WPC P59adǜdof(n{SHnw0+ Kx>.k{kEJW_)]xDIyBHne10mrLdžbzC@`A錷bq-uBzn4y^:OWc >\r]trɟ0Zhxh tR  2z  w>|~iѸR$vraBXƬo)%fX&!N~N;gIf @'ZP!-29+Q雿]wq] ƞHL̫Vr5'̮!ƤSh/[?8e^"A }gg3h53ᢾ}GD΀`t@!K Gxb]nԎŃzEUPDToٛyrTA'W`fKF ͽ0^ 4 %@ 04FNz#!| 1k 1u"}w@"4+?N mPgU N   rB)cX( $  HP LaserJet 5Si,,,,,,0$35;AGOW_e11.a.i.(1)(a)(i)1)a)3#37=CIQYag1.a.i.(1)(a)(i)1)a)  EIFs EIF EDHUEs corp     pension contri( 3|xUpension def(@ Z 6Times New Roman RegularȁȁH !   _8Xdd8  _XX%  _@  NotesonSampleOGEForm450 #XXČ#Ԉ    Entriesaremarked Sforspouse, Jforjointand Dfordependentchild.Ifthereisnoletter,weassumethattheentrybelongstothefiler.ThelinesontheSampleOGEForm450arenumberedforreferencetotheseNotes.YoudonotneedtonumberthelinesofyourReport.WeusethefollowingorganizationforPartIandrecommenditforyouruse:salaries,pensions,IRAs,annuities,mutualfunds,stocks,bonds,insurance,property,miscellaneous,estates,andtrusts.Withineachcategory,youarelistedfirst,thenyourspouse,thenyourdependentchild.Morethanonetypeofassetissometimesdiscussedononelinetosavespace. XX PartI.AssetsandIncome #XX# 8  L $3L2  1  .3    ԀYour nongovernmentSALARY, over$200inincome,providedbycloselyheldcompany. @  Forpartnerships,closelyheldcompaniesandsmallbusinessventuresthatare notpublicly 0  traded ,youhavetoprovidethename,location,anddescriptionofitsactivity.Alsonotethat  p  yourpositionwiththecompanyisreportedinPartIII.IfyoutakeyourcompensationfromanScorporationasdividendsratherthansalary,report sharesastheincome.Donotreportyourgovernmentsalary.2  2  .3  ԀSpousessalary,providedbycloselyheldcompany,over$1000inincome.SeeNote1foradditionalinformation.NotethatyourspousespositionwiththecompanyisNOTreportedinPartIII,asonlyYOURpositionsarereportedinthatPart.Donotreportyourdependentchildren'searnedincome.2  3  .3    ԀYour PENSION withGE.Forpensionplans,youmustreportthenameofthecompany,and  ifyoucannotcontroltheplansinvestments,indicate nocontrol.Theseare definedbenefit  p plans.Whenyoucantcontroltheinvestments,youdonthavetoreportthem.SeetheDefinitionsSectionoftheseNotesforfurtherexplanation.Whenyouarenotyetreceivingpayments,indicate Noneintheincomeblock.Becauseyouarereceivingpaymentsover$200,indicate pensionpayment.NotethatthepensionisalsoreportedinPartIV.Donotreportanygovernmentretirementplan,_TSP_ԀorSocialSecuritybenefits.SeeNote4foranothertypeofpension.2  4  .3    ԀYourpensionwithIBM.Thisisa definedcontribution plan,whichmeansthatyoucan #@! selecttheinvestmentoptionorcontroltheinvestmentsinyouraccount,whichmeansthatyoumustreporttheaccountsholdings.Reportthenameofthecompany,thenameofanindependentmanager,ifany,theinvestmentoptionyouselect,suchasgrowth,andanyselectedinvestments,suchasmutualfundsorotherinvestments.Donotindicatethatyouarereceivingpaymentsfromthistypeofpension,astheyarereallywithdrawalsofyourpreviousinvestmentandarenotincome.AlsoreportthepensioninPartIV.SeeNote3foranotherkindofpension.  401(k) plans,403(b)plans,and_SEPs_Ԁ(simplifiedemployeepensionplans),are p+&) establishedbyprivateemployersfortheiremployeesandofferalimitednumberofinvestmentoptions.Reportthenameoftheemployer,thetypeofplan(e.g.,401(k)),andtheinvestment P-(+        option(s)inwhichtheplanisinvested.Theinvestmentoptionsareyouraccountsholdingsandhavetobereported.2  5  .3  ԀYour IRA account.SeetheDefinitionsSectionoftheseNotesforfurtherexplanation.You  mustreporttheIRAsholdings,e.g., MUTUALFUNDS .Forpubliclyavailablemutualfunds, p identifythegeneralfamilyfundname,hereFranklin,andthenameofthespecificfund,hereEquity.YoudonotneedtoreportmoneymarketorcertificateofdepositIRAs.Keoghplans(HR10),forselfemployedindividuals,arecomparabletoIRAs.2  6  .3  ԀSpousesIRAaccount.Thisisa DIRECTEDACCOUNT withabrokeragefirm,soyou  p  