8
2 ȕA ; : ' Reor I 12005 Senae (Numr. Cit, State, Coe) -I Telephoe lncuae C) I Reor Aae ÓÔme ÖÒrREAiING:rÕeftNS' 'td!lF]l1StANSWl-R1EGHP07I1AE$EYQlCS:lJNSlA \m ... 11L .J¹A-¬-----"'--"· -· Lj .. -.! ..•.. --.. .Jf_ .... . . -·"'·--·'---'· .. . --=<μ· · ··· · ···-™-""--ÐMlL. ---- --җ-- --Җ---1 . . . .. _. Comolete Comolete Yes. Comolete your Report: NO ·y·iac.tz·f{'&tir ___ r _ _f · u1i½bi'lsw_ ··t±_·ÞrHattf¼÷'"f''1_ ¦a_ct __ ·:__ eRi1t _.,."_"'ifjd'·fot'e_ac_i_.°'M_ .. _. _- _1 _ · þ¾²r®r-1ii-;-- ið._ ,z:_ ×_ -_ tJ-³©i .. -.ê .. Q ,,i: à-9 .. . nj_Ǎ·>--, .. :: ҙw¥Қ· .. ,; · ,. . , . · ··hd, , -èí!,;•î -?. .: . Ǔ ǔ'. ' '':'Ǖ·. ,. . -ç\f.. 1.;., .Pé -ȗȘ!:ft : ; .•. Nj .. é . -·ǎǏ····ǐ - -åt _, ,sȖ- . .... . .. .. ., ·#Ǒǒ·· Rä- .. ï='" M· . ȓ- 'f .. ··,șfȚ.:t .. . (See aoo. mv know!eae ҕ 1 <Month, Day, __ t- M"" 1; ;: :. 8 -,1- UNITED ST ATES SENATE FINANCIAL DISCLOSURE REPORT FOR ANNUAL AND TERMINATION REPORTS last Nam firt Na and Middle Ital Anut Calendar YHr Covered b Reo CLINTON HILLARY RODHAM U.S. SENATE Ofc Adrss Stret. an·ZIP 476 RUSSELL OFFICE BLDG. WASHINGTON, DC 20510 ·Seate OfNJ Numb AҘ• 202-224-4451 Terato TerlaUo Dat (mddy): - Pr Ofe I . _ . -· ... . . _ . .. .. . . - ,, . .. YES YES Did you, your spouse, or dependent child receive any reportable travel or Did any individual or organization make a doation to carity in lieu of reimbursements fr travel in th reporng period (i.e., worh more than paying you for a spec, apparanc, or aricle in te reporting period? $305 from one source)? DC DC If Yes, Complete and Attach PART I. lf and Attach PART VI. Did you or your spouse have eared incme (e.g., salaries or fees) or nn- Did you, your spouse. or dependent child have any reporabe liability investent incme of more than $20 from any reportable source in the (mre than $10,000) durig the reporting period? reportin period? CD If Yes, Complete and Attach PART VII. DC If Yes, and Attach PART II. Did yu, your spous, or dependent child recive unarned or investment Did you hold any reporable psitins on or befre the date of fling i the incme of more than $20 in the reporting period or hold any reporble current clendar year asset worh more than $1,00 at the end of the period? If Yes, Complete and Attach PART VIII. If Yes, & Attach PART lllA and/or 1118. CD DC Did you, your spouse. or dependent chitd purcase. sell, or exchange any Do you have any reporable agreement or arrangement with an outsie reportable asset worth more than $1,000 in the reporing period? entity? If Yes, Complete and Attach PART IV. DC lf Yes, Complete and Attach PART IX. CD Did you, your spouse, or dependent child recive any reprtable gif in the lf this is FIRST Did you rceive compensation of more than reporting period (i.e .• aggregating more than $305 and not oterise $5,00 fom a single source in the two prior years? exempt)? If Yes, Complete and Atach PART X. If Yes, Com ete and Attach PART V. D0 DD .. .., .. .. . .. . . .. . .•.. ..-·· .. .. ., .. -- . . ç . . . ... . .ë: .. , .. :, , . File this repor and any amendments with the Secretar of the Senate, Ofice of Public Records, Room 232, Har Senate Ofice Building, U.S. Senate, Washington, D 20510. $200 Penalty fr filing more than 30 days afer due date. â ONLY by the Ofc of the Secretary of the Snate to any requesting person upon written application and wlbe reviewed by the Select Committee This Financial Disclosure Statement is required by the Ethics in Government Act of 1978, as amended. The statement will b made available on Ethics. Any individual who knowingly and willfully falsifes, or who knowingly and willfully fails to fle tis report may be subject to civil and criminal sanctions. 5 U.S.C. 6. 104, and 18 U.S.C. 1001. · . r Cerfcaton Inivual Date Year ·n i: f L I CERTIFY that the statements I have made on this fOl and all < _, r - - lj : Ȕ- o l\ atached shedules are true, coplete an coc to the best o 12, '•o< N (/ (Tl z and belief . > r I is the Oni of th rvier that the statements made in this fonn are in coplance with Title I o th Ethic in Goerment Ac. - i

