Eric F Melgren Financial Disclosure Report for 2010

8/3/2019 Eric F Melgren Financial Disclosure Report for 2010

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AOlORev. 1 /2011 FINANCIAL DISCLOSURE REPORTFOR CALENDAR YEAR 201 0Report Re quired by the Ethicsin Governmen t Act of 1978(5 U.S.C. app. 101-111)

I. Person Reporting ( last name, f irst , middle initia l)Melgren , Er ic F.

4. Tit le (Article I l l judges in dicate active or sen ior s ta tus ;magis t rate judges indicate fu l l- or par t - t ime)U.S. Dis t r ic t Judge - A ct ive

7 . C h a mb e rs o r Of f ice A ddre s sHon. Er ic F. MelgrenUnited S ta tes Cour thouse401 N. Marke tWichi ta , Kansas 67202

2. Court or OrganizationU.S. Dis t r ic t Cour t , D. Kansas

5a . Report Type (check appropria te type)] Nominat ion, Date[] Initial [] Annual [] Final5b. [] Amended Report8 . O n t he ba s i s o f t he i n fo rm a t i o n c o n t a i n e d i n t h i s Re p o r t a n d a n ymod if ica t ions perta in ing there to , i t i s , in my opin ion , in com pliancewith a pp l ica b le l a ws a nd re gu la t ions .

R e vie wing Off ice r Date

3. Date of Repor t05/1112011

6 . R e por t ing Pe r iod01 /01 /2010to12/31/2010

I M P O R T A N T N O T E S : The instructions accompanying this form must be followe~L Complete all parts,checking the NONE box for each pa rt where you have no reportable information. Sign on last page.

I . P O S I T I O N S . ~ R c p o n i .g i . a iv i d u a o . ty ; s e e r p . 9 - 1 3 of filing instructions.)~] NONE (No reportable positions.)

P O S I T I O N

2.3.4.

5.

NAME OF ORGANIZATION/ENTITY

II. AGREEMENTS. m e . o n i n g i n a i v ~ a . a t o n t y ; s e e p p . 1 4 - t 6 of.filing instructions.)~ N O N E (No reportable agree ments.)

D A T E _ PARTIES AND TERMS


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FINANCIAL DISCLOSURE REPORTPage 2 of 6

Name of Person ReportingMelgren, Er ic F.

Date of Report05/I 1 /201 l

I I I . N O N - I N V E S T M E N T I N C O M E . t R e p o n l n g i n d i v ld u a l a . d s p o . s e ; s e e p p . 1 7 - 2 4 of filing instructions.)A. Fi lers Non-lnvestm ent Incom e

~] (No reportable non-investment income.)ONEDATE SOURCE AND TYPE INCOME(yours, not spouses)

B . S p o u s e s N o n - l n v e st m e n t I n c o m e - if you were married during any portlon of the reporting year, complete this section.(Dollar amount not required except for honoraria.)~-~ (No reportable non-investment income.)ONE

D A T EI . 20102.3.4.

SOURCE AND TYPEW e s t E v a n g e l i c a l F r e e C hu 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, enter ta inment .(Includes those to spouse and dependent children; see pp. 25-27 o filling instructions.)~-~ (No reportable reimbursements.)ONE

SOURCE DATES LOCATION PURPOSE ITEMS PAID OR PROVIDED

1 . K a n s a s B e n c h / B a r f u n d 2/18/10 T o p e k a , K a n s a s K a n s a s B a r A s s o c i a t io n t r anspor ta t ionA n n u a l D i n n e r2. A m erica n C o n fe re n ce 2 /25 /10 - 2/26 /I 0 N e w Y o rk, N e w Y o rk P a n e l i s t a t E m p lo y m e n t T r a n s p o r t a ti o n , L o d g i n g , M e a l sInstitute Discr iminat ion Li t igat ionC o n f e r e n c e d3. K a n s a s B e n c h / B a r f un d 8 /2 6/1 0 - 8 /2 8/1 0 C olo ra do S pr in gs , C olo ra do 1 0th C ir cu it B en ch /B ar T ra ns po rta tio n, L od gin g, M e alsco n fe re n ce4.5.


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Name of Pe r son R epor t ingMc l g r e n , E r i c F .

D ate o f Rep o r t05/I 1/2011

V . G I F T S . a n c lu d e s t h o s e t o W o , s e , ,n d d e ~ , e n d e n t ch i l d ren ; see pp . 2 8 - 3 1 of f i l ing inst ruct ions. )N O N E (No reportable gifts.)

SOURCE DESCRIPTION1 .2.3.4.5.