mustreporttheaccountsholdings.Theseaccountsmayhavedifferentnames,includingbrokerageandportfolio.Evenifyouallowyourbrokertomakeallthedecisions,youstillhavetheabilitytocontrolyouraccountsholdings,soyouneedtoreportthem.Iftheholdingsarenumerous,youmaywanttoprovideabrokersstatementtrackingtheyearsholdings,andwhiteouttheaccountnumberandthevalues.Iftheholdingsarefew,youcouldlistthemonthelineonwhichyouidentifythedirectedaccount,orprovideaseparatetypedlist.2  7  .3  ԀYour ANNUITY .SeetheDefinitionsSectionoftheseNotesforfurtherexplanation.Foran  annuity,youmustreportthefullnameandwhetheritisfixedorvariable.Ifitis variable ,you  havetoreportyourannuitysholdings.SeeNote + pension contr+6  Հforhowtoreportholdings.2  8  .3  ԀDependentchildsannuity.Asitis fixed ,youonlyneedtoreportthefullname. ` 2  9  .3  ԀYour MUTUALFUND .Forpubliclyavailablemutualfunds,identifythegeneralfamily @ fundname,hereDreyfusPremier,andthenameofthespecificfund,hereCapitalGrowth.Youdonotneedtoreportmoneymarketmutualfunds.2   10  .3  ԀSpouses CASHORASSETMANAGEMENTACCOUNT .Thisaccountoftencontains P assetsotherthanjustcash,suchasamarginaccount,whichisactuallyyourliability,andvariousfunds.Itisnotconsideredamutualfund.Therefore,youhavetoreportthevariousholdingsofthistypeofaccount.IfyouhaveamarginaccountthatmeetsthecriteriaforreportinginPartII,youalsohavetoreportitthere.SeeNote + pension contr+6  Հforhowtoreportholdings.2   11  .3  ԀDependentchild's STOCK inGM.Identifythecompanyandthefactthattheassetisstock. #! Reportdividendsover$200asincome.Becausethestockwassold,mark X,andreporttheincreaseinvalueascapitalgaintypeofincome.2   12  .3  ԀYour BOND .Giveenoughinformationtoidentifythesourceofthebondanditspurpose. `'"% 2   13  .3  ԀYour LIFEINSURANCE policy.Donotreport term lifeinsurancepolicies.For cash @)$' value lifeinsurancepolicies,youmustreportthenameoftheinsurancecompanyandthetypeof 0*%( policy.For wholelife and universal policies,justreportwhichoneitis.SeetheDefinitions  +p&) SectionoftheseNotesforfurtherexplanation. -P(+ 2   14  .3  ԀSpouse's variable lifeinsurancepolicy.Forvariablepolicies,youmustreportthenameof  theinsurancecompany,thatthepolicyisvariable,andthepolicysholdings.SeeNote + pension contr+6  Հforhowtoreportholdings.2  15  .3  ԀJointlyheld RENTAL PROPERTY .NotethatthemortgageisreportedinPartII.You p mustindicateatleastthecityandstate.Youmayaddwhetheritisahouse,condoor_townhome_andthespecificaddresswhenyouhaveseveralinthesamelocality.Youdontreportyourpersonalresidenceifyoudontrentitout.2  16  .3  ԀJointlyheldundevelopedproperty.Ifitisforinvestment,youshouldincludethefactthatitisunimproved,andthecityandstate.Ifyouhavenoincome,put Noneintheincomecolumn.Ifthelandisbeingusedforaprofit,reportthetypeofactivityandincome.2  17  .3  ԀYourinvestmentina NONPUBLICLYTRADEDLIMITEDPARTNERSHIP .Because 0  itsnotpubliclytraded,youhavetoprovidethelocationanddescriptionofitsactivity.Ifitwerea publiclytradedlimitedpartnership ,justlistthefullname.  2  18  .3  ԀYour HONORARIUM forspeakingataconference.Notethatyouhavetoincludethedate.  2  19  .3  ԀYourinterestasabeneficiaryinaprobated WILL ofadeceasedperson.Youmustreport  thatinterestifyourshareoftheestateisover$1000,orifyouarereceivingincomeover$200.Yourinterestasanexecutorinawillofadeceasadedpersionon.Ifyouarereceivingafeeforyourworkasexecutor,anditisover$200,alsolistthefeeasincome.Youmustreporttheestatesholdings,althoughyoudonotneedtoreportpersonalproperty.Donotlistyourinterestasabeneficiaryinthewillofalivingperson.NotethatyourpositionasanexecutorisalsolistedinPartIII.SeeNote + pension contr+6  Հforhowtoreportholdings.2  20  .3  ԀDependentchildsinterestasbeneficiaryandspousesinterestastrusteeinaneducational TRUST establishedbyyouandyourspouseforyourson.SeetheDefinitionsSectionofthese @ Notesforfurtherexplanation.Youwouldneedtoreportiteitherbecauseyourspouseisthetrusteeorbecauseyoursonisthebeneficiary.Youmustreportthetrustsholdings.Becauseyouarenotthetrustee,donotreportitinPartIII.SeeNote + pension contr+6  