XGR Utter SFI

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    . . r -NEBRASKA (,.J i_) POSTMARK ~DATEACCOUNTABILITY ANDDISCLOSURE COMMISSION STATEMENT MICROFILM 7 9 ~ ( }., ') 0NUMBER ' t) N{.JtJ11th Floor, State Capitol OF.o. Box 95086 OFFICEUSE ONLYLincoln, NE 68509 FINANCIAL - PFC ' :" l(402) 471,2522 ,,_ L , 1 ]INTERESTS I PJl"rtl t } t)r; "_~~i'''.;t, ....I J &: !''iL~ S \ { : { / \

    BEFORE COMPLETING2 0 0 9 ~ i A R 1 7EAD FILING REQUIREMENTS P H 3 : - D 6NADC FORM C-1 ~ 1 E A C " 'O L " r " 't , n-, l T Y....:* . G l{,,,,fr..tHL 1 .&D I ; ,C L O S U R F tnr~!'4ICCt(H1

    Candidates for designated offices .and holders of designated offices and positions must file this statement. See Sections . 1 A and1B of the instructions. . - . Candidates (including incumbents) subject to this filinqrequirement must file with the Commission and with the appropriateelection official (See Instructions). Designated off iceholders and holders of designated positions must fi le this sta~ement with the Commission annually. Dollar values need not be report for 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 IYOUR NAME, ADDRESS AND PHONE Nl.JMBER

    Name U + + e r ' " 'Den,,;s If Telephone No. I/tJ2. - 463 - 9.>31LAST FIRST MIDDLEAddress 3(7 'h,;'; a ; I ~('rJ e H t J $ / , ~ S Ale 6&9(01STREET ADDRESSOR RURAL ROUTE CITY STATE ZIP CODEITEM 2 I OCCASION FOR FILING (Check Appropriate Box)

    DA candidate for elective office DLeft office or position~ Annual officeholder's or state.employee's report DNewly appointed to office or position

    ITEM 3 I OFFICE HELD & TERM OF OFFICE (Incumbent elected/appointed officialsand state employees. SeeIB of instructions)

    List the office or position you currently hold which requires this fi ling. If you have left office, list the office you held.Office or Position: S . J . a f e - 5 ! ! - 1 '1 C A -f0.,-- Term: ~~o9 ;(0/2-BEGINS ENDSName of City, County, District, or State Agency: 1J/~f.33- Nebraska . c.:I~ -I-t.{y~

    I_ .ITEM 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:

    ITEMS IPERIOD COVERED BY THISSTATEMENTThis 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 must cover all financial interests from the end of the calendar year for which you previously filed up to andincluding the date you left office.

    ~ This statement covers the preceding calendar year January1 through December 31, ;2L;o

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    ITEM 8~ I REAL PROPERTY OF THE FILER IN NEBRASKA (Real property valued at less than $1,000 and your- personal 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 identifthe location of the property. Exceptions: You need not report real estate owned by a business listed in ltern 6 or 7, your personaresidence of real property valued at less than $1,000. Personal residence refers to your principal dwelling-house and adjacent land usefor house-hold purposes, such as lawns and qardens.

    Location of Property Nature of Property(Description or Address (such as: agricultural, commercial, industrial, residential-rental)w~~w'l'y.~. ' f . -8-Cf a~s & , hfl~~Y'f ,41"{u.t.l ~L/~B-II-I ~4 wlh tfp;'1tf-~/~-II-1' ( 4 ' ) ' k (!~-"e~r(Jskq.: 1 , C l f f ~ (!/~; j ) , . . FirM~ p t" /~ t.lP ;~~ljMOC )r~a)~ so/~s-hfl~./;tJ ft ?9 C jO I

    7ttl.f7 ~~I'UCL iJJ 'Out-"\-\~.,P V'~s l 2 ~ e . I ~ L;~J NLJhCP/N 1 ~b8"SI~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 AddressI+J~) . D i P 1 U 1 1 y 7 : J 1 t N k . 'P o 6 ,,0 ,{ . I Jf ~ - K e " eS4U.J , ~ 6A9r~

    (b) List the names of the issuers of all stocks, bonds, and government securities, not otherwise listed under Items 6 or 7.'J)r1nc:fal HnA -r lCJ4JGr~ __S~ck.8ebe .. S~~.s I : Z : : : - " . . , c : - , - - S-IYt. -1Ylh->+{~S~A/t j.i~Ln ~ s k f~lUleJ 5 e .A w A i> ~ (Yp .-07 ~k~U;L / h - c J l 1 w . .(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 tangible personal property unless such property was held primarily for sale or exchange.< r , . ( " ~ C ,f t L / ~$t.U-(;.MLt2.. C f e . - C-vel'7lrrff,;,;,,~fer~M~I J./i : J ; > S . . . .e:e , - c~L'L ~l(Jxtf\er.s h n . . e t J p . . . " . . k . , V P T k , jtJE- LfoIK~ re~e--I .

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    , f,-, J-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 inst itution in the ordinarycourse of business need not be reported.

    Name AddresslJ~tt-

    '.

    ,

    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

    I N o n e . - 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 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 trueand complete.

    ~ iam: ,3-1t/--09 "(Signature of Filer) (Date)