OCC Jerram SFI

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    ~" N'EBRASKA I ~ , t POSTMARK 02/r ; l r J / t J C J;- DATEACCOUNTABILITY AND ..DISCLOSURE COMMISSION STATEMENT MICROFILM ' 1 , 9 0 C f0 5 011th Floor, State Capitol 'R ,..it'1t~~t',OF ; v*-lV "'-'''' '.' '.'P.O. Box 95086 f L E c T hHCC14\6l;iia~~~!QNL y' . ". . " , . , ' .Lincoln, NE 68509 FINANCIAL )\1...''\.)'(.\ i"t.~. ';"CO i iJ ~I>J:!R' ~~~l402) 471-2522 INTERESTS 1 M ' L1N ..n".-, .P".,j~.' ""-BEFORE COMPLETING l3 tJ IlGl)" p lU 0 9 F E B 2 3 A M 9 : 17READ FILING REQUIREMENTS ! N E . A C C D V l f L i 1 ,B i L i T Y &NADC FORM C-1

    " V IS C L O S U R C O ! " iM IS S !O N Candidates for designated offices and holders of designated offices and positions must file this statement. See Sections 1A and1B of the instructions. Candidates (including incumbents) subject to this fi ling requirement must fi le with the Commission and with the appropriateelection official (See Instructions). Designated officeholders and holders of designated positionsmust file this statementwith the Commission annually. Dollar values need not be reportfor any item, except Item 11. Persons who fails to file as required is subject to a civil penalty of up to $2,000.ITEM 1 I YOUR NAME, ADDRESS AND PHONE NUMBER

    Name :JCtteA /IV] C It e x : Q?JP 1ft ~ 2 ) Telephone No. If(J(}-q3;}-l{~lqLAST . FIRST MIDDLEAddress i( l '10 t-hcff::or '"'v rJ- {)M~ N 6rto'STREETADDRESSORRUIQALROUTE CITY STATE ZIPCODEITEM 2 I OCCASION FOR FILING (Check Appropriate Box)

    [A candidate for elective office D Left office or position ,Annual officeholder's or state employee's report D Newly appointed to office or positionITEM 3 I OFFICE HELD & TERM OF OFFICE (Incumbent elected/appointed officials and state employees. SeeIB of instructions)List the office or positionyou currently hold which requiresthis filing. If you have left office, list the office you held.Office or Position: Term:

    BEGINS ENDSName of City, County, District, or State Agency:ITEM 4 I OFFICE SOUGHT (Candidates only. See 1A of instructions)List the office sought which requires this filing. r - - - - . . ~.r

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    ITEM 6 ISOURCES OF INCOME OF OVER $1,000Income includes money or.any other form of recompense constituting income under the Internal Revenue Code. (See definitions)Name and address of any source' (including an individual, business, I List the nature of the source's business and the nature of the services youbody of government, political subdivision or body corporate) from rendered or the circumstances under which income was received. NOTE: Dowhom incorne of over $1 ,000 was received. list the amount of the income.1.) ;~i /: l t?~~~1RC,; t : CO. 1a.) LA 1_ ? ; ' r . . . . . . , - I ~ ..-:1.PiVIiC es\I

    () ./Vt~ /V~ & rto it2.) 2a.)

    3.) 3a.)

    4.) 4a.)

    'NOTE: IF INCOME RESULTED FROM EMPLOYMENT BY, OPERATION OF OR PARTICIPATION IN A PROPRIETORSHIP, PARTNERSCORPORATION OR OTHER PERSON, LIST THE SAME AS THE SOURCE OF INCOME, BUT NOT THE PATRONS, CUSTOMERS, PATIENTSCLIENTS THEREOF.ITEM 7 IBUSINESSES WITH WHICH YOU ARE ASSOCIATED (See definitions)Name and address of all businesses, organizations, or associations (profit and non-profit) with which you held a posi tion of officer, director, limited lcompany member, partner, or stockholder and any entity in which you held a position of trustee. Such reporting is requi red based on the posi tion helon whether income was received. You need not report business associat ions which are otherwise l isted under Item 6.

    Name and Address of Business or Organization I Nature of Association1.) B o,vc.c.) LaA16~D 0~IA 1a.) IU /.. .';P.i' - r.,..e,.;

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    ITEM 8 1 REAL PROPERTY OFi . '~ FILER IN NEBRASKA (Real property ,,_lied at less than $1,000 and yourpersonal residence need not be reported.)List all real property in your name or in which youhave a direct ownership interest. The description required must be sufficient to idethe location of the. property. Exceptions: You need not report real estate owned by a business listed in Item 6 or 7, your persresidence of real property valued at less than $1,000. Personal residence refers to your principal dwellinq-house and adjacent landfor house-hold purposes, such as lawns and gardens.

    Location of Property Nature of Property(Description or Address (such as: agricultural, commercial, industrial, residential-rental)L(illu H-z c~ra S.J-, te;:~~("'iJ?-~~( f W\.~ tJ ~ "&et tJ f a

    ITEM 9 1 OTHER FINANCIAL INTERESTS AND PROPERTY HELD DURING THE PERIOD OF THIS STATEMENTWHICH EXCEEDED A FAIR MARKET VALUE OF $1,000 AT ANY TIME DURING THE REPORTING PERIO(a) List the names and addresses of the institutions in which you had checking and savings accounts and certificates of deposit.

    Financial Institution A~.,,-,F;,rs~ f 3 . " " ' - / : ; t J . ' l A p .. .C v . . . . NIP \.- .t.~LV L0 HVI.~c..tu2. ,,'/J( / '\.. ~ cJY'o-. t t J () ~ j\.l(A - 4 - . O'"Y'wL & . p P C c'1 c.u,oO {>d ~ S~

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    1 I\ ./ITEM 10 I CREDITORS TO WHOM $1,000 OR MORE WAS OWED OR GUARANTEED BY YOU OR A MEMBER OF

    YOUR IMMEDIATE FAMILY.Exception: Loans from a relative and land contracts which have been recorded with the County Clerk or Register of Deeds need not bereported. Accounts payable, debts arising out of retail installment transactions or loans made by a financial institution in the ordinarycourse of business need not be reported.

    Name Address,-c, ' 1 - ; (hdr-fj;:r-.;s-, (,.d .. ~ I fr\._ , c ; - c s ; : j- )J ~A "or.-~ B>&/I-. - t : ? tI~1 ( .,,/; ) t":>o~ S J,o y}t;~ iJt? &,1 t J &./ /U(..V~~rd'-~~C'yU~ILf!'IO p s J . .

    O~.w~ ;Jg ~137ITEM 11 I SOURCES OF GIFTS OF A VALUE OF MORE THAN $100 RECEIVED EXCEPT GIFTS FROM RELATIVES.

    (See definitions) ';Name and address of Donor Occupation or nature of business of Value of Gift Description of Gift andDonor (See Key Below) Circumstances or Occasion foGift

    Choose Value:Choose Value:Choose Value:Choose Value:Choose Value:Choose Value:

    Choose Value:Choose Value:

    The monetary value of each gift shall be categorized based on the good faith estimate of the filer. For each reported gift insert in theValue column the letter which corresponds to the value category of the gift. The value categories are:A) $100.01 to $200; B) $200.01 to $500; C) $500.01 to $1,000; D) $1,000.01 or more.ITEM 12 ISIGNATURE OF FILER AND DATE.I hereby state that I have used all reasonable diligence in the preparation of this Statement and that to the best of my knowledge it is truand complete.Inj'~ :;;'-/)-01L.,P'-- ..~-- U 1'-"7\~ture of Filer) , v (Date)