Cainpfd

ooEFonn278(Rev.o9/2oJo) Executive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORT 5 C.F.R. Part 2634

Form Approved: OMB No. 3209- 0001

U.S. Office of Government Ethics

Reporting

(Check Appropriate Boxes) 05/03/2011

Reporting Individual's N arne

Last Name

Cain

Title of Position

Incumbent

D

Position for Which Filing Candidate for President

Calendar Year Covered by Report

I I New Entrant, Nominee, or ')(I Candidate

Termination Termination Date ( /{ Appli-Filer 0 cable) (Month, Day, l'ear)

I I First Name and Middle Initial

Herman

Department or Agency (If Applicable)

Fee for Late Filing Any individual who is required to file

this report and does so more than 30 days after the date the report is required to be filed, or, if an extension is granted, more than 30 days after the last day of the filing extension period, shall be subject to a $200 fee.

Reporting Periods Incumbents: The reporting period is

Address (Number Street City )tate and ZIP Code) T 1 h N (I 1 d A C d ) the preceding calendar year except Part Location of ' ' '· · ' e ep one 0 · nc u c rca ' 0 c II of Schedule C and Part I of ScheduleD Present Office 223 Montrose Drive. McDonough, GA, 30253 (678) 565-5335 where you must also include the filing

1 (or forwarding address) year up to the date you file. Part II of I Title of Position(s) and Date(s) Held ScheduleD is not applicable.

l'osilion(s) Held with the Federal Government During the !'receding 12 Months (I[ Not Same as Above)

Termination Filers: The reporting period begins at the end of the period covered by your previous filing and ends

t---------------------------+-:-:---:----------------------.----------------------1 at the date of termination. Part II of Schedule D is not applicable. Presidential Nominees Subject Name of Congressional Committee Considering Nomination Do You Intend to Create a Qualified Diversified Trust? I

to Senate Confirmation Not Applicable DYes I8J No Nominees, New Entrants and Candidates for President and

__ o_f_R_e_p_o-rt-in_g __ ln_d_•_·v-id_u_a_I ____________________________________ Vice President:

I CERTIFY that the statements I have made on this form and all attached schedules arc true, complete and correct to the best or my knowledge.

Other Review (If desired by

agency)

Signature of Other Reviewer

-;J_.t..(-;)..0((

Date (Month, Day, Year)

Schedule A--The reporting period for income (BLOCK C) is the preceding calendar year and the current calendar year up to the date of filing. Value assets as of any date you choose that is within 31 days of the date of filing.

Schedule B--Not applicable.

Schedule C, Part I (Liabilities)--The AgencyEthicsOfflcial'sOpinion Signature of Designated Agency Ethics O!Iiciai/Reviewing Official Date (Month, Day, Year) reporting period is the preceding calendar

. . . . . . year and the current calendar year up to On the ba"s of mformat10n contmncd m thiS any date you choose that is within 31 days report. I conclude thal the filer IS an compliance f '1' with applicable laws and regulations (subjeel to of the date 0 f1 mg. anv comments in the box below). I Signature I Date (MonLh Day Year) I Schedule C, Part II (Agreements or Office of Government Ethics ' ' Arrangements)--Show any agreements or

Use Only arrangements as of the date of filing.

Comments of Reviewing Officials (If additional space is required, usc the reverse side of U1is sheet)

·::- '.1" u·· ·J t _l . .,.. • ·.1 I ,. 1\.'f :1 ... '•I n :;J 1:1 10

I \; '·-· • ' · ... J , . ..,! 'l...,l _j... ..]

:8 Hd 9Z IIGl

Supersedes SF !j J\;<'{J [) ::u u 'j .. :;.1

(C/Jeck box if filing exrension granted & indicatc number of days----) D

(C/Jeck box Jf comments are continued on UJC reverse side) D

ScheduleD--The reporting period is the preceding two calendar years and the current calendar year up to the date of filing.

Agency Use Only

OGE Use Only

OGE Fonn 278 (Rev. 09/2010) 5 C.F.R. Part 2634 U.S. Office of Govenunent Ethics

Reporting Individual's Name Cain, Herman

Assets and Income

BLOCK A For you, your spouse, and dependent children, report each asset held for investment or the production of income which had a fair market value exceeding $1,000 at the close of the ing period, or which generated more than 200 in income during the reporting period, together with such income.

For yourself, also report the source and actual amount of earned income exceeding $200 (other than from the U.S. Government). For your spouse, report the source but not the amount of earned income of more than $1,000 (except report the actual amount of any honoraria over $200 of your spouse).

