AO 10 Rev.

1/2011

FINANCIAL DISCLOSURE REPORT FOR CALENDAR YEAR 2010

2. Court or Organization U.S. District Court E.D. PA 5a. Report Type (check appropriate type) ] Nomination, [] Initial Date [] Annual [] Final

Report Required by the Ethics in Government Act ofl978 (5 U.S.C. app. 101-111)

I. Person Reporting (last name, first, middle initial) Surrick., Richard B. 4. Title (Article III judges indicate active or senior status; magistrate judges indicate full- or part-time)

3. Date of Report 05/I 1/2011 6. Reporting Period 01/01/2010 to 12/31/2010

U.S. District Judge - Active

5b. [] Amended Report 7. Chambers or Office Address U.S. Courthouse- Room 8614 601 Market Street Philadelphia, PA 19106 8. On the basis of the information contained in this Report and any modifications pertaining thereto, it is, in my opinion, in compliance with nppllcable laws and regulations. Reviewing Officer Date

IMPORTANT NO TES: The instructions accompanying this form must be followed. Complete all parts,
checking the NONE box for each part where you have no reportable information. Sign on last page.

I. POSITION S. tRepor~,~ i.ai~d..I o,ly: ,,, pp. 9-t J of filing instruction&)

~] NONE (No reportable positions.) POSITION

NAME OF ORGANIZATION/ENTITY

2. 3. 4. 5.

II. AGREEMENTS. (R,por~.~ ~.d~v~.ot o,ty; ,,, pp. u4 6 of fillng instructions.)

NONE (No reportable agreements.) DATE
1.2000 2. 3.

PARTIES AND TERMS Commonwealth of PA State Employees Retirement System - No Control

Surrick., Richard B.

FINANCIAL DISCLOSURE REPORT Page 2 of 6

Name of Person Reporting Surrick., Richard B.

Date of Report 05/I 1/201 I

III. NON-INVESTMENT INCOME. tRepo~n# indivi~uot ond s~,o,..e: see ~,~ ~ Z-24 of ~ling instru.ion.)
A. Fliers Non-Investment Income ---] NONE (No reportable non-investment income.) DATE
I. 2010 2. 3. 4.

SOURCE AND TYPE

Commonwealth o f PA State Employee Retirement System

INCOME
(yours, not spouses)

$65,670.24

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.)

NONE (No reportable non-investment income.)

DATE
1. 2. 3. 4.

SOURCE AND TYPE

IV. REIMBURSEMENTS -- transpo.ation, lodging, food, entertainment.

(Includes those to spouse and dependent children; see pp. 25-27 of filing instructions.)

NONE (No reportable reimbursements.) SOURCE

1. 2. 3. 4. 5.

DATES

LOCATION

PURPOSE

ITEMS PAID OR PROVIDED

FINANCIAL DISCLOSURE REPORT Page 3 of 6

Name of Person Reporting Surrick., Richard B.

Date of Report 05/I 1/7011

V. GIFTS. an~l~d,~ ,hose ,o spo~e and dependent children; see pp. 28-31 of filing instructions.) NONE (No reportable gifts.)
SOURCE
1. 2. 3. 4.

DESCRIPTION

VALUE

5.

V I. L I A B I L I T I E S. anclud~ those ofspoase a.d depe.~en, children; see pp. 32-33 offillng instruc~ong)
NONE (]go reportable liabilities.) CREDITOR
I. 2. 3. 4. 5.

DESCRIPTION

VALUECODE

FINANCIAL DISCLOSURE REPORT Page 4 of 6

Name of Person Reporting Surrick., Richard B.

Date of Report 05/I 1/201 I

VII. INVESTMENTS and TR USTS -i.come, val.e, ~..~.c, io.~ a.cl.des,hose o/s~ou~e .nd depende.! children; see plx 34-60 of filing imtruction&)
NONE (No reportable income, assets, or transactions.)
Description of Assets (including trust assets) Income during reporting Ixriod (I) Amount Code I (A-H) (2) Type (e.g., div., rent, or int.) Gross value at end of reporting period (I) (2) Value Code 2 (J-P) Value Method Code 3 (Q-W) (I) Type (e.g., buy, sell, redemption) Transactions during reporting period (2) (3) (4) Value Date mm/dd~ Code 2 (J-P) (5) Identity of buyer/seller (if private transaction)

Place "(X)" after each asset exempt from prior disclosure

Gain Code I (A-H)

Commonwealth of PA Slate Employees Retirement System

None None None

PI J K

W W W Sold (part) 08/06/10 J

2. 3.
4.

Equi Vest Retirement Program Pershing Government Account Rollover Retirement Account

5. 6.
7.

8.

9.

I0.

12.

13.

14.

15.

16.

17.

I. Income Gain Codes: (Sc Columns BI and D4) 2. Value Codes (See Columns CI and D3) 3. Value Method Codes (S~c Column C2)

A =$1,000 or less F =$50.001 - $100,000 J =$15,000 or less N ~$250.001 - $500.0~O P3 =$25.000.00 1 - $50.000.090 Q ~Appmisal U ~Book Value

B =$1,001 - $2.500 G =$100.001 - $1,000.000 K =$15.001 - $50.000 O =$500.001 - $1.000.00~ R =Cost (Real I.state Only) V =O~ho"

C =52,501 - $5.000 III =51.000.001 - $5,000.000 L =$50.001 - 5100.000 PI =51.000.0OI - $5.000.000 P4 =More Ihan $50.000.000 S =Assessment W =Estimated

D =$5.001 - $15.000 112 =More than $5.000.000 M =5100.001 - 5250.000 12 =$5.00).0OI - $25.000.0~O T =Cash Markcl

E =$15.0OI - $50.000

FINANCIAL DISCLOSURE REPORT Page 5 of 6

Name of Person Reporling Surrick., Richard B.

Date of Report 05111/20l I

VIII. ADDITIONAL INFORMATION OR EXPLANATIONS. (Indicate part of report)

FINANCIAL DISCLOSURE REPORT Page 6 of 6 IX. CERTIFICATION.

Name of Person Reporting Surrick., Richard B.

Date of Report 05/I 1/2011

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 was withheld because it met applicable statutory provisions permitting non-disclosure.
1 further certify that earned income from outside employment and honoraria and the acceptance of gifts which 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.

Signature: S] Richard B. Surrick.

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