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Page 1: 9£t3 2 39.3 2 4 - Home | Judicial Watch...8 YPO Windy City Chapter (Spouse) Chicago, IL : Speech 11107105 : $100,000 : 9 Jewish Federation of Metropolitan Chicago (Spouse) Chicago,

2 A ;z; :> ';

Reoort

I 12005 Senate (Number. City, State, Code) -I Telephone lfncluae Code) I Reoort Aae

me rlREAi:>ING:rn eftNS' 'td!l ]l1':1NSti'ANSW.l:-R1E P.lt07 1iAE$EYQl!JCS:Jil N'Sl'A \tm ... 11L .J A-- -----"-'-·--·-"-'·-· .. -.! ..•.. --.... JfiJ_ ... . . . --·"'·--·'---'· .. . --=< ······· • ····- -""-- Ml.L. ---- -- -- -- ---1 ., . . .. • _.

Comolete

Comolete

Yes. Comolete

your Report:

NO

· ·i:ac.ht ·fi '&tir ___ r _ _.fYr_··u1Si bii'tl'lfsw_ ··t! _·· rHattfi '"'fi5''1fi_a_c:-ti" __ ·: __ e1jRit11tta_.,."_"''ifijfd'·fot'l!'e_ac_ii_. 'ME_ ... _._--_1_·

r r-,;11ifif-i; -i .£_,z:_ _-_tJ-t i .. -. .... Q ,,i"':":.:: -m9 .... _,_ ·>--, ... :i:: w¥ · .. ,,; ·,..,.···hd, , - !,.,;• -?'.t:..::.c. '.' '':.J' ·.,.. . - - \f:'.P...1.;;i..,, .P - !:f.t : ; .•. .. .. -.· ···· --- t _, ,s - .... . . .. ...('., ·# ·· R. -....... ='""M· . - 'ri.f .... ··, fiq .:tr ....

(See aoo.

mv know!edae

1 <Month, Day,

__. _. t.e.:_-+v-j M""""

1-;; ;::j :..; -,.1-

UNITED ST ATES SENATE FINANCIAL DISCLOSURE REPORT

FOR ANNUAL AND TERMINATION REPORTS last Name first Name and Middle Initial Annuat

Calendar YHr Covered by Report: CLINTON HILLARY RODHAM U.S. SENATE

Offlce Address Street. and·ZIP

476 RUSSELL OFFICE BLDG. WASHINGTON, DC 20510

·Senate Off Number A •

202-224-4451

TerminationTermlnaUon Date (mm/ddlyy):

-Prior Office I

. _ . --·· •. . . . . _ . .. .. . . - ,, . ..

YES YES Did you, your spouse, or dependent child receive any reportable travel orDid any individual or organization make a donation to charity in lieu of reimbursements for travel in the reporting period (i.e., worth more than

paying you for a speech, appearance, or article in the reporting period? $305 from one source)? DC8J DC8JIf Yes, Complete and Attach PART I. lf and Attach PART VI.

Did you or your spouse have earned income (e.g., salaries or fees) or non­Did you, your spouse. or dependent child have any reportable liability investment income of more than $200 from any reportable source in the (more than $10,000) during the reporting period?

reporting period? C8JD If Yes, Complete and Attach PART VII. DC8JIf Yes, and Attach PART II. Did you, your spouse, or dependent child receive unearned or investment

Did you hold any reportable positions on or before the date of filing in theincome of more than $200 in the reporting period or hold any reportable

current calendar year? asset worth more than $1,000 at the end of the period?

