0GB Form 5 GER. Part 2634 Of?ca of Government Ethics Executive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORT Form Approved: OMB No? 3209-0001 Date of Appointment, Candidacy, Elect-icin- hiatus Incumbent Calendar Year New Entrant,? Termination Termination Date?fdpp?- Fee for Late Filing or Nomination (Month, Day, Year) (Check Appropriate Covered by Report Nominee, Of Filer Gable) Day: Year) Any individual who is required to ?le Boxes) Candidate this report and does so more than 30 . days after the date the report is required Last Name First Namejand Middlc'initial lobe ?led, or, if an extension is Reporting Indmdual 5 Name Cam-f Robert lemma, more than 30 days WI 316 inst day of the ?ling extension period, Position for Which Filing Title of Position- Department or 'Agencv shad-be sabiect to a $200 fee-- Commissioner, Food and Drug Administration Department of Health and Human Services Reporting Periods Incumbents: The reporting period is Location of Present Of?ce (or forwarding address) Address (Numben Street; Gian-Stare. and ZIP Tenement). (Ynelude Area Code) the preceding calendar year except Part 10903 stew Hampshire Avenue, Silver Spring, MD 20903 240402-501 6 II of Schedule and Part I of Schedule ID where you must also include the ?ling year up to the date you ?le. Part II of with the Federal Government During the Preceding l2 Months (5N0: Same as Above) Title Schedule is not applicable. Deputy Commissioner for Medical Products and Tobacco, Food and Drug Administration - 3r15to Present Termination ilers: The reporting period begins at the end of the period covered by your previous ?ling and ends Presidential Nominees Subject to Sena to Con?rmation Name of congressional Committee Consrdering Nomination DdYou Intendrc Create a Quali?ed Diversi?ed Trust? [at the date of termination. Part II Health, Education. Labor and Pensions Committee Yes XINO of Schedule is not applicable. I Nominees. New Entrants and Certi?cation Signature of Rc'ponihg'lndiridasl. Dale-(Mould. Dov. Year) iCandidates for President and that the statements [have made on this form and all attached [schedules are true, complete and correct WW Vice President: Schedule A?The reporting period for income BLOCK C) is the preceding calendar vear and the current calendar year up to the date of ?ling Value to the best of my knowledge. Signature $03.19? Recicw?f: Date ?i?rl?a?d? Year) Other Review - . (If desired by - agency) (7 9/,11/13 I Iassets as of any date you choose that is within 3] clove ofthe date of?ling. Schedule B?Not applicable. Agenc? Ethics "Official?s Opinion ewingo?iciai I (Month, Yedr?l asis of infomatlon contained in this report, I conclude that the ?ler is in compliance with applicable laws and regulations (subject to any comments in the box below}. . . . .. Si [mature ochs ignored. Agency. EthiQ-i .O?icialrlteri 7/22/25 Schedule C, Part I (Liabilities)? The reporting period is the preceding calendar Vear and the current calendar Veer up to any date You choose that IS within 31 davs of the date of ?ling. Of?ce of Government Ethics Use Only Signature Date-(Meme. Day, Year} MM Schedule C, Part II (Agreements or ArrangemeotSP-Show any agreements or arrangements as of the date of ?ling. Comments of {ffdh'diir?onai splice is'reziia?rethe ofrhr's sheer} Schedule D?Thc reporting period is (Check box if?ir?ng extension granted (it indicate number of days Wow-2E] (Check box if comments are continued on the reverse side) the preceding two calendar years and the current calendar year up to the date of ?ling. acreage 093v 0G.E."Iise Onlv OGE Form 273 (Rev._ 12120 1 1) 5 C.F.R., P3112634 U.S.. Of?ce of Government Ethics Reporting Individual?s Name - Page Number Califf, Robert M. SCHEDULE A 2 Assets and Income Valuation of Assets Income: type and amount. If "None (or less than $201)" is checked, at close of reporting period 110 other entry is needed in Block for that item. BLOCK A BLOCK 3 BLOCK For you, your spouse, and dependent children, i reporte'ech asset: lield'for?invmentp?hc production of'mcome a fair market. vaiue exceeding close ofthe-re Engperim or who generated-more 31311.52 0' Other . Date in ipgomeduring-the repo'rimgperiod, together Income . (Ma. Dav. with such income. (SNOW 1" -) - f? Type For yourself, also report the source and actual 8 . 