NoneD

Central Airlines Common 1-------------DoeJones&Smith. Hometown, Stale Examples 1-------------Kempslone Equity Fund 1-------------IRA: llearlland 500 Index Fund

1 Cox Radio, Inc, Atlanta, GA

2 (S) The New Voice, Inc., Stockbridge, GA

3 Hallmark Cards, Inc., Kansas City, MO

4 Agco Corporation, Duluth, GA

5 Whirlpool Corporation, Bento("! Harbor, Ml

6 Whirlpool Corporation Common

..... 0 q .... ; £ "'' "' I-< o· ..._,_

'Q)

§. z

·-·----

SCHEDULE A Page Number

2 of 13

Valuation of Assets ·Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCKB BLOCKC

Type Amount 0 ] 0 0

0 0 0 .... 0 0 0 0 0 0 0 0 Other Date q 0 J:l.<· q 0 0 Q, o. '-' N 0 (Mo., Day, 0 8· 0 0 0· 0 0 .Q 0 0 0 Income

0 0 0 0 0 q ci § "' t:: 0 0 g" 0 (Specify Yr.) -1< q 0 Q) b q 0 0 0 0 0 0 0 lJ"l lJ"l 0 :0 cO 0 0 0 0 Type& 0 -0 0 lJ"l 0 q 0 lJ"l N 0 '-' '-' Cil: ..c: 0 0 0 R 0 q 0 lJ"l 0 q 0 "' '-' 0 0 q Only if 0 N· lJ"l ...... 0 "I 0 "' 0 0 0 .... 0 0 Actual lJ"l lJ"l ...... 'Ef7 0 I I ...... 2 .s "' 0 lJ"l q lJ"l lJ"l ...... 0 I 0 0 "' N' Amount) Honoraria ...... 1." I "1. 0 ...... ...... 0 0 .s E-< Q) 0 lJ"l .... I 0 .... 0 0 0 0 cO - I 0 I I .... ,...., ...... q 0 Cl ....... ' ...... q o_ o-: 0 0 "d ] "d. ... ' 0 I ...... .... 0· 0 0 lJ"l 0 ' ' ...... ,...., 0 ,...., ,...., 6 0 2l ·;. 0 lJ"l .... o. 0 0 0 0 g ] ..._, ' .... .... ...... g. 0 0 0 0. 0 0 0 0 0: 0 ! Q) .... 0 0 0 0 0 0 q .n· 0 ... 0 q .n. ... d :a t:: q "!. q vi" 0 ... 0 ... o: lJ"l o: Jj & 0 0 ,_.;- Q) ...... ...... lJ"l ....... N l/"l. lJ"l N· § 0 •Q) ..s cO 0 N- ...... N· lJ"l lJ"l .... > u z 0

X '· X X .. 1- I- f.,- I- 1-- ·- . :_ ·-1- --1-- r- 1- 1-.- ·- ·- I- 1-- 1- 1- ·- --- 1----_I __ law Partnership

Income $130,000 1- I- 1--. I- 1-- ·- ·.- ·- - - - -- ·- ··- - - 1- - ··- ·- --- 1-----:-1-r: X _I_L :.:.1_ - ·---. ..__ i-. - 1--: - :- ·- - -- '- -.- ·- -·- 1.,- '- f- -- '-- - --- 1----X ,. X X

' Salary $165,183

Salary ·.

., Director's Fees $120,000

Director's Fees $202.500

Dir. Fees/Stk Option Exercise $359.008

.· ·.

X I X X

* This category applies only if the asset/income is solely that of the filer's spouse or dependent children. If the asset/income is either that of the filer or jointly held by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate.

OGE Form 278 (Rev. 09/20 I 0) 5 C.F.R. Part 2634 U.S. Office of Government Ethics

Reporting Individual's Name

Cain, Herman

Assets and Income

BLOCK A

1 The Coca-Cola Company Common

2 (S) The Coca-Cola Company Common

3 Sale of 2,000 shares SonicWalllnc Common

4 Federated GA Municipal Cash Trust

5 Supervalu Inc Common

6 Whirlpool Corporation Common

7 Agco Corporation Common

8 Delaware National Hi-Yield Municipal Bond A Common

C) Sale of 2,000 shares Whirlpool Corporation Common

SCHEDULE A continued Page Number

(Use only if needed) 3 of 13

Valuation of Assets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCKB BLOCKC

Type Amount

;::::;- 0 § 0 0 0 0 0 0 ...... 0 o_ 0 0 0 0 0 Other Date 0 0 0 J.!.< 0 0 ...... 0 0 0 0 0 I N 0 0 Income (Mo., Day, 0 0 0 0 0 0 0 0

