XGR Campbell SFI

download XGR Campbell SFI

of 4

Transcript of XGR Campbell SFI

  • 8/14/2019 XGR Campbell SFI

    1/4

    , i f, cNEBRASKA POSTMARK ~;lPDATE 7'\1,ACCOUNTABILITY ANDDISCLOSURE COMMISSION STATEMENT MICROFILM 794013211th Floor, State Capitol NUMBEROF q'lP.O. Box 95086 OFFIr'ifl 'nLincoln, NE 68509 FINANCIAL U N C O L rtN E p .R A S f1 f!(402) 471-2522 v . s: 1 > .,INTERESTS z o n 9 H A R 2 4 P M 3: 34BEFORE COMPLETINGREAD FILING REQUIREMENTS r . ~ E ,A C C O U 1 H / ~ B 1 L / T Y & :NADC FORM C-1 D I S C L O S U R tC O t 1 M iS S I O N

    Candidates for designated offices and holders of designated offices and positions must file this statement. See Sections 1A and18 of the instructions. Candidates (including incumbents) subject to this filing requirement must file with the Commission and with the appropriateelection official (See Instructions). Designated officeholders and holders of designatedpositions must file this statement with the Commission annually. Dollar values need not be report for any item, except Item 11. Persons who fails to file as required is subiect to a civil penalty of up to $2,000.

    ITEM 1 IYOUR NAME, ADDRESS AND PHONE NUMBERName CAMPBELL KATHY Telephone No. 402-423-3311LAST FIRST MIDDLEAddress 6111 Chartwell Lane Lincoln NE 68516

    STREETADDRESSORRURALROUTE CITY STATE ZIPCODEITEM 2 IOCCASION FOR FILING (Check Appropriate Box)

    D A candidate for elective office D Left office or position[8] 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 requires this filing. If you have left office, list the officeyou held.Office or Position: State Senator Term: Jan '09 - Jan '13

    BEGINS ENDSName of City, County, District, or State Agency: District 25ITEM 4 IOFFICE SOUGHT (Candidates only. See 1A of instructions)List the office sought which requires this filing.Office:Name of City, County, District, or State Office:

    ITEM 5 IPERIOD COVERED BY THIS STATEMENTThis statement must cover all financial interestsfor the entire "preceding calendar year" and not just as of year-end. If you haveleft office, this statement must cover all financial interestsfrom the end of the calendaryear for which you previously filed up to andincluding the date you left office.[ g J This statement covers the preceding calendar year January1 through December 31, 2008D L eft o ffi c e, th is s ta te m e nt co ve rs th e p erio d Ja nu ary 1 , to (DATEYOULEFTOFFICEORPOSITION)

    I RevisedAugust2007

  • 8/14/2019 XGR Campbell SFI

    2/4

    - . . ~" . ..ITEM 6 ISOURCES OF INCOME OF OVER $1,000Income includes money or any other form of recompense consfitutinq 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. l ist the amount of the income.1.) CEDARS Home for Children Foundation 1a.) non-profit child serving agency; fundraising division

    620 North 48th St., Suite 110Lincoln, NE 68504

    2.) Northwoods LL 2a.) land development company5625 South 56th SI.Lincoln, NE 68516

    3.) Vil lage Gardens Development Co. LLC 3a.) land development company5625 South 56th s r .Lincoln, NE 68516

    4.) Campbells Nurseries & Garden Centers Inc. 4a.) retail nursery, landscape & garden center business5625 So. 56th siLincoln, NE 68516

    'NOTE: IF INCOME RESULTED FROM EMPLOYMENT BY, OPERATION OF OR PARTICIPATION IN A PROPRIETORSHIP, PARTNERSHICORPORATION OR OTHER PERSON, LIST THE SAME AS THE SOURCE OF INCOME, BUT NOT THE PATRONS, CUSTOMERS, PATIENTS,CLIENTS THEREOF.ITEM 7 I BUSINESSES WITH WHICH YOU ARE ASSOCIATED (See definitions)Name and address of all businesses, organizations, or associat ions (prof it and non-profit) with which you held a position of officer, director, limi ted liabcompany member, partner, or stockholder and any entity in which you held a position of trustee. Such reporting 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.) BryanLGH 1a.) Medical Center Board of Trustees, Secretary

    1600 South 48th community hospital boardLincoln, NE 68506

    2.) Lincoln Electric System 2a.) Administrative Board, Vice-chair1040 0Street advisory board to the City of Lincoln's public power utilityLincoln, NE 68508

    3.) Leadership Lincoln 3a.) Board of Directors920 0Street, #300 non-profit organization providing leadership training programs for adultsLincoln, NE 68508 _and youth

    4.) Nebraska On the Move 4a.) Board of Directors530 South dSt., Ste. 110 non-profit organization studying Nebraska transportation needsLincoln, NE 68508

    5.) Sa.)

    6.) 6a.)

    7.) 7a).

  • 8/14/2019 XGR Campbell SFI

    3/4

    ._

    " , \,\!"ITEM 8 I REAL PROPERTY OF THE 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 identthe location of the property. Exceptions: You need not report real estate owned by a business listed in Item 6 or 7, your personresidence of real property valued at less than $1,000. Personal residence refers to your principal dwelling-house and adjacent land usfor house-hold purposes, such as lawns and qardens.

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

    Pilger, Stanton County 240 acres - rural,non-improved agricultural real estate

    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 REPORTING PERIOD(a) List the names and addresses of the institutions in which you had checking and savings accounts and certificates of deposit.

    Financial Institution AddressUnion Bank and Trust Co. 4243 PioneerWoods Dr., Lincoln, NE 68506

    (b) List the names of the issuers of all stocks, bonds, and government securities, not otherwise listed under Items 6 or 7.AG Edwards 6003 Old Cheney Rd., Suite 200 Lincoln. NE 68516

    (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 andestates, cash value life insurance, IRAs, deferred income and retirement plans. Exception: Do not include accounts receivable,inventory, fixtures and equipment owned or used by a business listed in Items 6 & 7 or household goods, personal automobiles andother tanqible personal property unless such property was held primarily for sale or exchanqe.

  • 8/14/2019 XGR Campbell SFI

    4/4

    , " IJITEM 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 AddressAmerican National Bank 3801 Vermaas PI. Lincoln, NE 68502Union Bank and Trust Co. 4243 Pioneer Woods Dr., Lincoln, NE 68506

    ITEM 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 f

    GiftChoose 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.Ihereby state that Ihave used all reasonable diligence in the preparation of this Statement and that to the best of my knowledge it is truand complete.

    ~ ~ AAA. .- I s....--- ~/~?;lOq(Signature of Filer) I , (Date) .