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Ray. 1/2010

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FINANCIAL DISCLOSURE REPORT


FOR CALENDAR YEAR 2009

Report Required by the Ethics


in Government Act of 1978 (s u.s.c, app. ~" 101-111)

I. Pemn Reporting (last n~ne, first, middle initial)

2. Court or Organlzadou

3. Date of Report

4. Title (A~dcl Ill judges indicate ac~ve o~ savor status;

5a. Report Type (check appropriate t3Ve)

6. Reporting Period

7. Chambers or Office Addrc.ss ~ "~ 9 g 1~ ~. ~1~ ~ ~" ~.

5b. [] Amended R~poct & On the basis of the iaformatton contained ta this Report and aay modifications pcrtafmin~ thereto, it is, in my opinion, in compliance with applicable law~ and regulatiom.

IMPORTANT NOTES: The instructions accompanying this form must be followeg Complete all parts,
checking the NONE box for each part where you have no reportable information. Sign on last page.

Polozola, Frank J.

B. Spouses Non-Investment Income - If you were married during an)portion of the reporting year, complete this sectiar~
(Dolla~ amount not required except for honoraria.)

[~ NONF, (No reportable non-investment income.) DATE


1. 2. 3 4

SOURCE AND TyP~

IV. REIMBURSEMENTS - ~,~po,~o,~ So~g~ng, /ood, ,,,~,,,~ ....~


(Includes those to spouse and dependent children: see pp. 25-27 of filing instructions.)

[~

NONE (No reportable reimbursements.) ~ DATES LOCATe[ON PURPOSE ITEMS PAID OR PROVIDED

1. 2. 3. 4. 5.

FINANCIAL DISCLOSURE REPORT

Name of Person Reporting

Date of Report

~ NO~ ~o reportable g~ts,) ~ I. 2. 3. 4. 5. DESC~P~ON

VI. LIABILITIES. a,~tu,te, ~o,, o~,o.~. ~,,,~ a,~,,a~,~ thUd, e,,,. see pp.
~] NONE (]go reportable liabilities.) CREDITOR ! 2 3 4. 5. DESCRIPTION

FINANCIAL DISCLOSURE REPORT Page 4 of 6

~. I~STMENTS and TRU S TS -i~


~ NO~ ~o rePo~able income, ~sets, or ~sactionsO

............................~.
~ of As~ {including ~t ~s~) Pla~ "(X)" a~ ~ch ~t ~x~pt~pfiordi~losur~

~, ...........

~ ............ ...... ~ ........................


Gross v~u~ at ~d

~. ............................
Tr~cfons ~g ~g p~

] ~c~ ~ng [ rep~g ~od

~ ~o~t ] Type (e.g., ~ V~ue Co~ l [ div,r~t, Cod~2

Value Me~

"ry~ (.g, b~,sell,

Date ~n~/dd~T

V~u i Gain C~e2 ~ C~e 1

[d~fi~ of b~/seller

2. 3.

14. 15. ]6. 17.

(See Colmnn C2)

U :Book Value

V ~Oth~

W ~.~irrmt~d

FINANCIAL DISCLOSURE REPORT

VIII. ADDITIONAL INFORMATION OR EXPLANATIONS.

FINANCIAL DISCLOSURE REPORT

IX. CERTIFICATION.
I certify that all information given above (including information pertaining to my spouse and minor or dependent children, if any) is accurate, true, and complete to the best of my knowledge and belief, and that any information not reported was withheld because it met applicable statutory. provisions permitting non-disclosure. I farther certify that earned income from outside employment and honoraria and the acceptance of gifts which have been reported are in compliance with the provisions of 5 U.S.C. app. 501 eL seq., 5 U.S.C. 7353, and Judicial Conference regulations.

NOTE: ANY INDIVIDUAL WttO KNOWINGLY AND WILFULLY FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CI~qL AND CRIMINAL SANCTIONS (5 U.S,C. app. 104)

FILING INSTRUCTIONS Mail signed original and 3 additional copies to: Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544

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