0 0 0 0 0 0 q 0 0 0 0 8 (Specify Yr.) i< 0 0 i< 0 0 0 0 0 0 0 v) Lrl Lrl 0 ;:1 0 0 0 0 0 v) 0 Type& .s 0 0 0 q N .s 0 0 0 0 0 q 0 0 0 Lrl. 0 0 0 '"' ..... 'Cil 0 0 o_ 0 0 0 Only if 0 N Lrl .-I 0 I 0 (/) ;g 0 0 .-I q Actual (/) v) >, (/) (/) Lrl 0 (/) Lrl ...... 0 I I .-I 0 . s (/) 0 Lrl Lrl ...... I 0 Amount) Honoraria .-I .-I ...... 0 a q N v) ...... 0 .-I 0 .I I I 0 0 I 0 I I ...... o_ 0 0 0 0 (/) ell ...... I I q 0 q 1-< I ...... .-I 0 0 0 E "d ] "d ] .c..? 1-< I ...... o. ...... .-I 0 I I .S· 0 0 ...... 0 0 Lrl t:: '"' 0 .-I ...... 0 .-I Lrl ...... 0 0 0 0 0 0 Q) (/) .-; I ...... .-I ...... 0 0 0 0

J 0 0 0 0 o" g" 0 0 0 1-< ! 0. "d ..... 0 0 0 q 0 0 1-< 0 q ·!i 0 1-< 0 q Vi Q) ·:;: q Ill q 0 q 0 Lrl Q) Vl 0 .-I Lrl .-1 N Vl .-t" Lrl N JS a a .5 0 N .-I .N Lrl .-I Lrl ...... ...... u z (,1'> 0 .(,I'>

X X X

X X X "C

X I X X

.. X I I X X X .

X X X ...

.. ' X X X

·•

X

' X ' X X

X I X X "


---

OGE Fonn 278 (Rev. 09/2010) 5 C.F.R. Part 2634 U.S. Office of Govenunent Ethics .... -


Cain, Herman

Assets and Income

BLOCK A

1 Federated Prime Obligations Trust


3 Federated GA Municipal Cash Trust


5 Federated Prime Obligations Trust


7 Suntrust Bank, Dunwoody, GA - Checking

8 Suntrust Bank, Dunwoody, GA - Money Market

q Branch Banking & Trust Co., Fayette, GA-Checking

,..... 0 q .......

-s "' "' 1-<" -9. ·0 z

X



ValuationofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCKB BLOCKC

Type Amount 0 ] 0 0

0 0 0 0 0 0 0 0 0 0 0 Other Date 0 0 0 0 0 0 0 0 d N 0 0 Income (Mo., Day, 0 0 0 0 0 0 0 0

0 0 0 0 0 0 q 0 <11 "' t:: 0 0 0 0 (Specify Yr.) "" o_ 0 § ·11 b 0 0 0 0 0 0 0 0 lrl lrl 0 ro 0 0 0 0 vi' 0 Type& 0 0 0 lrl 0 0 0 lrl. N 0 "' ...- ...- -s 0 8 0 0 0 0 0 0 q 0 0 N lrl ,....;- 0 ., 0 "' 0 0 q o. 0 .... 0 0 Actual Only if I" 8 "' "' lrl 0 0 lrl lrl ..... 0 I ..... 0 .s "' 0 .....; lrl lrl ..... 0 I Amount) Honoraria ..... I ....... 0 E-< ·0 o_ lrl- ..... ....... 0 I I 0 ..... 0 ..: 1- 0 I I ..... q 0 0 0 0 ro ..... I I o_ ·o q ..... ..... .q. i::5 al "0 al "0 L? _s I ..... 0 I ....... ..... 0 0 o. 0 lrl ...- I I ....... ..... 0 ..... lrl ...... 0 t:: 0 ...... . 0 0 0 0 0 0 . 0 I s .gj .Cij "' -;. •.1 ....... ...... ...... ·o 0 0 0 0 0 0 0 g 0 0 0 0. ;';::: <11 ....... 0 0 0 0 0 0 0 q vi' 0 o. 1-< 0 o_ vi' -; ... <11 § 0 o_ lrl q vi' 0 1-< q lrl ,....;- t:: N" 0 ...... ....... lrl ....... N lrl lrl N §: ·<1) .5 N ...... lrl ....... lrl ...... .......

0 a ..: u z

X I X X X

X X

X X X X

I X X X

x. X X X

X X X

X X X ..