If Yes, Complete and Attach PART VIII. If Yes, & Attach PART lllA and/or 1118. C8JD DC8J Did you, your spouse. or dependent chitd purchase. sell, or exchange any Do you have any reportable agreement or arrangement with an outside reportable asset worth more than $1,000 in the reporting period? entity?If Yes, Complete and Attach PART IV. DC8J lf Yes, Complete and Attach PART IX. C8JD Did you, your spouse, or dependent child receive any reportable gift in the

lf this is FIRST Did you receive compensation of more than reporting period (i.e .• aggregating more than $305 and not otherwise $5,000 from a single source in the two prior years?

exempt)? If Yes, Complete and Attach PART X.

If Yes, Com ete and Attach PART V. D0 DD .. .., .. .. . . . . . .. . .••• .. ..-·· .. .. .,.. ---- . . .. . .... . : .. , ... :.,,,.

File this report and any amendments with the Secretary of the Senate, Office of Public Records, Room 232, Hart Senate Office Building, U.S. Senate, Washington, DC 20510. $200 Penalty for filing more than 30 days after due date.

ONLY by the Office of the Secretary of the Senate to any requesting person upon written application and will° be reviewed by the Select Committee This Financial Disclosure Statement is required by the Ethics in Government Act of 1978, as amended. The statement will be made available

on Ethics. Any individual who knowingly and willfully falsifies, or who knowingly and willfully fails to file this report may be subject to civil and criminal sanctions. 5 U.S.C. 6. 104, and 18 U.S.C. 1001.

· .. rri

Certification Individual Date Year ·ni:JfT)LJ1I CERTIFY that the statements I have made on this fOITrl and all

<_, r"1 -0 -

:x -ol\attached schedules are true,

complete and comict to the best of 12, '2-•o<,. N (/}(Tlz

•and belief. .s:- >

rTlIt is the Opinion of the reviewer that the statements made in this fonn are in compliance with Title I of the Ethics in Government Act.

-i

i

Page 2: 9£t3 2 39.3 2 4 - Home | Judicial Watch...8 YPO Windy City Chapter (Spouse) Chicago, IL : Speech 11107105 : $100,000 : 9 Jewish Federation of Metropolitan Chicago (Spouse) Chicago,

9£tfH:H3 2 39.3 2 4 Reporting Jndivicluars Name

PART II. EARNED AND NON-INVESTMENT INCOME p--2

Report the source (name and address}, type, and amount of earned income to you from any source aggregating $200 or more during the reporting period. For your spouse, report the source (name and address) and type of earned income which aggregate $1,000 or more during the reporting period. No amount needs to be specified for your spouse. (See p.3, CONTENTS OF REPORTS-Part 8 of Instructions.) Do not report income from employment by the U.S. Government for you or your spouse.

Individuals not covered by the Honoraria Ban: For you and /or your spouse, report honoraria income received which aggregates $200 or more by exact amount, give the date of, and describe the activity (speech, appearance or article) generating such honoraria payment. Do not include payments in lieu of honoraria reported on Part I.

Name of Income Source Address (City, State} Type of Income Amount

Example: JP Computers Wash., DC Example · Salary Example $15,000

MCI (Spouse) Arlington, VA Example Salary Example Over$1,000

1 Serono International (Spouse} Paradise Island, The Bahamas Speech 02/03/05 $150,000

2 Jewish Federation Council of Greater L.A. (Spouse) Los Angeles, CA Speech 02/16/05 $125,000

3 CLSA (Spouse} Hong Kong, PRC · Speech 02122105 $100,000

4 Savage/Rothenberg Productions (Spouse) Los Angeles. CA Speech 03/02/05 $125,000

5 Savage/Rothenberg Productions (Spouse} Los Angeles, CA Speech 03/03/05 $125,000

6 Association of Southern California Defense Counsel (Spouse} Los Angeles, CA Speech 03104/05 $125,000

7 Goldman Sachs {Si)ouse} Kiawah Island, SC Speech 04/20/05 $125,000

8 Global Strategic Ventures (Spouse) New York, NY Speech 04/26/05 $150,000

9 Deutsche Bank (Spouse} Baltimore, MD Speech 05/04/05 $150,000

10 Lancaster Chamber of Commerce (Spouse) Lancaster, PA · Speech 05104105 · $150,000

11 National Multi-Housing Council (Spouse) New York, NY Speech 05/10/05 $150,000

12 KMD (Spouse) Copenhagen, Denmark Speech 05117/05 $250,000

13 Griwa Consulting GMBH (Spouse} Berne, Switzerland Speech 05/18/05 $250,000

14 American Academy of Achievement (Spouse) New York, NY Speech 06/01 /05 $150,000

Page 3: 9£t3 2 39.3 2 4 - Home | Judicial Watch...8 YPO Windy City Chapter (Spouse) Chicago, IL : Speech 11107105 : $100,000 : 9 Jewish Federation of Metropolitan Chicago (Spouse) Chicago,