VALUE

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 a . d d e p e n d e . t children; see p p . 3 2 - 3 3 of filing instructions.)~ N O N E (No reportable liabilities.)

C R E D I T O R DESCRI PTI ON1 . D O E S tu d e n t L o a n2.3.4.5.

VALUECODEL


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N a m e o f P e r s o n R e p o r t i n gMelgren , Er ic F.

Date of Report05/I I12011

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 tu e , transactions (Includes those of spouse and dependent children; seepp. 34-60 of filing instructions.)D N O N E (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( in c lu d in g tr u s t a s s e ts ) re p o r t in g p e r io dO) (2 )

Place "(X)" after each asset A m o u n t Type (e.g.,exempt from prior disclosure C o d e 1 d i v . , r e n t ,( A - H ) o r i n t . )

1 . B a n k o f A m e r i c a IRA ( c a s h eqv) None2. Axa Equitable Variable Life Insu rance None3. Vanguard Total Bond Market Index NoneInvestment4. V a n g u a r d L i f e S t ra t e g y C o n s e r v a t ive G r o w th None5. Vanguard Windsor II Fund None

6. American Funds EuroPac R4 None

7. V a n g u a r d L i f e S tr a t e g y Moderate Growth None8. V a n g u a r d L i f e S tr a t e g y Growth Fund None9.

10 .

1 1.

12 .

13 .

14 .

15 .

1 6.

B. C. D.I n c o m e d u r i n g G r o s s v a l u 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 r t i n g p e r i o d

(1 )Type (e.g.,buy, se l l ,

redempt ion)

(2) (3) (4) (5 )D a t e Value [ Gain Identity of

m m / d d / y y Code 2 Code 1 b u y e r / s e l l e r(J-P) (A-H) (if private

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

of repor t ing per iod(1) (2)

V alue V a lu eC ode 2 Method

(J-P) C ode 3( Q-WJ

J T

J T

J T

K T

J T

J T

K T

L T

1 7 .

1. Incom e G ain Cod es: A = $1,000 or less B = $ 1,001 - $ 2,5 00 C =$2 ,50 1 - $5 ,0 0 0( Se e C olum ns B I a nd D4) F = $5 0,001 - $ 100,00 0 G ~$100,001 - $1,000,000 H 1 =$1,000,001 - $5,000,0002. V alue C od e s J = $ 15 ,000 o r less K = $15,001 - $ 50,000 L = $ 5 0,001 - $100,000(See Col um ns C I and D3 ) N =$250.001 - $500,000 O =$500,001 - $1,000,000 P 1 =$1,000,001 - $5,000,000

P3 -$ 25,000,001 - $ 50,000,000 14 = M o re than $50 ,000,0003 . V al ue Met hod Codes Q -Appra i sa l R = Cost (Rea l E s t a t e Onl y ) S =As s e s s me nt( Se e Colu mn C2) U = B ook V al ue V = O t h e r W =Es t ima te d

D = $5 , 001 - $15 , 000H2 -Mor e tha n $5 ,0 0 0 ,0 00M = $100, 001 - $25 0, 000P2 =$5,000,001 - $25,000,000T =Ca s h Ma r k e t

E = $15 , 001 - $5 0 , 000


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N a m e o f P e r s o n R e p o r t in gMelgren , Er ic F.

Date of Report05 / 11/ 2 011

V III . ADDITIONAL INFORM ATION OR EXPLANATIONS.


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Name o f Perso n R ep o r t in gM e l g r e n , E r i c F .

D a t e o f Re p o r t05/1 1/2011

IX. CERTIFICATION.I c e r ti f y t h a t a l l in 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 in g i n f o r m a t i o n p e r t a in 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 l d r e n , i f a n y ) i sa c c u r a te , t r 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 ie 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 ld b e c a u s e i t m e t a p p l i c a b le s t a t u to r yp ro v i s i o n s p e rm i t t i n g non-disclosure.I f u r th e r c e r t if y t h a t e a rn 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 ts w h i c h h a v e b e e n r e p o r t e d a r e i nco m p l i a n ce w i 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 . 7 3 5 3 , a n d Ju d i c i a l C o n fe re n ce r e g u l a t i o n s .

Signatu re: S/Eric F. Melgren

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 FU L L Y F A L S IF I ES O R F A I L S T O F IL 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 RI M I N A L S A N C T I O N S ( 5 U . S . C . a p p . 10 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 eAd m in i s t r a tive O f f ic e o f th e U n i t e d S ta t e s C o ur t sS u i t e 2 -3 01O n e C o lumb us C i rc le , N. E .W a s h i n g to n , D . C . 2 0 5 4 4

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Eric F Melgren Financial Disclosure Report for 2010