X X X

X I X X


OGE Form 278 (Rev. 09/2010) 5 C.F .R. Part 2634 U.S. Office of Government Ethics


Cain, Herman

Assets and Income

BLOCK A

I Branch Banking & Trust Co., Fayette, GA -Certificate of Deposit

2 (S) Branch Banking & Trust Co., Fayette, GA-Checking

3 (S) Branch Banking & Trust Co., Fayette, GA -Certificate of Deposit

4 Less than 1% ownership in a computer wholesale company in West Palm Beach, FL.

5 Vanguard lnterm-Term Investment-Grade lnv

6 Vanguard Total Stock Mkt ldx lnv

7 Sale of 1 ,999 shares Whirlpool Corporation Common

8 Sale of 1 ,999 shares Whirlpool Corporation Common

q Residential property in Atlanta, GA

...... 0 q ...... "" 2 £ "' "' _£

i

X

X



Valuation of Assets Income: type and amount. If"None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCKB BLOCKC

Type Amount 0 ] 0 0

0 0 0 ;:;- 0 0 .o 0 0 0 0 0 Other Date 0 c5 0 0 0 0 c5 8 N 0 c5 0 0 0 0 0 "" 0 q Income (Mo., Day,

0 0 0 c5 0 q c5 "' 2 8 0 0 0 0 0 0 (Specify Yr.) 0 0 0 c5 c5 0 b tr) tr) £l (1) 0 0 0 0 b 0 .n 0 ·p 0 0 c5 tr) q N "" 0 £ 0 0 0 0 c5 q .n 0 Type& q c5 0 0 "" "' ..., t:: til 0 0 0 N tr) ....... 0 "" I c5 ;g 0 0 q 0 0 ...... 0 "" 0 Actual Only if tr) tr) ..... "" I I s "' 0 tr) q c5 "" "" c5 ...... 0 .... "' N' tr) tr) ..... "" c5 I Amount) Honoraria ..... "" "" I I I 0 ..... ..... 0 0 E-< "' q tr) ..... "" I 0 ...... 0 "" I I ...... q 0 0 0 c5 ...... "" "" "" ·I ' q 0 o. ' ...... ..... .. 0

..... ...... 0 0 c5 l a! "0 'd'• !;.!). 8 "" ' ' ...... 0 0 0 ..... 0 tr) c:: s:: ..., ' ...... ..... 8 ..... tr) ..... .0 0 0 0 q 0 0 §, (1) «$ "' til ' ..... :..-. ..... 0 0 ,.; 0 ,.; 0 0 0 0 0 0 8. 0 0 "0 ...,· ...,. ...... 0 0 0 q 0 c5 0 .... q .n c5 0 .... q .n «$ (1) 0 q "l q 0 0 tr) 0 s:: tr) 0 ..... ...... tr) ...... N ctrl ...... tr) N § (1) .5 N ..... N tr) ....... tr) ...... ..... "" ,.; "" 0 Ci u Vf

X X X

X X X

X X X

X X Distributive Share

X X X

X .. ·

X X

X X

X X

X .· X X


OGE Form 278 (Rev. 09/2010) 5 C.F.R. Part 2634 U.S. Office of Government Ethics


Cain, Herman

Assets and Income

BLOCK A

I Residential property in Atlanta, GA

2 Investment in Bell Research Companies, Tilton, GA

3 Sale of 1,000 shares Mentor Graphics Common Stock

4 Sale of 450 shares Plains Exploration Common Stock

5 Sale of 332 shares Centurylink Common Stock

6 Blackrock Global Allocation A IRA Investment

7 LM CBA Appr A IRA Investment

8 (S) The Hartford Growth Opportunities Fund - L Mutual Fund Investment IRA Investment

C) The Hartford Growth Opportunities Fund - L Mutual Fund Investment IRA Investment

...... 0 o_ ..... ""7 a -s "' "' _£

J

X

X.

X



ValuationofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCKB BLOCK C

Type Amount 0 § 0 0

0 0 0· ..... 0 0 . 0 0 cS

"'"' 0 0 0 Other Date ·0 cS 0 0 0 0 cS 0

J N 0 cS 0 0 0 0 0 o_ ""' 0 0 Income (Mo., Day,

0 0 0 0 cS 0 q 0 !:1 0 0 cS 8 (Specify Yr.) b o_ 0 b 0 0 0 cS c:5 0 l/') l/') 0 :0 '" 0 0 0 0 0 0 q c:5 o_ l/') N !'17 -s 0 8 0 0 cS q vi' 0 Type& q l/') 0 0 ..., 0 '-' I 0 0 0 0 N l/') ..... 0 ""' •I cS "' 0 o_ g 0 ...... 0 ""' 0 Actual Only if l/') l/') ..... ""' I I :::1 sg "' 0 l/') o_ I c:5 ""' ""' c:5 ...... 0 "' l/') ..... ""7 cS Amount) Honoraria ..... ""7 ...,

