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Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app..~.~ 101-111)
8. On the basis of the information contained in this Report and any modifications pertaining thereto, it is, in my opinion, in compliance with applicable laws and regulations. , Reviewing Officer Date
IMPORTANT NOTES: The instructions accompanying this form must be fotlowea~ Complete all parts,
checking the NONE box for each part where you have no reportable information. Sign on last page.
NAME OF ORGANIZATION/ENTITY
NORTHERN DISTRICT OF ILLINOIS COURT HISTORICAL ASSOCIATION, an Illinois not-for-profit corporation
3. 4. 5.
II. AGREEMENTS. mo, o.lng i.divia.al o.ty; see ~,p. 14-16 of filing instructions.)
~]
Hart, William T.
Page 2 of 8
Ill. NON-INVESTMENT INCOME. mepo.ing individual andspouse; seepp. 17-24 of filing instructions.)
A. Filers Non-Investment Income
~]
2. 3. 4.
B. Spouses Non-Investment Income - If.you were married during any portion of the reporting year, complete this section.
(Dollar amount not required except for honoraria.)
[~]
I. 2. 3. 4. 5.
V. GIFTS. (Includes those to spouse and dependent children; see pp. 28-31 of fifing instructions.)
NONE (No reportable gi_fis.)
SOURCE I. 2. 3. 4. 5. DESCRIPTION
VALU~
VI. LIABILITIES. tlndudes those of spouse and dependent children; see pp. 32-33 of filing instructions.)
NONE (No reportable liabilities.)
CREDITOR I. 2. 3. 4. 5. DESCRIPTION
VALUECODE
VII. INVESTMENTS and TRUSTS - income, ,alue, transactions (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets (including trust assets) Place "(X)" after each asset exempt from prior disclosure Income during reporting period (1) (2) Amount Type (e.g., Code I div., rent, (A-H) or int.) Gross value at end of reporting period Transactions during reporting period
(1)
Value Code 2 {J-P)
(2)
Value Method Code 2. (Q-W)
(2) (3) (4) Da~e Value Gain mm/dd/yy Code 2 Code I O-P)
(s)
Identity of buyer/seller (if private transaction)
I. 2. 3.
Distribution
4. ---DRU, INC. 5. 6. 7. 8. 9. I0. --Caterpillar FNL SVC ---Dural BK Catano PR CD ---HSBC Fin. Corp. --BBT Cap. T. ---M&T Capital Trust ---PNC Capital Trust E Buy 04115110 M
II. --Credit Suisse GU 12. 13. 14. 15. 16. 17. ---J.P. Morgan Chase ---American Express Credit --American Intl Group ---UBS Bank Deposits UBS FINANCIAL SERV., INC. ---British Petroleum
A Dividend K T
I. Income Gain Codes: (See Columns B I and D4) 2. Value Codes (See Columns CI and D3) 3. Value Method Codes (See Column C2)
A =$1,000 or less F =$50,091 J -$15,000 or less N =$250.04)1 - $500.000 P3 =$25.b~0.0~1 - $50.00{).000 Q =Appraisal U =Book Value
B =$1.0~1 - $2.500 G =SI0~.0~I - $1.0~0,0~0 K -$15.001 - $50.0~) O -$50~.001 - SI,000,0~0 R Co,t (Real Estale Only) V =Other
C =$2,501 - $5,00~ H I =$1,0~9,0~ 1 - $5.0~1,090 L =$50.001 - $100,00~ Pl =$1,000,001 P4 =More than $50.000,0~3~ S =Assessment W =Estimated
D =$5,001 - $15,000 H2 =More than $5,0~0,00~ M =$10~,001 - $250.000 P2 =$5,0D0.0~1 - $25.000,000 T =Cash Market
E =$15.001 - $50,0~O
VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; seepp. 34-60 of filing instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets Income during
(including trust assets) Place "(x)" after each asset exempt from prior disclosure
reporting period (i) (2) Amount Type (e.g., code I div., rent, (A-H) or int.)
Gross value at end of reporting period (I) (2) Value Value Code 2 Method Code 3 O-P)
(Q-W)
Type (e.g.,
buy, sell,
redemption)
18.
