01/09/2014 02-08 Fox 504 582 8011 JONES WALKER JUDICIAL ADMIN OFFICE SECTION INVOLVEMENT IN NONPROFIT ORGANIZATIONS Hyatt mayor your spouse are a director or of a nonpro?t omanizatian. complete this Section. Sac Rultzi' oftlu: La. Supreme Ct, Port N, Rule MIX. Section NOT. APPLICABLE Otherwise. check the box add so to the next Section. I. Relates to: Spouse 2. Name of Nonpro?t 3. Address of Nonpro?t: 4. Brief Description of Nonpro?t 5. Nature of Association with Director Of?cer Non ro?t i. Information: Relates to: Filer El Spouse 2. Name of Nonpro?t 3- Address of Nonpro?t: 1 4. Brief Description of Nonpro?t 5. Nature of Association with Director Of?cer i- Nonpro?t I SECTION IV. INCONIE This Section solely concerns income earned by you and/or your spouse in' the preceding calendar year. Please note that each subsection requests irylormatton concerning speci?c source: of income. See Rule: of the La. Supreme Ct? Part N. Rule Section Subsection A. Income from State or Political Subdivision or from Services Performed for or in Connection with in Gaming Interest Complete this Subsection thither you or your spam, or if any business in which you or your spam. either individually or collectiveba, own an interest which exceeds tan percent oftltat bounces. receive: my? source of Income ?oor the state or any political subdivision or fan: services or in connection with a gaming interest. (See the definition of gaming interest or political sub?vMM) JUDICIAL INCOME MUST APPEAR-IN THIS SECTION. I none, check the box and old to the next Subsection. NOT APPLICABLE 1. Information Relates to: Filer Spouse Business in which Filer and/or Spouse owns more than a 10% Interest I 2. Wig Sgu?ceLog 3. of Ignore-me: I Jot markType of Income Received: State or Political Subdivision STA-TE Services Performed for or in Connection with a Gaming Interest 5. Speci?c Amount of Income Received: [00?83?00 I "?corv mu ATTACH ADDITIONAL macs as Form PFDS for Judges (Adopted February 20! l) Page 2.. of 01/09/2014 02:08 FAX 504 582 8011 JONES WALKER 141004/004 1. Information Relates to: 5 Filer Spouse Business in which Filer and/or Spouse owns more than a 10% interest 2. Name of Source of Income 3. Address of Source at Inco?: 4. Type of income Received: State or Political Subdivision El Services Performed for or in Connection with 3 Gaming Interest 5. Speci?c Amount of Income Received: . lnl?omntion Relates to: Business in which Filer and/or SpouSe owns more than interest 2. Name of Source of Income 3. Address of Source of Income: 4. Type of Income Received: [3 State or Political Subdivision Services Perfumed for or in Connection with :1 Gaming n" Interest 5. Speci?c AmOunt of Income Received: I. Subection B. Income from Employers - Pravide the name and address ofony employer who provided income to you or your spouse pursunl tofu?- tlme airport-time enmloymenr. In your response. include a brief description ofthe nature ofthe services mnderedpursuanl to such employment and the amount of such income. WW Mgr-motion that gas ?at-ted guguont to uremia; Salome; inane. check the 313" box to (newer! Subsection or APPLICABLE. 1. information Relates to: 2. Position El Filer gnu-Time 1E Spouse A Part-Time? A 3. Name of Employer 4. Address of Employer: Oaks-or we MA 6 2m New?!? Awe. MN: on.? LA 7m 6. Brief Description of the Nature of Services Rendered It.? 31 7. Amount of Income Received 1] LESS THAN $5,000 $5,000 - $24,999 I $25,000 - $100,000 1. lnt'oration Relates to: 2.. Position El Filer El Full-Time El Spouse Part-Time 3. Name of Employer 4. Address of Employer: 5. Job Title 5. Brief Deacription ol' the Nature _oi Services Rendered 7. Amount of Income Received LESS THAN $5,000 13?55000-3243509 I 1 MORE THAN 3:00.000 I cow AND ATTACH mos?s As'NicessAnv Form PFDS for Judges (Adopted February 20! l) Page 3- of l,