Հforhowtoreportholdings.XX PartII.Liabilities #XX,# $" C  $$C--2  1  .3  ԀJointmortgageonrentalpropertylistedinPartI,asitisover$10,000duringthereportingperiod.Includethenameofthebank,andthecityandstate.Youshouldreferencewhichproperty,especiallyifyouhavemorethanone.Notethatyoudonotneedtoreportanymortgageonyourpersonalresidence.2  2  .3  ԀDependentchild'sstudentloan.2  3  .3  ԀYourmarginaccountmustbelistedifitmeetsthereportingcriteria. (-x(+ ЇXX PartIII.OutsidePositions #XX=0#  C  $$C--2  1  .3  ԀYourpositionasPresidentofyourconsultingcompany.Ifyoumakemorethan$200inincome,youalsoneedtoreportitinPart1.Ifnot,onlyreportithere.2  2  .3  ԀYourpositionasanexecutoroftheestate.2  3  .3  ԀYourpositionasanofficerofaprofessionalassociation.Youwouldnotreportitifyouwereonlyamember.2  4  .3  ԀYourpositionasanofficerofahomeownersassociation.Asyounolongerholdtheposition,putan Xinthebox.XX PartIV.AgreementsandArrangements #XX3# 8 C  $$C--2  1  .3  ԀYourGEpensionplan.Includeadescriptionoftheterms,suchaswhenpaymentsbegin.TheplanmustalsobereportedinPartI.2  2  .3  ԀYourIBMpensionplan.Includethedatesandparties.TheplanmustbereportedinPartI.2  3  .3  ԀYouragreementwithBoeingregardingfutureemployment. PartV.GiftsandTravelReimbursements  p C  $$C--2  1  .3  ԀYourfreeticket,whichyoureceivedbecauseyouareanofficer,toattendtheconference.Includelocationanddateoftrip.  "` @ INDEXTOLINESINPARTI    Salaries `    Lines12  SCorp `    Line1  Pensions `    Lines34 p   401(k) `    Line4 `  IRAs   `    Lines56 P  Annuities `    Lines78 @  MutualFunds   Lines5,9 0  Stocks `    Lines6,1011  p    Brokerage   Line6 `    Cash/Asset   Line10 P    Stock `    Line11 @  Bonds   `    Line12 0  Insurance `    Lines1314   Property `    Lines1516  LimitedPartnership  Line17  Honorarium `    Line18  Estates `    Line19  Trusts `    Line_20%   _   XX@% DEFINITIONS #XX%>#Ԉ   Annuities     FixedTheCompanyguaranteesaspecificrateofreturn.  VariableTheinvestorhaslimitedoptionsofinvestmentandthereturnisbasedonperformanceofinvestment. ExceptedInvestmentFunds(EIFs) 󀄀Investmentfundssuchasmutualfunds,commontrust h  fundsofbanks,definedcontributionpensionplans,investmenttrustsandlimitedpartnerships IF  X  theymeetthecriteria.IfaninvestmentfundisnotanEIF,youmustreportitsholdings.StockinindividualcompaniesandbrokerageaccountsarenotEIFs.ThecriteriaforanEIFare:  a)widelyheld(usuallymorethan100participants,suchaspensionplansofmediumtolargecompanies)and  b)independentlymanaged(youhavenocontrolovertheinvestmentsinthefund)andeither  c1)publiclytradedoravailable(asmostmutualfunds)or  c2)widelydiversified(nomorethan5%ofitsvalueinsecuritiesofoneentity(exceptU.S.Government)andnomorethan20%ofitsvalueisinaparticulareconomicorgeographicsector). ExceptedTrusts(_%  ETs_) 󀄀Truststhatyoudidnotcreateandinwhichyouhavenospecific  knowledgeoftheholdingsorsourcesofincome.Youdonotreceiveanyreports.Donotreportitsholdings. IRAs 󀄀Accountsareindividual,sotheyarenotwidelyheldandthusdonotqualifyasEIFs. H TheymaybeinvestedinEIFs. LifeInsurance  h   TermDoesnotrequiredisclosure.  CashvalueThetypesarewholelife(alsoordinaryorstraight),inwhichyouhavenocontroloverinvestments;universal,inwhichyoureceiveaminimallyguaranteedrateofreturn;andvariable,inwhichyouchooseinvestmentsfromseveraloptions. Pensions  $ "   Fixed,guaranteedpensionpaymentTheemployermakescontributionsandguaranteesthateachemployeereceivesacertainfixedbenefit.Youcannotcontroltheassetsofthispension.Donotreportitsholdings.  AbilitytocontrolYoumaymakecontributionstoaseparateaccountmaintainedbytheemployerandreceivewhatevertheinvestmentearns.Ifyoucancontrolorselectthetypesofinvestmentinthisaccount,youmustreporttheaccountsholdings.Iftheinvestmentispooledforalargenumberofemployeesandiswidelydiversified(seeEIFs,above),youonlyhavetoidentifythenameofthepoolanditsmanager.Examplesoftheseare401(k)or403(b)pensions.