8/14/2019 XGR Price SFI

1/5

r , '-".- !-' \ I (NEBRASKA POSTMARK ~JATEACCOUNTABILITY ANDDISCLOSURE COMMISSION STATEMENT MICROFILM 7 9 6 C ~ ~ ; _ "NUMBER11th Floor, State Capitol OF J ? C 6 & W i= '[ 'P.o. Box 95086 OFFICE 5 1 ,; - t_ ILincoln, NE 68509 FINANCIAL L !;livUJ;..f"j .:'i~t'!le ( fl :~l\}(402) 471~2522 INTERESTS 2 0 0 9 I 'P R - I P M 3 : 0 ~

BEFORE COMPLETING ~ i E t e c rl t;'IPOd I T YREAD FILING REQUIREMENTS r\ _-~~.; j V - \ .. / ~ ~ }\tn~ P t .NADC FORM C-1 D i S C L O S U R E C D t~ ~ 1 f ~ ! ; 1 S S I Candidates for designated offices and holders of designated offices and positions must fi le 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 appropriateelection official (See Instructions). Designated officeholders and holders of designated positions mustfile this statement with the Commission annually. Dollar values need not be report for any item, except Item 11. Persons who fails to file as requiredis subiectto a civil penalty of UP to $2,000.ITEM 1 IYOUR NAME, ADDRESS AND PHONE NUMBER - -

Name _prl( .e .. - 5co/i Allee Telephone No. i-J02. 2 . .-rs .23 8 ,QLAST FIRST MIDDLEAddress 13702. So 2{3 --/I , (!.ir &Ikvv-e.. Ul 0el23STREETADDRESSORRURALROUTE CITY STATE ZIPCODEITEM 2 I OCCASION FOR FILING (Check Appropriate Box)

o A candidate for elective office o Left office or position~ Annual officeholder's or state employee's report o 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 position you currently hold which requiresthis filing. If you have left office, list the office you held.Office or Position: Le5cdq iGf t Term: : h , . . , 01 i:k 1 2BEGINS ENDSName of City, County, District, or State Agency: 3ITEM 4 I OFFICE 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 I PERIOD COVERED BY THIS STATEMENTThis statement must cover all financial interests for the entire "preceding calendar year" and not just as of year-end. If you haveleft office, this statement mustcover all financial interests from the end of the calendaryear for which you previously filed up to andincluding the date you left office.v This statement covers the preceding calendar year January1 through December 31, '2.a.:>e0 Left office, fnls statement covers the period January 1, to

(DATE YOU LEFT OFFICE OR POSITION)

visedAugust2007

8/14/2019 XGR Price SFI

2/5

L - -~.

ITEM 6 ISOURCES OF INCOME OF OVER $1,000Income includes money or any other form of recompense consti tutina income under the Internal Revenue Code. (See definitions)Name and address of any source' (including an indiv idual, business, List the nature of the source's business and the nature of the services youbody of government, pol it ical subdivision or body corporate) from rendered or the circumstances under which income was received. NOTE: Do notwhom income of over $1,000 was received. list the amount of the income.1.) t . S c . 1a.) 1\-,.:0 ::J :-r S~nrlr"'A'\. -Ii.;)/J ~&?dr' 't.li,

'4"20 L .V ;'/slt ; r - c D r S6e .30; R ,,;. ., - u .. . - . ~ , : > , ' - . ./ A ",_ oldDelfetve fJf 08:052.) D4'M-('fdAdf ' ; ' I ,c V a i a i a r r V e : & ,O W . l A f k . l d 2a.) f)1

8/14/2019 XGR Price SFI

3/5

,I, >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 identifythe location of the property. Exceptions: You need not report real estate owned by a business listed in Item 6 or 7, your personalresidence of real property valued at less than $1,000. Personal residence refers to your principal dwell ing-house and adjacent land usedfor house-hold purposes, such as lawns and aardens.

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

/ J I l t

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 AddressC r ( e & ~ - r W-est t . " ' I ~ * - 'lIt; ()-u{Vlfv I~J. Dc/levV! e V i l - (PtX.o))

(b) List the names of the issuers of all stocks, bonds, and government securities, not otherwise listed under Items 6 or 7.C D . Fcrr-f t.,;).,~yvJ F , ,v l? lfV l- I'",,/ >.e{VL te .s j /0/ J ! M'!>.){N Ave. &//evv-

8/14/2019 XGR Price SFI

4/5

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 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

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 forGift"e-b,r~'K4. Spudivc t. 670(// Choose Value: tll-J (Af'iInt'I? .L lu,'" l; Pt bBsj,

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 I SIGNATURE 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 trueand complete.

U~/167--- 5/~ loo/