I I I 0 ...... ..... 0 0 0 N l/') ..... ..., ""' I 0 ..... 0 ""' I I ...... q 0 0 .0 cS 'T-1"': ""' ""' ""' I I q 0 q ..... ...... 0 'o I "0 "0 ] (.!) .... ..... I ..... ..... 0 0 ""' I I ' 0 0 ·0 ..... cS c:5 l/') Q) Q) '-' :""; .s ..... ..... 0 ..... cS l/') ..... 0 0 0 0 0 ""' 0 ""' 0. Q) "' ., ..... ..... ..... 0 0 o. ""' ""' 0 0 0 cS cS cS o· 0 .o_ .... "0 ...... 0 0 0 q 0 g 0 .... q vi' c:5 0 .... o_ o_ Q) 0 o_ ll'l.. q 0 .... o_ l/') 0 l/') §< l/') Q) ..... ....... l/') ...... N l/')' ..... l/') .N a '-' :£ N ..... N l/') ...... l/') ..... :> ..... ""' ..., ""' ""7. ""' ·""' 0 ""' ""' .""7 Cl ..s u ""' ""' ·""' ""' ·""· ""' ""' 0 ""' .0

X X X

X

X X

t X X

X X

X .·

X X

X X X

X X X

X ' X X


------ --------

OGE Fonn 278 (Rev. 09/2010) 5 C.F .R. Part 2634 U.S. Office of Government Ethics


Cain, Herman

Assets and Income

BLOCK A

I Sun Trust Advantage Money Market Account

2 Note Receivable Bell Research Companies

3 Land held for investment, Walton County, GA

4 Berkshire Hathaway Inc Common Stock, Cl B

5 Alliance Bernstein Global Thematic Growh Fd Cl A

6 Fidelity Advisor Growth Opportunities Fund Cl T

7 Goldman Sachs Technology Toll keeper Fd Cl A

8 Oppenheimer Champion Income Fund - Cl A

q 50% ownership in VHC Investments, LLC a rental real estate holdings company

...... 0 C?. .....

a -s "' "' 2-§ z

X



Valuation of Assets Income: type and amount. If "None (or less than $201 )"is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCKB BLOCKC

Type Amount 0 "Cl 0 0 .

0· 0 0 & 0 ..... 0 0 0 c5 0 0 0 Other Date 0 c5 0 0 0 0 c5 0 i N 0 c5 0 0 0 0 0 0 0 0 Income (Mo., Day,

0 0 0 c5. 0 C?. c5 c5 0 0 o_ 0 0 0 (Specify Yr.) 0 0 0 c5 c5 0 -1< tr) tr) «$ 0 0 0 0 -1< o_ 0 0 0 ·.c 0 0 0 c5 tr) 0 C?. 0 tr) N 0 ...... } ..c: 0 0 0 0 0 C?. 0 tr) 0 Type& o_ c5 I "' ..... 0 0 C?. c5 0 Actual Only if 0 N tr) ...... 0 c5 Q) 0 0 ...... 0 tr) tr)· ..... I. ' "' "' 0· tr) C?. I 0 0 ...... 0 "' tr) tr) ...... 0 Amount) Honoraria ..... I ' I 0 ...... ..... 0 0 C?. N tr) ..... I 0 ...... 0

I I ...... C?. ·a 0 0 0 "' «$' ...... I ' C?. 0. C?. ..... ...... 0 c5 "Cl "Cl 13 "Cl "Cl (.!) ... ..... ' ...... ..... 0 0 I . I ' 0 0 0 ..... g tr) 2;l Q) ..... 2 ..... ..... 0 ..... tr) ..... 0 0 0 0 0 c5 Q. fr Q) (lj "' ca I ..... ...... ..... 0. 0 0 0 0 0 0 c5 c5 c5 0 .o_ ... fr "Cl -1-'· ...... 0 0 0 0 0 0 0 ... C?. ,tr)- 0 0 ... o_ C?. "> d Q) .....

0 C?. tn.. C?. vi 0 ... 0 tr) 0 tr) Jj Jj 0. 0 ...... ...... tr) ...... N .tr) ...... tr) N a Q .s «S· N ..... N tr) ...... tr) ..... ......-0 u

X X X

X X X

X ' X X

X X X

X X X

' X X X

X X X

X X

X X X I


- -------

OGE Foml278 (Rev. 09/2010) 5 C.F.R. Part 2634 U.S. Office of Government Ethics

Rcporling Individual's Name

Cain, Herman

Assets and Income

BLOCK A

1 100% ownership of s-carp THE New Voice. Inc., a public speaking and publishing entity

2 Wells Fargo Advantage Core Equity Fd Cl A

3 Godfather's Pizza Restaurant

4 Prime Money Market Fund RBC Investor Class

5 Sale of 2,163 shares The Coca-Cola Company Common Stock

6 Sale of 5,738 shares The Coca-Cola Company Common Stock

7

8

q

...... 0 q ......

