Professional Documents
Culture Documents
1/2011
Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app. ~.~ 101-111)
8. On the basis of the information contained in this Report and any modifications pertaining thereto, it is, in my opinion, in compliance with applicable laws and regulations.
~ Reviewing Officer
Date
IMPORTANT NOTES: The instructions accompanying this form must be followed Complete all parts,
checking the NONE box for each part where you have no reportable information. ~qlgn on last page.
NAME OF ORGANIZATION/ENTITY
2. 3. 4. 5.
II. AGREEMENTS. tReVorting individuul only; see v,. 14.16 of filing instruction~)
NONE (No reportable agreements.)
DATE
1. 2. 3.
Hall, James R.
III. NON-INVESTMENT INCOME. (Reporting indi,idual and spouse; see pp. 17-24 offiling instructions.)
A. Filers Non-Investment Income
~ NONE (No reportable non-investment income.)
DATE
INCOME
(yours, not spouses)
2. 3. 4.
B. Spouses Non-Investment Income - if ~,ou were married durlng any portlon of the reporting )ear, complete this section.
(Dollar amount not required except for honoraria,)
D
I. 2010 2. 3. 4.
DATE
2. 3. 4. 5.
V. GIFTS. (Includes those to spouse and dependent children; see pp. 28-31of filing instructions.)
NONE (No reportable gifts.) SOURCE
I. 2. 3. 4. 5.
DESCRIPTION
VALUE
Vl. LIAB IL1TI ES. anaud, s ,hos, oy,pou,~ ,,nd de~,~nd~nt children; see pp. 32-33 of filing instructions.) D NONE (No reportable liabilities.)
CREDITOR I. 2. 3. 4. 5. Augusta First Bank Wachovia Bank Sallie Mae Unsecured Note Loan Guaranty-Patriot Foods, Inc. Guaranty - Student loan~
DESCRIPTION
VALUECODE
K N K
VI 1. IN VESTMENTS a nd TRU STS - income, value, transactions (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets (including trust assets) Place "(X)" after each asset exempt from prior disclosure Income during reporting period Gross value at end of reporting period Transactions during reporting period
O)
Amount Code I (A-H)
(2)
Typ~ (e.g., div., rent, or int.)
(1)
Value Code 2 (J-P)
(2)
Value Method Code 3
O)
Type (e.g., buy, sell, redemption)
(2) (3) (4) Date Value Gain mratdd!yy Code 2 Code I (J-P) (A-H)
(5)
Identity of buyer/seller (if private transaction)
(Q-W)
I. 2. 3. 4. 5. 6. 7. 8. Patriot Foods, LLC-Member Interest Hall Augusta Properlies, LLC-Member Interest Northwestern Mutual Universal Life Insurance Policy First Bank of Georgia Accounts LPL Financia IRA-Fidelity Financial Independence Mutual Fund LPL Financial IRA-Goldman Sachs Bank Cash Account Smith Barney IRA E A A F Distribution None Dividend Interest None None Distribution N O K J W W U T Redeemed Redeemed Redeemed 07/05/I 0 07/05/I 0 10/0l/[O J J K A A A
I. Income Gain Codes: (S~e Columns BI and D4) 2. Value Codes (S~c Columns CI and D3) 3. Value Method Codes ISce Colunm
A =$1,000 or less F =550,001 J =$15.000 or less N -$250.0~11 - $50~,0(~ P3 =$25.00~.001 - $50.00~.000 Q =Apprai:,al U =Book Value
B -$1.001 - $2,500 G =SIDO.001 - 51,0OO.O00 K =$15,0~1 - $50,0OO O =$500,0OI - $ 1.000,000 R =Cost (Real Estalc Only) V =Olher
C =52,501 - $5,000 HI =$1.000,001 L =$50,0~1 - 5100.000 PI =$1.000,001 - 55.090.000 P4 =More than $50.000.0~1 S =Assessment W ~Estimatcd
D =$5,D01 - $15,0~0 H2 =More than $5,000,00~ M =$ 100.0~ I - $250.00~ P2 -$5,1~)0.001 o $25,000,000 T =Cash Market
E =515.001 - $50,000
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 pro~sions permitting non-disclosure. 1 further certify that earned income from outside employment and honoraria and the acceptance of gifts ~vhich have been reported are in compliance with the provisions of 5 U.S.C. app. 501 et. seq., 5 U.S.C. 7353, and Judicial Conference regulations.
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FALLS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. 104)
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544