---Duke Energy
A B B A A B B A A B A
Dividend Interest Dividend Dividend Interest Interest Interest Interest Dividend Dividend Interest
T T
19. ---Chi Bd. Ed. Bonds 20. 2 I. 22. 23. ---Bristol MeyersSquibb ---General Electric ---Sunrise W & G ---Hudson GO Purp B
K K
T T Redeemed 10/01/10 J A
K L J J K L
T T T T T T
24. ---Luzeme, COGO B 25. 26. 27. ---Kansas CY CLGS ---Credit Suisse ---Deutsche BK Cap 111
28. ---UBS Bank USA 29. 30. 3 I. 32. 33. 34. STOFAN AGAZZI ACCT: ---III. Rural Bk Bd Rev Bond ---Walgreen ---Romeoville, IL GO ---Wash. St. Higher Ed. Fac Bond ---IM-IT Bond Fund 79 (Van Kampen)
B A B B A
K K K K J
T T T T T
Redeemed (part)
08/01/10
I. Income Gain Codes: (See Columns BI and I)4) 2. Value Codes (See Columns CI and D3) 3. Value Mclhod Codes (Scc Column C2)
A =$1.000 or less F =$50,001 - $100,000 J $15,000 or less N =$250.001 - $500,000 P3 =$25.000,001 - $50.000.000 Q =Appraisal U =Book Value
B =$1.001 - $2.500 G =$100,001 - $1.00O,000 K =$15,001 - $50.000 O -$500,00 | - $1,00O.000 R =Cost (Real Estate Only) V Olher
C =$2,501 - $5,000 HI =$1,000.0~1 - $5,000.000 L =$50.001 - $100,000 PI $ 1.000.001 - $5,000.000 P4 =More than $50.000,000 S =Assessment W-Estimated
D =$5.001 - $15,1)00 H2 =More than $5,000,000 M -$100,(~11 - $250,000 P2 =$5,0~0,001 - $25,0~O,0~)0 T =Cash Market
E =$15,001 - $50.000
VII. INVESTMENTS and TRUSTS -income, value, transactions (Includes those of spouse and dependent children; seepp. 34-60 of filing instructiom.)
1~] NONE (No reportable income, assets, or transactions.)
A. Description of Assets (including trust assets) Place ~(X)" after each asset exempt from prior disclosure B. Income during reporting period (1) Amount Code l (A-H) (2) Type (e.g., div., rent, or int.) C. Gross value at end of reporting period O) Value Code 2 (J-P) (2) Value Method Code 3 (Q-W)
Transactions during reporting period
O)
Type (e.g., buy, sell, redemption)
(2)
(3)
(5)
Identity of buyer/seller (if private transaction)
35.
36.
A
A
Interest
Interest
J
J
--Harris Bank(checking) RMA Money Mkt --Mass. Mut. Life Ins. (Paid Up) --The Clare Residency Deposit Account
A A
K J K O
I. Income Gain Codes: (See Columns BI and D4) 2. Value Codes (see Columns CI and D3) 3. Value Method Codes (See Colunm C2)
A =$1,00O or less F =$50,001 - $100,000 J =$ I 5,090 or less N =$250.001 - $500,00~ P3 =$25,000.001 - $50,000.000 Q =Appraisal U =Book Value
B =$1.001 - $2,500 G =$100.001 - $1,000,000 K =$15,1)01 - $ 50,1)00 O =$500.0~1 - $1,000,000 R =Cost (Real Estate Only) V Other
C =$2,501 - $5,000 HI =$1,000,C01 - $5,000,000 L =$50,001 - $ 100,000 PI =$l,000,00l - $5,000,000 P4 =More than $50,000,000 S =Assessment W =Estimated
D =$5.001 - $15,000 H2 =More than $5,000,000 M =$ 100.001 - $250,000 P2 =$5,0~0,001 - $25,000,000 T =Cash Market
E =$15,001 - $50,000
IX. CERTIFICATION.
I certify that all information given above (including information pertaining to my spouse and minor or dependent children, if any) is accurate, true, and complete to the best of my knowledge and belief, and that any information not reported ~vas withheld because it met applicable statutory provisions permitting non-disclosure. l further certify that earned income from outside employment and honoraria and the acceptance of gifts ~vhich have been reported are in compliance with the provisions of 5 U.S.C. app. 501 et. seq, 5 U.S.C. 7353, and Judicial Conference regulations.
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. 104)
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544