"' "' .... .s

X·

X



Valuation of Assets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item.

BLOCK B BLOCKC Type Amount

0 "Cl 0 0 o. 0 0 § ;:::;- 0 0 0 0 0 0 0 0 Other Date 0 0 0 0 0 0 0 0

m N 0 0 (Mo., Day, 0 0 0 0 0 0 0 0 Income

0 0 0 0 0 0 q 0 "' C1 0 0 0 0 (Specify Yr.) b q 0 § Q) i< 0 0 0 0 0 0 0 Lr) Lr) 8 :.::1 ro 0 0 0 0 0 vi' 0 Type& 0 0 0 Lr) 0 q 0 Lr) N '-' til .s 0 0 0 0 0 q 0 0 q 0 "' 0 0 q 0 0 Actual Only if 0 N Lr) ...... 0 ·I 0 "' 0 0 ...... 0 2 ;:1 ;:..., "' "' Lr) q Lr) Lr) ...... 0 I I ...... 0 "' &l .s "' 0 N" Lr) Lr) ..... 0 I 0 Amount) Honoraria ..... I I ' 0 ..... ..... 0 0 f:-o 0 Lr) ..... I 0 ...... 0 ., I 0 0 0 ro ...... - 0 q ...... ...... ...... q 0 0 "Cl "Cl ] "Cl -g c.::J .... ' ' ...... q ' ...... ..... 0 0 0 ' I ' 0 0 .0 ..... 0 Lr) Q) C1 '-' .s ...... ..... 8 ..... Lr) ..... 0 0 0 0 0 0 0 Q) ·ro "' til I ..... ..... ..... o. 0 0 0 0 0 0. 0 0 0 0 0 .... ! "Cl ·..., ..... Q) ...... 0 0 0 0 0 0 0 .... q .vi' 0 .... 0 q Lr)" ·a: C1 o. "l q .vi' 0 0 0 Lr) 0 ........

Q) 0 0 ..... ...... Lr) ....... N . Lr) Lr) N a .s «l' N· ..... N· Lr) .... Lr) .... ...... -Cl u

X X

X I X I X

Operating X Income $53,965.50

X X X

X X

X X


--------------

OGE Fonn 278 (Rev. 09/2010) 5 C.F.R. Part 2634 U.S. Office of Government Ethics

Do not complete Schedule B if you are a new entrant, nominee, or Vice Presidential or Presidential Candidate

Reporting Individual's Name Cain, Herman 1 SCHEDULE B

Part I: Transactions Report any purchase, sale, or exchange by you, your spouse, or dependent children during the reporting period of any real property, stocks, bonds, commodity futures, and other securities when the amount of the transaction exceeded $1,000. Include transactions that resulted in a loss.

Do not report a transaction involving property used solely as your personal residence, or a transaction solely between you, your spouse, or dependent child. · Check the "Certificate of divestiture" block to indicate sales made pursuant to a certificate of divestiture from OGE.

Identification of Assets Examptc1 Ccnlral Airlines Common

2

3

4

5

NoneO

Transaction Type (x)

Q) Q)

:g Cl c: .<:: "' Q) .<::

.ll :;) <ii a. (/)

X

Dale (Mo., 'O Day, Yr.) .-<O

00 o· ·"' ........ """"

2/1/99

Page Number 9 of 13

Amount of Transaction (x)

• • o 88 8 .--10 o& 8 88 go .. qq qq qg g 88 gg 88 8 .. ,.o oo oo o 0 l;jo 00 0 • qo. liJ • g-s s:o ........ >.--. . .--itri u;:G >:;:;

YH;I} f:flY.t V'tY.t {;1;)(;.1') O&:t Y,t{;l') Y.tb") {;l')bl'}

X

*This category applies only if the underlying asset is solely that of the filer's spouse or dependent children. If the underlying asset is either held by the filer or jointly held by the filer with the spouse or dependent children, use the other higher categories of value, as appropriate.

