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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
AO I0
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
to
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
2,
3.
4.
5,
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
8/3/2019 Joseph S Van Bokkelen Financial Disclosure Report for 2010
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FINANCIAL DISCLOSURE REPORT
Page 2 o f 9
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
2.
3.
4.
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
2.
3.
4.
DATE SOURCE AND TYPE
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
1.
2.
3.
4.
5.
PURPOSE ITEM S PAID OR PROVIDED
8/3/2019 Joseph S Van Bokkelen Financial Disclosure Report for 2010
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FINANCIAL DISCLOSURE REPORT
Page 3 of 9
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
I.
2.
3.
4.
5.
VALUE
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
I.
2.
3.
4.
5.
VALUECODE
8/3/2019 Joseph S Van Bokkelen Financial Disclosure Report for 2010
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FINANCIAL DISCLOSURE REPOR T
Page 4 o f 9
N a m e o f P e r s o n R e p o r t i n g
Van B okke lcn , Jo s eph S .
D a t e o f 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 - 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 . )
2.
3.
4.
5.
6.
7.
8.
9.
10 .
II.
12 .
13 .
14 .
1 5 .
16 .
17 .
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 Dividend
K
J
T
T
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
K
K
T
T
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
8/3/2019 Joseph S Van Bokkelen Financial Disclosure Report for 2010
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FINANCIAL DISCLOSURE REPORT
Page 5 o f 9
N a m e o f P e r s o n R e p o r t i n g
Van Bo kkelen, Joseph S.
D a t e o f R e p o r t
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 . )
N O N E (No reportable income, assets, or transactions.)
1 8 .
1 9 .
20 .
21 .
22 .
23 .
24 .
25 .
26 .
27 .
28 .
29 .
30 .
31 .
32 .
33 .
34.
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
K
-EQ/JP M organ Core Bond Fund
-EQ/Alliance Bem stein Quality Bon d
-EQ/Equity 500 Index
A Dividend K T
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 Dividend
A Dividend
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
8/3/2019 Joseph S Van Bokkelen Financial Disclosure Report for 2010
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FINANCIAL DISCLOSURE REPOR T
Page 6 o f 9
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 .
D a t e o f 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 ~ , 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 . )
35 .
36.
37 .
38 .
39 .
40 .
41 .
42 .
43 .
44 .
45 .
46 .
47 .
48 .
49 .
50.
51.
N O N E (No reportable income, assets, or transactions.)
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 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
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- $50,000
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FINANCIAL DISCLOSURE REPORT
Page 7 o f 9
N a m e o f P e r so n R e p o r t i n g
Van Bokkelen, Joseph S.
D a t e o f R e p o r t
05/15/201 I
V I I . I N V E S T M E N T S a n d T R U S T S - i n c o , ~ e , v a ~ u e , t ~ a , ~ o ~ # o , ~ a n d ~ d ~ t h o s e o / s ~ , o . se o ~ d ~ e ~ , e ~ d e ~ t c h i t d , e ~ : s e e ~ , ~ ,. 3 4 - 6 0 of filing instructions.)
[~ ( N o r e p o r t a b le a s s e t s , o rONE i n c o m e . t r a n s a c t i o n s . )
D e s c r i p t i o n o f A s s e t s T r a n s a c t i o n s d u r i n g r e p o r t i n g p e r i o d
( in c lud in g t rus t a s se t s )
P l a c e " ( X )~ a f t e r e a c h a s s e t
e x e m p t f r o m p r i o r d i s c lo s u r e
I n c o m e d u r in g G ro s s v a lu e a t e n d
r e p o r t i n g p e r i o d o f r e p o r t i n g p e r i o d
( I ) ( 2 ) (l) (2) ( 1 ) (2) (3) (4) ( 5 )
A m o u n t T y p e ( e . g . , V a l u e V a l u e Type (e.g., D a t e V a l u e G ain I d e n t i t y o f
C o d e I d i v . , r e n t , C o d e 2 M e tho d b uy , s e l l , m m / d d / y y C o d e 2 C o d e I b uy e r / se l le r
( A - H ) o r in t . ) ( J - P ) C o d e 3 r e d e m p tio n ) ( J-P ) ( A - H ) ( i f p r i v a t e
(Q-W) t r a n s a c t i o n )
52 .
53 .
54 .
55 .
56 .
57 .
58 .
59 .
60 .
61 .
62 .
63 .
I. In co m e Gain C o d es : A -$ 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
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FINANCIAL DISCLOSURE REPORT
P a g e 8 o f 9
N a m e o f P e r s o 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 .
Date o f Repor t
05/15/2011
VIII. ADDITIONAL INFORMATION OR EXPLANATIONS.
8/3/2019 Joseph S Van Bokkelen Financial Disclosure Report for 2010
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FINANCIAL DISCLOSURE REPORT
P a g e 9 o f 9
Name o f Pe r son Repor t ing
V a n B o k k e l e n , J o s e p h S .
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
8/3/2019 Joseph S Van Bokkelen Financial Disclosure Report for 2010
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AO I0
Rev. 1/2011
FINANCIAL DISCLOSURE REPORT
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
to
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
2.
3.
4.
5.
