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. , ~ hNEBRASKA \ f POSTMARK J - A f),;ACCOUNTABILITY AND DATE . ,.DISCLOSURE COMMISSION STATEMENT MICROFILM I i 940!2 4 411th Floor, State Capitol NUMBEROF.o. Box 95086 OFFICEUSEONLYLincoln, NE 68509 FINANCIAL : ~ : ' . : . L :U Jt:),(402)471-2522 INTERESTS L . ~ j [ ;C : L ~ ~ \ : ' . ~ ~ : ~ : t; S~~:BEFORE COMPLETING ? n r q t " U ", f l f i 9 : 5 2. ,J j ~ihht.~.~

READ FILING REQUIREMENTS NADC FORM C-1 i' E ~ t; C c [ n J 1;; - r t. 2 ! L . I T 'y (:r - ' i. ; , W 'J 2 f ~c r'(ie .: ~ ~ I~.;~jr : I e , :~_. ._~., 'tu. -;..... /, ~~ i!-~~ ..;~>JI'"

Candidates for designatedoffices and holders of designatedoffices and positions must file 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 officeholdersand holdersof designated positionsmust file this statementwith the Commission annually. Dollar values neednot be reportfor any item, except Item 11. Persons who fails tofile as required is subject to a civil penaltyof upto $2,000.ITEM 1 IYOUR NAME, ADDRESS AND PHONE NUMBERName A / A N - r ~ f S ~f\-1V:rE / I ~ ~elePhone No. V O J . - C ( 7 J rz)(;~LAst {j:[{~ MIDDLEAddress ~~(~ < 5 + t .s -. CO {t-U -r: G~')v -rSTREETADDRESSORRURALROUTE t. CITY STATE ZIPCODEITEM 2 I OCCASION FOR FILING (Check Appropriate Box)

D A candidate for elective office D Left office or position~nnual 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 holdwhich requiresthis filing. If you have left office, list the office you held.Office or Position: Sl!

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, j , . ITEM 8 I REAL PROPERTyl. ~ ) THE FILER IN NEBRASKA (Real propJ~~Ialued 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 identhe location of the property, Exceptions: You need not report real .estate owned by a business listed in Item 6 or 7, your persoresidence of real property valued at less than $1,000. Personal residence refers to your principal dwelling-house and adjacent land ufor house-hold purposes, such as lawns and cardens.

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

ITEM9 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 Address . ..-- , !v~~ ~ Po f3,Of~ l(G( g~ A~",e

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.)-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 aris ing out of retail installment transact ions or loans made by a f inancial inst itution 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 andf Donor (See Key Below) Circumstances or Occasion forI1 Gift

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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.

iJJd6r- 3~;Z3-Uf(Signature o f Filer) - - " (Date)