3 J, Actual Only if amount of earned income exceeding $200 (other 3 =1 a, =3 a. 3' Amount) Honoraria than ?rm the U.S. Government). For your spouse, .42 . - ct a. report the source but not the summit ofearned a a? . m. - 3 income of more than $1,000 (except report the - a? ?5 - ,4 .5 actual acount of any honoraria over $200 your spouse). .D sea. 5 5 None . Central Airlines Common Examples immature - - .- . .. KempstoneEquity Fund I. I IRA: Heartland 500 Index Fund 1 Fidelity lnvestinents: Growth 'investni?h't xx acct, managed by Capital Management . 00:51:. ADple loo. 2 - Acme United Co 3 - (S) AFLAC Inc. 4 -- (S) Albermarle Corp, 5 (8) Applied Meteriais incEst-3ibis categog'applies only if the assc?income is soigly that of he filer-'5 spouse or dispersion;- children. If the_as?etlincome is either-tirat'of the ?ier- or the ?ler with the spouse or dependent children, mark the other-higher categories. ofyalnergs Appropriate.- 7. with 111: spam a: aepggdem childre-?, alarms ath?r hi' (it cats cries O'fvaluc, as appr?ptia?t?,. Con?cl - Comm (8) Sanfil A (S) G'reenhille (30., Inc? - Google Class - (S) Las Vegas Sands Corp - N?astercard In'c. Class A - (S) Baker Hughes Inc? 1 Capita! Management (31'th A??oun't' (S) Houston Wire 8; Cable Co- fhiS' 'cawg?ry applies Onlyiffhc. assay 8) (2H. Robin?on Wo?dwide inc ppo John 8 Ex Son Inc. '4 (S) Eaton Vance corp. (non-vctin'g 1119mm: 1 Assets and Income Reporting Indmdual?s Name Caiiff, Robert M. US. Of?ce of Government Ethics .5 .. . . r?awhkx. . .ll. .5 . . BLOCK $ny"wng?i? . mam .r 92 $98.98.. Valuation of Assets at close of reporti ng peri od was . . ?959. 9n1 yl . .. .xu?wmm. . .u mix-.56. wag?..me Type . bin?y held BLOCK Amount Other Income Actual Amount) Only if Yr.) Date 0/10.. Dav. onorana mo other entry is needed in Block for that item. If"None (or less than $201)" is checked, Income: type and amount needed) SCHEDULE A ma?a? Page Number 0GB Form 273 (Rev. 1212011) 5 cm Part 2534 063 Form 278 (Rev. 1212011) 5 C.F.R. Pan 2634 US. Of?ce of Government Ethics Repeng Individml?s Name A con tinue Page Number Robe? (Use only if needed) Assets and Income BLOCK A Valuation (If-Assets at close of reporting period Income: type and amount. If "None (or less than $201)" no other entry is needed in Block for that item. BLOCKC hecked, $1,001 - $15,000 Amount_ $250,001 - $500,000 Over $50.000,000 0m- $1,0'00,000* h? .1: ,5 . 143$5,000,001 - $25,000,000 $1,001'- $2,500 $50,001} $100,000 me.- Over $5,000,000 Other Income (Specify Type Actual Amount) Date (Mon Dav. Yr.) Onlv if Honoraria Capital Management Growth Account Con'd: (S) Marsh 8: MCLennan Co 2 (5) Noble Corp PLC - (3) Norfolk Southern Corp? a. (8) Oracle Corporation 5 (8) Paychex Inc. 6 Principal? Fioancia} Group 7 - (S) PRA Group Inc. a - (S) Prudential Financial 9 - (8) Google Class A 0m; ihis ifth?e'assetiincome'is the ?lers-sponge o'r de?endeme by 012003030001: spouse or dependent children, mark-the other higher caiegoriesof value. as appropriate. - hiidren_.