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
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FINANCIAL DISCLOSURE REPORT
Page 2 of 9
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 .
D a t e o f R e p o r t
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
DATE SOURCE AND TYPE
2,
3.
4.
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
DATE SOURCE AND TYPE
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 )
2.
3.
4.
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
2.
3.
4.
5.
SOURCE DATES LOCATION PURPOSE ITEM S PAID OR PROV IDED
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FINANCIAL DISCLOSURE REPORT
Page 3 of 9
N a m e o f P e r so n R e p o r t i n g
Van B okkelen , Joseph S.
D a t e o f R e p o r t
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
I.
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 . 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
1 .
2.
3.
4.
5.
VALUECODE
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FINANCIAL DISCLOSURE REPOR T
Page 4 of 9 Iame o f Pe rson Report ing
V a n B o k k e l e n , J o s e p h S .
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 ~ )
2.
3.
4.
5.
6.
7.
8.
9.
1 0 .
I1 .
1 2 .
1 3 .
1 4 .
1 5 .
1 6 .
1 7 .
N O N E (No reportable income, assets, or transactions.)
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
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
A
A
Interest K
D iv idend K
T
T
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
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FINANCIAL DISCLOSURE REPOR T
Page 5 of 9
N a m e o f P e r s o n R e p o r t i n g
Van B okkelen , Joseph S.
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~)
1 8 .
1 9 .
20 .
21 .
22 .
23 .
24 .
25 .
26 .
27 .
28 .
29 .
30 .
31 .
32 .
33 .
34 .
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
K
-EQ/JP Morgan Core Bond Fund
-EQ/Alliance Bernste in Q uality Bond
-EQ/Equity 500 Index
A Dividend K T
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
Notes
A Dividend
A Dividend
A Dividend
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 - $50,000
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FINANCIAL DISCLOSURE REPOR T
Page 6 of 9
N a m e o f P e r s o n R e p o r t i n g
Van B okkelen , Joseph S.
D a t e o f R e p o r t
05/15/2011
Vl l . I N V E S T M E N T S a n d T R U S T S - income, vMue, transactions (Includes those of spouse and dependent children; seepp. 34-60 of filing instructlong)
NONE (No reportable income, assets, or transactions.)
D e s c r i p t i o n o f A s s e t s I n c o m e d u r i n g
( i n c l u d i n g t r u s t a s s e ~ ) r e p o r t i n g p e r i o d
(1) (2)
Place "(X)" after each asset ! A m o u n t T y p e ( e . g .,
e x e m p t f r o m p r i o r d i s c lo s u r e [ Code I d i v . , r e n t ,
( A - H ) or i n t . )
G r o s s v a l u e a t e n d
o f r e p o r t i n g p e r i o d
O) (2)
V a l u e V a l u e
C o d e 2 M e t ho d
( J - P ) C o d e 3
T r a n s a c t i o n s d u r i n g r e p o r t i n g p e r i o d
(I ) (2) (3) (4} (5 )
T y p e ( e . g . , D a t e Value Gain I d e n t i t y o f
buy, se l l , m m/ddh/y Code 2 C ode I buyer /se l ler
r e d e m p t io n ) ( J - P ) (A-H) ( i f p r i v a t e
t r a n s a c t i o n )
3 5 . - E l i L i l ly C o . A Dividend J Buy 11115/10 J
36 . -Lockheed Ma ~ inCorp. A Dividend J Bu y 11/15/10 J
37 . -Barclay’s Bk PIc 6.625% Ser & Adr A I n t e r e s t J Bu y 1 0 / 0 7 / 1 0 J
38 . -National W estminster B K PLC SponsoredADR
3 9. -Pe r sh in g Pr ime Res e rv e s
A
A
I n t e r e s t J
I n t e r e s t K
T
T
Bu y 10/07/10 J
Bu y 12/01/10 K
40 .
41 .
42 .
43 .
44 .
45 .
46 .
47 .
C e n t ie r B a n k
Fidelity Fund Cash Reserves
Peoples Bank
Oceana County, BenonaTownship, Michigan
A
A
A
A
I n t e r e s t
I n t e r e s t
I n t e r e s t
R e n t
J
J
J
T
T
T
So ld 07/08 /1 0 A
48 .
49 .
50.
51 .
I. I n co m e G a i n Co d es :
( See C olu mns BI and 1 ) 4)
2. V al ue Co d es
( S c c C o l u m n s C I a n d D 3 )
3 . V a l u c M e t h o d C o d c s
( S c c Column C2)
A =$ 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
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FINANCIAL DISCLOSURE REPOR T
Page 7 of 9
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 .
D a t e o f 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 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~)
52.
53.
54 .
55 .
56.
57 .
58 .
59 .
60.
61 .
62 .
63.
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
(Q-w)
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
t r a n s a c t i o n )
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
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FINANCIAL DISCLOSURE REPOR T
P a g e 8 o f 9
Name of Person Repor ting
Van Bo kkelen , Jo sep h S .
D a t e o f R e p o r t
05/15/2011
VIII. ADDITIONAL INFORMATION OR EXPLANATIONS.
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FINANCIAL DISCLOSURE REPORT
P a g e 9 o f 9
N a m e o f P e r s o n R e p o r t i n g
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