0fH?J'06 2 3-03 2 5 Reporting lndivldUal's Name p __ , HILLARY RODHAM CLINTON PART II. EARNED AND NON-INVESTMENT INCOME 3

Report the source (name and address), type, and amount of earned income to you from any source aggregating $200 or more during the reporting period. For your spouse, report the source (name and address) and type of earned income which aggregate $1,000 or more during the reporting period. No amount needs to be specified-for your spouse. (See p.3, CONTENTS OF REPORTS-Part B of.Instructions.) Do not report income from employment by the U.S. Government for you or your spouse.

Individuals not covered by the Honoraria Ban: For you and /or your spouse, report honoraria income received which aggregates $200 or more by exact amount, give the date of, and describe the activity (speech, appearance or article) generating such honoraria payment. Do not include payments in lieu of honoraria reported on Part I.

Name of Income Source Address (City, State) Type of Income Amount

JP Computers Wash., DC Example Salary Example $15.000Example: Over$1,000 MCI (Spouse) Arlington, VA Example Salary ExampltJ

1 Goldman Sachs (Spouse) Paris, France Speech 06/06/06 $250,000

2 Congregation Beth-El Zedeck (Spouse) Indianapolis, IN Speech 06/08/05 $150,000

3 America's Health Insurance Plans (Spouse) Las Vegas, NV Speech 06/10/05 $150,000

4 Goldman Sachs (Spouse) Greensboro, GA Speech 06/13/05 $150,000

5 Gold Service International (Spouse) Mexico City, Mexico Speech 06/21/05 $200,000

6 Gold Service International (Spouse) Bogota, Columbia Speech 06/22105 $200,000

7 Gold Service International (Spouse) Sao Paulo, Brazil Speech 06/23/05 $200,000

8 Gold Service International (Spouse) Sao Paulo, Brazil Speech 06/24/05 $200,000

9 Blex S.L (Spouse) Canary Islands, Spain Speech 07/24/05 $350,000

10 Carnegie Abbey Club (Spouse) Portsmouth, RI Speech 08/11/05 $150,000

11 Deutsche Bank (Spouse) New York, NY Speech 08/11/05 $150,000

12 HSM Italia (Spouse) Video Conference from New York Speech 09120/05 $125,000

13 Young President's Organization (Spouse) New York, NY Speech 09/20/05 $150,000

14 Leading Minds (Spouse) Copenhagen, Denmark Speech 10/03/05 $125,000

Page 4: 9£t3 2 39.3 2 4 - Home | Judicial Watch...8 YPO Windy City Chapter (Spouse) Chicago, IL : Speech 11107105 : $100,000 : 9 Jewish Federation of Metropolitan Chicago (Spouse) Chicago,

I I

Development Corporation (Soouse)

0000:0230326 Reporting Individual's Name HILLARY RODHAM CLINTON PART II. EARNED AND NON-INVESTMENT INCOME

Page Number

4

Report the source (name and address), type, and amount of earned income to you from any source aggregating $200 or more during the reporting period. For your spouse, report the source (name and address) and type of earned income which aggregate $1,000 or more during the reporting period. No amount needs to be specified for your spouse. (See p.3, CONTENTS OF REPORTS Part B of Instructions.) Do not report income from employment by the U.S. Government for you or your spouse.

Individuals not covered by the Honoraria Ban: For you and /or your spouse, report honoraria income received which aggregates $200 or more by exact amount, give the date of, and describe the activity (speech, appearance or article) generating such honoraria payment. Do not include payments in lieu of honoraria reported on Part I.