- if we assethrleome 15:61:th that or the ?ler or jomtly held Con'd: - (S) Qualcom inc. - (8) Urban Out?tters inc, - (S) Visa Enee (8) Cveht Eno? (8) Orbotech - (S) Capital'Ma?agement botoora?On Cash Account (cash) Seadrm Ltd- Tr?nsocean Capital Maneger?ent Account I. (S) lnterpublic Group of 00., mo. BLOCK A Assets and Income US. Of?ce of Government Ethics {Repomng In'di?dual's Caiif? Robert M. BLOCK in. .1. . want, a. Valuation of Assets at close of reporti ng peri od .. Arum?; J, 'his category applies only If {He assetfinoome ts solely that of the film?s spouse or depen ant 11 nan. the assets by the ?ier with the soonse'or dependent-children. mark the other higher value, asi'appm'p?ate. $.93 - 89:8 .?khxuuvzno :hcom? as ?ner-that ofthe .?ler'or jointly ?eld- ?.xv w. v. a?w?v?m . . . BLOCK type and amount no other entry is needed in Block for that i If "None (or less t?an $201)" is checked, tem. Income needed) SCHEDULE A 0011th (Use only ed Page" Number 5 CIR. P311 2634 OGE Form 278 (Rem 1212011) OGE Form 278 (Rev. 1212011) 5 CFR. Part 2634 US. Of?ce of Government Ethics 31 md' ?d 1? Page Number mg 5 am SCHEDULE A continued cam Esme? (Use only if needed) Assets and Income BLOCK A Valuation of Assets at close of reporting period BLOCK BLOCK c. Income: type and amount. If "None (or less than $201)? is checked, no other entry is needed in Block for that item. $1,001 - $15,000 ,r 5? dends Ni $5,000,001? $25,000,000 Over $1,000,000* Over 350,000,000 - $250,001 - $500,000 Eic?pied Trust I I $50,001 - $100,000 None (or iess_tl1an $201) $50,001 - $100,000 $1,001 $5,001 - $15,000 Over $1,000,000* Over $5,000,000 Other Income (Specify Type Actual Amount} Date (Ma. Dav. Yr.) Onlv if Honoraria i Capit?-i Management Growth Account investors mass F2 Con'd: - (8) American Funds Fundamental 2 - (8) American Funds (3!th Fund of America Class F2 3 - American Fiind? I Company of America Class F2 4 - American Funds New Perspective Fund Ciass F2 5 American Funds Tax Exempt Bond Fund of America Ciass F2 a - (S) ?ioreador Internationai institutional; Fund \u ?t 7 INTENTIONALLY LEFT BLANK 7? 8 INTENTIONALLY LEFT BLANK 9 LEFT BLANK .5. .33. r. ?is-p??tggo?ry-appii? solely mater? the film's spouise or dependent'chi then. If he asse income is 01' er. that-0f aha-?ler or jointly held by .th ?ler With 'the or "d?ndeni children; mail:- the other higher categories of value.- as approonate. OGE Form 273 (Rev 1212011) 5 FR Part 2534 Of?ce ofGovemment Ethics Reporting {edmduai?s?ame {3.3002 Robert M. A continued (Use only if needed) Page-Number Valuation of Assets at close of reporting period Assets and Income BLOCK A no other entry is needed in Block for that item. BLOCK Income: type and amount. If "None (or less than $201)" is checked, $1,001 - $15,000 $50,001 - $100,000 $250,001 - $500,000 I Over $1,000,000* $5,000,001 $25,000,000 Over $50,000,000 Amount 15;;1?1 . a 2 ?fey: Eb-v. w. t: o. '1 1-124: 9.23 3 v- to ?JaimistayFidelity Insiestments, IRA, Managed by Capital Management Corp.: - (3) American Funds New Perspective Fund Over 35,000,000 Other Income (Specify Type Actual Amount) Date (Ma. Dav. Yr.) 0an it: Honorana 2 American Funds investment Funds of Class 3 I- American Funds Fundamental Investors Ciass F1 '4 - (8) American Funds Growth Fund-of- America Class F1 '05 - (8) Capital management: Fideliiy'Cash Reserves Fund '6 Am Equitahie Life insurance (Universai Life) '7 AKA Equitable Life Insurance (UniVersa! Life} 8 (tonnage-America Virginia 529 Cottage Savings Plan 1: (S) American Funds New Perspective Fu nd '9 (8) American Funds investment Company of America Class F1 his category $111100 only if the 00501001201005 seleiy'that 'of?tt??e?s Spouse'or crepe meme-is e11 Wine ?ier With the 5:100er 'or-denenefent children. mark the other higher. categories el?mhrea aesapprepriaze OGE Form 278 (REV. 1212011) 5 C.F.R. Pan 2634 U.S.O?ice ofGovatmnemE?dcs I Repor?hg Individual's Name A cond Page Number Califf. Robert M. II I (Us: on]? ifneeded) 8 Assets and Income Valuation of Assets Income: type and amount. If "None (or less than $201)" is checked, at close of reporting period no; other entry is needed in Block for that item. BLOCKA BLOCKB BLOCKC I 5 ype Amount Other Date . . Income (Ma. Dav. an .I (Specify Yr.) I c: I Tweak avg: . I-. .gI Actual Onlvif Amdum) Honoraria v.Buv-? u- 1-Iun - 'g-:53. 