OCC Stothert SFI

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    ST A TEMENT ..~'~Jlltt'~I~~~'/O7 0OF RfeE I; l : r o t ; ; IH6~~~i~'~~~1~I.~E.RFINANe IAIl~ a U~. ~~tl?ht~'t.fEB\-lt P If:q 3INTEREST~9 F E B -6 i$ ; A 'R L ~ s g tw N r y , NEE lR A SKA

    NEBRASKAACCOUNTABILITY ANDDISCLOSURE COMMISSION11th Floor, State-CapitolP.b. Box 95086Lincoln, NE 68509(402) 471-2522BEFORE COMPLETING

    READ FlUNG REQUIREMENTS

    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 filing requirement must file with the Commission and with the appropriateelectionofficial.(See Instructions). Desiqnatedefflceholders'and holders of designated positions must file this statement with the Commission annually. Dollar.valoes-need.aot be-report for any item, except Item 11. Persons who fails to file as required is sublect to a civil penalty of UP to $2.000.ITEM1 IOUR NAME, ADDRESS AND PHONE NUMBER

    SEANF I R S T

    5'10 q ~ J IX -r. PCLS-rOTHEE..TLAST

    LMIDDLE

    OM. AHANameAddress

    STREET ADDRESS OR RURAL ROUTE " CITY S TA TE ZIP CODE

    . ITEM 2: IOCCASIONFOR;~ILlNG(Check Appropriate BOx) .St\j::~.i1qid~teforElI,ective office -. ' .. ""'. 0Left office or positionoAO~ualofficeh()lder'sorstate ~mploye~'s~re'porl." 0'Newly'appo~ntedtooffice or-position. ..

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    JJEM 3.l0FF,19t:J-tEL~ & . r~~M 'OF OFFICE (In~~~bent elected/appointed officials and state employees. ~IB 'of Instructions) .' , , .' . '. ...List the office or position you currently hold which requires this filing. If you have le~ office~li~t the office you held.Offic~orPasition: .,~ Term:

    BEGINS ENDSNam ofCity, County,District, or State Agency:ITEM 4 IOFFICE SC?UGHT(Candi~ates only. See 1A of instructions)Listthe office sought which requires this filing.Office: "","0 ',T;':', '("6u iJc...; L

    lJ lS-r R lc:..T ~.ame of City, County, District,or State Office:..,.... . ''''.' ,. '", " ."

    .:" < I" ,_This statement must cover C!IIfjO K . ' , : . 'D Left office, this statementcovers th~ periodJanuary 1,

    . . ,lj"to

    --~---'- (D ATE YOU LEFT OFFICE OR POS ITION)

    Revised August 2007

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    ITEM 6 ISOURCES OF INCOME OF OVER $1,000Income includes money or any other form of recompense constitutinq income under the Internal Revenue Code. (See definitions)Name and address of any source> (including an individual, business, 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: Do nwhom income of over $1,000 was received. list the amount of the income.1.) 1a.)

    2.) 2a.)

    3.) 3a.)

    4.) 4a.)

    'NOTE: IF INCOME RESULTED FROM EMPLOYMENT BY, OPERATION OF OR PARTICIPATION IN A PROPRIETORSHIP, PARTNERSHCORPORATION OR OTHER PERSON, LIST THE SAME AS THE SOURCE OF INCOME, BUT NOT THE PATRONS, CUSTOMERS. PATIENTS,CLIENTS THEREOF.ITEM 7 IBUSINESSES WITH WHICH YOU ARE ASSOCIATED (See definitions)Name and address of all businesses, organizations, or associations (profi t and non-profit) with which you held a position of officer, director, limited liabcompany member, partner, or stockholder and any entity in which you held a position of trustee. Such repor ting is required based on the position held,on whether income was received. You need not report business associations which are otherwise listed under Item 6.

    Name and Address of Business or Organization Nature of Association1.) M.I L.L-~2..D p v i!>L-tL 6(.\-\-00(" S 1a.) ~I tzc..:r~D SL 1-\;00 L ~oA.r2...t> M ElY\ \3E:l2

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    \ITEM 8 I REAL PROPERTY OF HfE FILER IN NEBRASKA (Real property valued at less than $1,000 and yourpersonal residence need not be reported.)List all real property in your name or in which you have a direct ownership interest. The description required must be sufficient to identhe location of the property. Exceptions: You need not report real estate owned by a business listed in Item 6 or 7, your persoresidence of real property valued at less than $1,000. Personal residence refers to your principal dwelling-house and adjacent land ufor house-hold purposes, such as lawns and gardens.

    Location of Property Nature of Property(Description or Address (such as: agricultural, commercial, industrial, residential-rental)

    ;ITEM 9 I 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 REPORTIr-iG PERIOD(a) List the names and addresses of the institutions in which you had checking and savings accounts and certificates of deposit.

    Financial Institution Address

    U~rrED KEPv~LIC-. BI"\t-J ~ I I I N. 1C ()/s 7 . ~T/ p O B~ ~-4D1( CI\-WYDA- l c f>..cco (J";'') o M./'t.liA. rJ e- & , '6l~-yWt-US \-~KbO 13v\tVL o W) 1'\l-{A I n ~ ILJ:\- S K .. A-L r E " Q . . ' 7 o IV A L ~C.C ,",1/ tV, '\

    (b) List the names of the issuers of all stocks, bonds, and government securities, not otherwise listed under Items 6 or 7.

    (c) Describe other property owned or held for the production of income not otherwise disclosed in Items 6, 7, 8 or 9(a)(b). Includeleaseholds and other interests in real estate, promissory notes and other obligations owed to you, beneficial interests in trusts ~(ldestates, cash value life insurance, IRAs, deferred income and retirement plans. Exception: Do not include accounts receivabl~:inventory, fixtures and equipment owned or used by a business listed in Items 6 & 7 or household goods, personal automobiles;l~dother tangible personal property unless such property was held primarily for sale or exchanQe.\

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    ITEM 10 I CREDITORS TO WHOM $1,000 OR MORE WAS OWED OR GUARANTEED BY YOU OR A MEMBER OFYOUR IMMEDIATE FAMILY.Exception: Loans from a relative and land contracts which have been recorded with the County Clerk or Register of Deeds need not breported. 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

    ITEM 11 r 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 Descript ion of Gift andDonor (See Key Below) Circumstances or Occasion fGift

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

    t 'Y 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 , Q O O ; D) $1,000.01 or more.ITEM 12 I SIGNATURE 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.

    ~tfAA ~ n /J/u,4.f ~-I ~ ;A DOC,(Signaturvr) U (Date) I