Name of Income Source Address (City, State) Type of Income Amount

JP ComputersExample: MCI (Spouse}

Wash., DC Example

Arlington, VA Example

Salary Example

Salary Example

$15,0()()

Over$1,000

1 Adam Smith Conferences (Spouse)

2 tinePublic, Inc. (Spouse)

Moscow, Russia

London, Ontario, Canada

Speech 10/12/05

Speech 10!17/05

$125,000

$125,000

3 International Centre for Business Information (Spouse) Video Conference from Toronto, Canada Speech 10118/05 $125,000

4 The Power Within (Spouse) Toronto, Canada Speech 10/18/05 $350,000

5 The Power Within (Spouse) Calgary, Canada Speech 10!19/05 $300,000

6 Leading Minds (Spouse) Sydney, Australia Speech 10!27/05 $125,000

7 Jewish Federation of Metropolitan Chicago (Spouse) Chicago, IL Speech 11/07/05 $150,000

8 YPO Windy City Chapter (Spouse) Chicago, IL Speech 11107105 $100,000

9 Jewish Federation of Metropolitan Chicago (Spouse) Chicago, IL Speech 11/08/05 $150,000

10 Golden Tree Asset Management (Spouse)

11 Macklowe Properties on behalf of State of Israel Bonds

New York, NY

New York, NY

Speech 11109/05

Speech 11/10!05

$150,000

$250,000

12 Global Business Enterprises (Spouse) Abu Dhabi Speech 11/15/05 $300,000

13 Leading Minds (Spouse) Dubai, UAE Speech 11/28/05 $125,000

14 Hubert Burda Media GmbH (Spouse) Munich, Germany Speech 12/01/05 $300,000

Page 5: 9£t3 2 39.3 2 4 - Home | Judicial Watch...8 YPO Windy City Chapter (Spouse) Chicago, IL : Speech 11107105 : $100,000 : 9 Jewish Federation of Metropolitan Chicago (Spouse) Chicago,

3 royalties charity)

Compensation

partner

BfH'.)002 39327 PageNunberReporting lrdividll<ll'S Name

HILLARY ROD HAM CLINTON PART II. EARNED AND NQN:.INVESTMENT INCOME 5

Report the source (name and address). type, and amount of earned income to you from any source aggregating $200 or more during the reporting period. For your spouse, report the source (name and address) and type of earned income which aggregate $1,000 or more during the reporting period. No amount.needs-to be specified for your spouse. (See p.3, CONTENTS OF REPORTS PartB of-Instructions.) .Do not.report income from employment by.the U.S. Government for you or your spouse.

Individuals not covered by the Honoraria Ban: For you and /or your spouse, report honoraria income received which aggregates $200 or more by exact amount, give the date of, and describe the activity (speech, appearance or article) generating such honoraria payment. Do not include payments in lieu of honoraria reported on Part I.

Name of Income Source Address (City, State) Type of Income Amount

Example; JP Computers Wash., DC Example Salary Example $15,000 MCI (Spouse) Arlington, VA Example Salary Exe mp/fl Over$1,000

1 Leading Minds (Spouse) Munich, Germany Speech scheduled for $125,000

12/13/05

2 Simon & Schuster Inc. - Living History Parsippany, NJ Book Royalties $872,891

Simon & Schuster Inc. - It Takes a Village (Senator Clinton Parsippany, NJ Book Royalties $4,465donates the from this book to

4 Random House {Spouse) New York, NY Book Royalties over $1,000

5 Info US A (Spouse) Omaha, NE Nonemployee

over $1,000

6 Yucaipa Global Opportunities Fund I, LLC {Spouse) Los Angeles, CA Guaranteed payments

over $1,000lo

7

8

9 .

10

11 -

12 .

13

14

Page 6: 9£t3 2 39.3 2 4 - Home | Judicial Watch...8 YPO Windy City Chapter (Spouse) Chicago, IL : Speech 11107105 : $100,000 : 9 Jewish Federation of Metropolitan Chicago (Spouse) Chicago,

1 value) (S)

1 value)

I 1

System (S) 1

value} {S}

.... r _;. ..,. -

x

x

l·d:

-

f.:;.2

;�� I'""'' :!% .· I 1::·

_.,. "''"I , :�1. lff

l,.·c. [?

{

�x'

.ii

x

: ;: -

;u_

I · 0, It

::�:

a. -

"rd l '.14

;! Other 1ic;: c:;l

! ) : .: (Specifylt.§ fC:l . .,, ' 8 ·

;N; : · . ; t l l '

"• ; ;) r�� ,. ;J li.l(1

lt;t,; , !! K;:;�

. c

.... .,

l'.,; m UN \)('.