Part II: Gifts, Reimbursements, and Travel Expenses

3

4

5

For you, your spouse and dependent children, report the source, a brief descrip-tion, and the value of: (l) gifts (such as tangible items, transportation, lodging, food, or entertainment) received from one source totaling more than $335 and (2) travel-related cash reimbursements received from one source totaling more than $335. For conflicts analysis, it is helpful to indicate a basis for receipt, such as personal friend, agency approval under 5 U.S.C. § 4111 or other statutory authority, etc. For travel-related gifts and reimbursements, include travel itinerary, dates, and the nature of expenses provided. Exclude anything given to you by

Source (Name and Address)

the U.S. Government; given to your agency in connection with official travel; received from relatives; received by your spouse or dependent child totally independent of their relationship to you; or provided as personal hospitality at the donor's residence. Also, for purposes of aggregating gifts to determine the total value fi·om one source, exclude items worth $134 or less. See instructions for other exclusions.

None 0 llrief Description Value

NY, NY___ I ____ _ oi"Frank.)ones. San Francisco, CA I Leather briefcase (personal friend)

5500

$350

"-< 0

"'" ·-"' 8:a

OGE Fonn 278 (Rev. 09/2010) 5 C.F.R. Part 2634 U.S. Office of Govemment Ethics

Do not complete Schedule B if you are a new entrant, nominee, or Vice Presidential or Presidential Candidate

Reporting Individual's Name Cain, Herman I Part 1: Transactions

Identification or Assets

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

SCHEDULE B continued (Use only if needed)

Transaction Type (x)

"' gj e ::l a. "' (ij

(/)

"' "' 1ij

Date (Mo., Day, Yr.)

Page Number

10 of 13

Amount or TransaCtion (x)

• o ;.8 g I 0 ,......!Q 1"""'iQ QQ 00 q ....-10 00 00 00 00 00 0 oq,qqlqo" o"o" o"o" Q"O ,..o qV'l tnO 00 Oll"'l lnO !l.lq ....-1....-1 ....-11.1") 1.1')1"""'1 ....-IN Ni.r) 1.1")....-1 >....-1

(;,I'Hfl f;fl-E.R

-o 00 qq 00 00 00 ....;v)

"'"'

1 o o 50 00 0

00 00 0 oo oo Lfo 0 ... u1 u10 CJO V'lN NV) >U")

*This category applies only if the underlying asset is solely that of the filer's spouse or dependent children. If the underlying asset is either held by the filer or jointly held by the filer with the spouse or dependent children, use the other higher categories of value, as appropriate.

0 cd::l

'-'> U"O

OGE Fonn 278 (Rev. 09/2010) 5 C.F.R. Part 2634 U.S. Office of Government Ethics Reporting Individual's Name Page Number Cain, Herman SCHEDULE c 11 of 13

Part I: Liabilities a mortgage on your personal residence NoneO Report liabilities over $10,000 owed unless it is rented out; loans secured by Category of Amount or Value (x) to any one creditor at any time automobiles, household furniture during the reporting period by you, or appliances; and liabilities owed to your spouse, or dependent children. certain relatives listed in instructions. •o .-<0 0

' .o 0 .-<0 .-<O 00 0 Check the highest amount owed See instructions for revolving charge ' 'O .-<0 .-<0 .-<0 0 00 00 00 q

.-<0 .-<0 .-<O 00 ·00 oo. q 00 0.6 66 0 during the reporting period. Exclude accounts. 00 00 00 00 qo. 00 0 deS 00 00 0 00 00 q6 66 00 ...,o 00 00 00 ...,q

'c)v) v)c) 00 0 • vlO Date Interest Term if 00 OV> V>O .. q ·"' QJO ........ .... "' "' .... .-<N NV> "' .... >.-. tnN NV> Creditors (Name and Address) Type of Liability Incurred Rate applicable ..,.., ..,.., ..,.., ..,.., ..,.., ..,.., o ... ..,.., .,.., ..,..,

__ ___ 1991 8% __ 1-- _!_ ---- - I-- - 1--Examples r-i999 r--- .-. - .-hn Jones, Washington, DC Promissory note 10% on demand X

I Sun Trust Investment Services, Inc. Line of Credit · paid off during reporting period on X 2009 prime+1 Dunwoody, GA demand

2

3

4

5

*This category applies only if the liability is solely that of the filer's spouse or dependent children. If the liability is that of the filer or a joint liability of the filer with the spouse or dependent children, mark the other higher categories, as appropriate.

Part II: Agreements or Arrangements Report your agreements or arrangements for: ( 1) continuing participation in an of absence; and (4) future employment. See instructions regarding the report-employee benefit plan (e.g. pension, 40lk, deferred compensation); (2) continua- ing of negotiations for any of these arrangements or benefits. NoneD tion of payment by a former employer (including severance payments); (3) leaves

Status and Terms of any Agreement or Arrangement Parties Date

Example I Pursuant to partnership agreement, will receive lump sum payment of capital account & partnership share Doc jones & Smith, Hometown, Stale 7/85 calculated on service performed through 1100.

