0 00 .0 01 - $ 25 .0 00 .0 00

P3 =$25.000.001 - $50.000.0~O P4 =More lhan

3 . V a l ue M et h o d Co d es Q =Appraisal R -~?os! {Real Estate Only) S = Assessm en t ]" =Cash Markc~

( See C olu mn C 2) U =[ look Value V = O t h e r " W = E st i m a ted

E = $ 1 5 . 0 9 1 - $ 5 0 .0 ~ 0

P a g e 8 o f 9

Name of Person Repor ting

Van Bo kkelen , Jo sep h S .

05/15/2011

VIII. ADDITIONAL INFORMATION OR EXPLANATIONS.

P a g e 9 o f 9

V a n Bo k k e l e n , J o se p h S .

Da~e o f Repor t

05/15/201 I

IX. CERTIFICATION.

I c e r t i f y t h a t a l l i n fo rm a t i o n g i v e n a bo v e ( i n c l u d i n g i n fo rm a t i o n p e r t a i n i n g t o m y sp o u se a n d m i n o r o r d e p e n d e n t c h i l d r e n , i f a n y) i s

a c c u r a t e , tr u e , a n d c o m p l e t e t o t h e b e s t o f m y k n o w l e d g e a n d b e l i e f, a n d t h a t a n y i n f o r m a t i o n n o t r e p o r t e d w a s w i t h h e l d b e c a u s e i t m e t a p p l i c a b l e s t a tu t o r yp ro v i s i o n s p e rm i t t i n g n o n - d i sc l o su re .

I f u r t h e r c e r t i f y t h a t e a rn e d i n c o m e f ro m o u t s i d e e m p l o ym e n t a n d h o n o ra r i a a n d t h e a c c e p t a n c e o f g i f t s wh i c h h a v e be e n r e p o r t e d a r e i nc o m p l i a n c e wi t h t h e p ro v i s i o n s o f 5 U . S . C. a p p . § 5 0 1 e t . s e q . , 5 U . S . C. § 73 5 3 , a n d J u d i c i a l Co n fe r e n c e r e g u l a t i o n s .

Signature: S[ Joseph S. Van Bokke len

N O T E : A N Y I N D I V ID U A L W H O K N O W I N G L Y A N D W I L F U L L Y F A L S I F IE S O R F A L L S T O F I L E T H I S R E P O R T M A Y B E S U B J E C T T O C I V I LA N D C R I M I N A L S A N C T I O N S ( 5 U . S . C . a p p . § 1 0 4 )

C o m m i t t e e o n F i n a n c i a l D i s c l o s u r eAdmin is t ra t ive Off ice o f the Un i ted S ta te s Cour tsSui te 2- 301O n e C o l u m b u s C i r c l e , N .E .W a s h i n g to n , D .C . 2 0 54 4

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