1:;z:,

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0 ci 0 IO <ft ....

g: 0 .0 g .... ..,.

I ;:

il

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:

ti1 i - o :o·

t::

'00£)00.23032 8 Reporting Individual's Nilma P9Ni..<mor

PART lllA. PUBLICLY TRADED ASSETS AND UNEARNED INCOME SOURCES HILLARY RODHAM CLINTON 6 ·BLOCK A BLOCKS BLOCKC

Identity of Publicly Traded Assets Valuation of Assets Type and Amount of Income And Unearned Income Sources

Report the complete name of each publicly

At tile close of r!lporting period. If None. or less thart $1,001,

If "No11e (or less tha_n $_21!1)" is ghecked, rio ot_her enlly is needed In BJo _C fO! tha! item. Thjs includes income received or accrued to the benefit of the individual.

traded asset held by you, your spouse, or your dependent child, (See p.3, CONTENTS OF REPORTS Part B of fnstructions) for production of income or investment which:

Check the first column.

(1) had a value exceeding $1,000 at the close of the reporting period; and/or

(2) generated over $200 in "unearned' income during the reporting period.

Include on this PART lllA a complete identification of each public bond, mutual fund, publicly traded partnership interest, excepted investment funds, bank accounts, excepted and qualified blind trusts, and publicly traded assets of a retirement plan.

Example: . IBM Corp. (stock) or J (SJ Keystone Fund

Citibank (Deposit Accounts) (J)

2 Northwestern Mutual Life Insurance (cash

3 Northwestern Mutual Life Insurance (cash

4 Senate Qualified Blind Trust (J) 5 Arkansas Public Employees Retirement

6 National Life Insurance Company (cash

7

8

9

10

.......

§ xy.:-

x

x

.':.!'"i:

:?

o•r:·

- __;� _ x

"rJ! ...,.,.

:t t; :;: : .. ;::

l�,; ' · :r·

;;; . r:· ••

Type of Income Amount of Income

· -=

x

x

x

x

x

-"f •.

. :f.-.; c

.:.:. ·-'

')c·

-, : F

--::· ·

iii !;;

.:g

8 x :lw 0

' :-:.i

' tt11

,,_;_

re: o .8

Type) ·...; 8 ,, -- - t'°.·.!!: o_ IO ,..-,5. ;:; "! f0 �� ,: 8 0 fg'r"":;

i-Cj 0 IO ; '

Exlimple x

x

EKample

fj"f,t[• .;J·

-, : i.-·.-.:

x

'"'

··;<.1 .

··.' \: riG i ·i11 i

"''�:" [: · ......

<-

-x _,, . ,

< . . ".

00 00 00

- ·' '•

.. - .: 0

-

"

0 0 o . 0 0

: g-o -g - jO · a :'8 <ft ci • ·e:,-

& g 8_g w; o :4§ <ft <ft

x

x

Actual Amount

Required if

"Other' Specified

ExampleExample

EXEMPTION TEST (see instructions befor£J matking box): If you omitted any asset because lt meets the three-part test for exemption described In the lnstrudions. please check box lo the right. -·This categoiy applies only if the asset ls/was held independently by the spouse or dependent child. If !he asset ls/Was either held by the filer or joinUy held, use the other categories ofvalue, as appropriate. D

Page 7: 9£t3 2 39.3 2 4 - Home | Judicial Watch...8 YPO Windy City Chapter (Spouse) Chicago, IL : Speech 11107105 : $100,000 : 9 Jewish Federation of Metropolitan Chicago (Spouse) Chicago,

" .-) :d -<::;,:'. r>lg-;: __

(f;:;11:::;1gi p, 8r!E' ;_, ·-· I i '.; ,' f ;L g ?,; .

c

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oaid)

rt ;.::::r:: ; ,;:· :t9 lbl :: < n :

' 2005;? ;' ·5t :J

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f4 t

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'::l l 1 11 i: o ''fA-::< 0 .... . :,. ;:i?�Y..�: 11 1 ..1 1:1 i l 1f mxT A-l'illliJ n.t:;;i B,00··::1 if: ·1 1··x:·1 Jt I 1 1M l 1;, ?1 'rod: I ... = .rift: ,,: ·'--

evo1w :lifoAci x l":::"li

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7

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00008230329 Reporting lndividuars Name p--