1 Pursuant to directors agreement with Hallmark Cards, will receive quarterly retirement payments beginning 03 2011 for 5 years Hallmark Cards 03/01

2

3

4

5

6

OGE Fonn 278 (Rev. 09/2010) 5 C.F.R. Part 2634 U.S. Office of Government Ethics


Cain, Herman SCHEDULED

Part I: Positions Held Outside U.S. Government

Page Number

12 of 13

Report any positions held during the applicable reporting period, whether compen- organization or educational institution. Exclude positions with religious, sated or not. Positions include but are not limited to those of an officer, director, social, fraternal, or political entities and those solely of an honorary trustee, general partner, proprietor, representative, employee, or consultant of nature.

None D any corporation, firm, partnership, or other business enterprise or any non-profit Organization (Name and Address) Type of Organization Position Held From (Mo., Yr.) To (Mo., Yr.)

Examples Rock N2::._N2'._ ___________ Non-profit education President 6/92 Present 1-:-------------- -------------- ----' Doc .)ones & Smith, llomctown, State Law firm Partner 7/85 1/00 1 Acgo Corporation, Duluth, GA Agricultural equipment manufacture Director 12/2004 4/2011 2 Hallmark Cards, Inc., Kansas City, MO Greeting card retail Director 03/2001 4/2011 3 Whirlpool Corporation, Benton Harbor, Ml Appliance manufacture Director 12/1992 11/2003 4 Whirlpool Corporation, Benton Harbor, Ml Appliance manufacture Director 04/2005 4/2011

5 Morehouse College, Atlanta, GA Non-profit education Trustee 04/2002 6/2011 6 Bell Research Companies, Tilton, GA Agricultural research Director 01/2009 6/2011

Part II: Compensation in Excess of $5,000 Paid by One Source Do not complete this part if you are an Incumbent, Termination Filer, or Vice

Report sources of more than $5,000 compensation received by you or your non-profit organization when Presidential or Presidential Candidate. business affiliation for services provided directly by you during any one year of you directly provided the the reporting period. This includes the names of clients and customers of any services generating a fee or payment of more than $5,000. You

None D corporation, firm, partnership, or other business enterprise, or any other need not report the U.S. Government as a source.

Source (Name and Address) Brief Description of Duties , .Jones & Smith, llomclown, State Legal services

Examples ---------------------------------------------------tro University (client of Doc jones & Smith), Moneytown, Stale Legal services in connection with university construction 1

2

3

4

5

6

OGE Form 278 (Rev. 09/2010) 5 C.F.R. Part 2634 U.S. Office of Government Ethics

Reporting Individual's Name Cain, Herman SCHEDULED

Part I: Positions Held Outside U.S. Government

Page Number

13 of 13

Report any positions held during the applicable reporting period, whether compen- organization or educational institution. Exclude positions with religious, sated or not. Positions include but are not limited to those of an officer, director, social, fraternal, or political entities and those solely of an honorary trustee, general partner, proprietor, representative, employee, or consultant of nature.

None D any corporation, firm, partnership, or other business enterprise or any non-profit Organization (Name and Address) Type of Organization Position Held From (Mo., Yr.) To (Mo., Yr.)

Assn. of Rock Collectors, NY, NY _________ President 6/92 Present Examples -------------------- -------------- ----oc Jones & Smith, Hometown. State Law firm Partner 7185 1/00

1 The New Voice, Inc. Firm involved in public speaking appearances and Shareholder book publishing 09/2004 Present

2 VHC Investments, LLC Rental real estate holding company Member 12/2006 Present

3 Cox Radio Group Atlanta, Atlanta, GA Radio broadcast company Employee 01/2008 2/2011

4

5

6

Part II: Compensation in Excess of $5,000 Paid by One Source Do not complete this part if you are an Incumbent, Termination Filer, or Vice

Report sources of more than $5,000 compensation received by you or your non-profit organization when Presidential or Presidential Candidate. business affiliation for services provided directly by you during any one year of you directly provided the the reporting period. This includes the names of clients and customers of any services generating a fee or payment of more than $5,000. You

None D corporation, firm, partnership, or other business enterprise, or any other need not report the U.S. Government as a source.

Source (Name and Address) Brief Description of Duties Jones & Smith. Hometown, State Legal services

Examples ---------------------------------------------------tro University (client of Doc Jones & Smith), Moncytown, State Legal services in connection with university construction 1

2

3

4

5

6

Prior Editions Cannot Be Used.