PART VII. LIABILITIES

f,.: ··.o.&; 'j -. i)t'l>iT' ; of Amount of Value

Report liabilities over $10,000 owed by you, your spouse, or dependent child (See p.3 = - <t:J ,. .· . ·; tK(.= : /

I ·

CONTENTS OF REPORTS Part B of Instructions), to any one creditor at any time ·

during the reporting period. Check the highest amount owed during the reporting ::1 .$ period. Exclude: (1) Mortgages on your personal residences unless rented; (2) loans ro

a:: secured by automobiles, household furniture or appliances; and (3) liabilities owed to ii)certain relatives listed in Instructions. See Instructions for reporting revolving charge : accoun . Jg

Name of Creditor Address Type of Liability

.0 g

tit tit tit tit.tittit :-.tit',;i ,:ir.J! :7: :,·r 'i;,;,.'i_',

s. First District Bank Wash., DC Mortgage on undeveloped land 13% x pExample: DC,

e p ·. :.

Wash., DC Promissory Note : 10% · .: .. ; : _ .. . ..... ;orJ (J) John Jones ; g:E

2

Citigroup New York, NY Credit Card (monthly balance - :-;: ;: L; :·;

:;·-·

·.!"

· · . :.

3

4 k;1; ��H;i: •. : ' 1·.

-::w : .

f� t:��it:f.·.··: ... • • k ·:, '!.F

_::) .·· . .- . '

5

6 ;.J ·· :: ·:·r:

; :: 7

a

9

1 1

12

�r.�[ll! :

-. : : t:r:

" '

.. :;l . . . • : 'j

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EXEMPTION TEST (SH inslltlctions before marking box}: If you omitted any asset because it meets the three-part lest for exemption described in the Instructions, please check box to the right. ••• lhJs category applies only If the asset ls/was held Independently by the spouse or dependent child. If the asset istwas either held by the filer or Jointly held, use the other categories of value. as appropriate. D

Page 8: 9£t3 2 39.3 2 4 - Home | Judicial Watch...8 YPO Windy City Chapter (Spouse) Chicago, IL : Speech 11107105 : $100,000 : 9 Jewish Federation of Metropolitan Chicago (Spouse) Chicago,

indenendentlv manaaed, fullv olan)

ovtions

oursuant customarv trade)

(will royalty payments pursuant customarv trade)

Foundation)

paid by publisher}

assianed Society)

payments assiQned Society paid directly by publisher)

14

00000236330 Reporting lndlviduars Name

PART IX. AGREEMENTS OR ARRANGEMENTS

Page Humber

8

Report your agreements or arrangements for future employment (including agreements with a publisher for writing a book or sale of other intellectual property), leaves of absence, continuation 9f payment by a former employer (including severance payments), or continuing participation in an employee benefit p lan. See Instructions regarding the reporting of negotiations for any of these arrangements or benefits.

Status and Terms of any Agreement or Arrangement

Pursuant to partnership agreement, wilf receive lump sum payment of capital account & partnership share calculated on services performed through 11/0X and retained pension benefits (diversified,

Example: funded, defined contribution

Employment agreement with XYZ Co. to become Vice President of Government Relations. Terms of agreement include salary between $50,001-$100,000, signing bonus between $2,501-$5,000 and stock

1 Publishing agreement regarding the literary work "It Takes a Village" (will receive royalty payments to usual and terms of the

2 Publishing agreement regarding the literary work "Living History" approved by Select Committee on Ethics receive to usual and terms of the

3 Publishing agreement regarding the work "Dear Socks, Dear Buddy" (royalty payments assigned to the National Parks

4 Charitable gift assignment regarding the work "Dear Socks, Dear Buddy" (royalty payments assigned to National Parks Foundation and directly the

5 Publishing agreement regarding the literary work "Invitation to the White House" (royalty payments

to the White House Historical

6 Charitable gift assignment regarding the literary work "Invitation to the White House" (royalty to the White House Historical and the

7

8

9

10

11

1 2

13

Parties Date

Jones & Smith, Hometown, USA Example 1183

XYZ Co., Bethesda, MD Example 1/0X

Simon & Schuster, Inc. 01/04/96

Simon & Schuster, Inc. 01/02/01

Simon & Schuster, Inc. 09/98

National Parks Foundation 09/98

Simon & Schuster, Inc. 12/99

White House Historical Society 12199

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