3 r: a .34. a 1 Virginia 529 Coliege Savings Plan 1 cen'd: - (S) American Funds Fundamental Investors Class 2 (S) American Funds Growth Fund of America Class F1 3 - (S) American Funds Washington Mut'uai' investors Fund?Class F1 I 4 Coifeg?e?meriee - Virginia 529 College Savings Man 2: - (8) American Funds new Perspective Fund 5 - (8) American Funds Investment Company of America Ciass F1 6 - (8) American Funds Fundamentai Investors Class F1 7 Fideiity Investments, IRA, Managed by Capital Management Corp: - Fidelity Cash Reservices Fund 8 - AON PLC 9 - Marsh 8: McLehnan Co?his cagegory applies-only if?ueias?r?nceme is seen: them? the net?s Spouse or 'giepcn?ent .11. eithenhat of the ?ier or goin?yheid bv. the ?ler with me meme-of: dependent ehikigeo; mark the other higher categories of "value as appropriate. :Iby-tno- ?int-With the sponge or dependem chiidmm mark {he-other Eight?! Catogo?es .of-fnluo? as appropriateIii} - Visa inc. - AFLAC his. sategoo' - Pnyohex inc - Group inc. - Eaton V?nce Corn 38591133 0111 3! Arthur J. Gallagher Co 1 Capital Management IRA Con'd Tool Works Inc. Mask??rd Incorporated i _6 Vanguard Dividend Appreciation ETF BLOCK A Assets and Income Caiiff. Robert O?ice of Government Ethics Reporting Indiwdu'al's Name XI: . . put.? . .. . . is soie?: xh?tofmc agar-?; .. 1.1.x ?3.57 an. spouse 0 BLOCK dep?n eat-'03 1 . ?gong Eaten, 9. Valuation of Assets at close of reporti ng peri od ?xaifm .. no @8038 Han? I 7112313 925.25 . ban?5:9? I . . {xnmm?..vx . .. . . . {yaw . . . 5.59:: magma gomziy' he!" 0an if . onorana BLOCK no other entry is needed in type and amount Block for that i If "None (or 1653 than $201)" i tom. Income 5 ohecked 9 (Usa- on] SCHEDULE A continued :11 needed) Page Number 5 Part 2634 OGE Form. 2?8 (Ram 132011} ?10 Page Number item. BLOCK Ameunt If "None (or less than $201)" is checked, Block for that ded in (1 IS nee Income: type and amount. no-other entry 21 Date Dav Yr.) Only i Home 98.823 .56 x. 5. 9. .139?? 55.5 . ?uxww in?? meme? Ha . 396mm .u~.n.2u.4.cx . . fame. . :19 held Join .an523.. . $34. . Gena andf?l Lina acme 15 either that of the ?ler or in needed) 1 (Use onl . .. 1. Eamon?N..? SCHEDULE A continue ion of Assets rting period Valuat at close of repo .m 5.x. 1er that the ?lm?s sponse or de?ant ent if asset;f . . .1 Wa??mw> BLOCK . . . . 2HRS ?ve .35.. Sea . a. . .3. wry Asnsets and OGE Form 278 (Rev. 1212011) 5 GER. Part 2634 US. Of?ce of Government Ethics Rc'porzin 3; 1nd Evideat?s Name Cai?f. Robert M. BLOCK A bv the ?ler with the ouse or de endent children. mark the other 111' er eate cries of value as a promiate.dTrm F..Q .F mnugmanEMF MEI .mpr [?"Emu NamV 3mg .cru 0GB Fem 278 (Rev. 1212011) 5 ORR. Part 2634 US. Of?ce of Gement Ethics Name continued Fege'Number cam: Robes (Use only if needed) 11 Assets and Income Valuation of Assets Income:- type and amoimt. If "None (or less than $201)" is checked, at close of reporting period 110' other entry is needed in Block for that item. BLOCK A BLOCK BLOCK 3: Other Date 1 A Income (Ma. DavActual OHIV Amount) Honoraria P'ortola Pharmaceuticals, Board Fees San Francisco, CA 2014 $60,000 2015 $4500 2 (8) ownership interest in residentiai property, Denyer, CO 3 (S) PNC Bank: (caSh accounts) 4 Na?ona! Ehterp'rise Associates Distribution Presidents Fund LP. (Divested: $8700 underlying assets not ascertainable) 5 (J) Weifs Fargo: (cash accounts) 6 [3er University Federal Credit Union: (cash accounts) 7 Private ?iagno??e Clinic Pr?fit Sharing and 401m) Plan: - Fidelity Internationai Discovery Fund Class .. 3 Vanguard ins?tut?onai index Fund Institutional Shares 9 - Janus Fund Class S: #3352. AK ?x 5.5 Us . This caiegqry 81191183 onlyifthemseifmcomc'13 salely. ma; 'of't ?lter-4s sp0use or dependentchiidxen. [f the asse?inmme 15 either that-of the ?ler or jointly held '.'the ?ier with the 3 case or "endent thildm mark the other hi er? categories of value. as appropriate OGE Form 273 (Rev 1212011) 5 GER Part 2634 US. Of?ce of Govemment Ethics Reportm Califf?, Robert M. SCHEDULE A continued (Use only if needed) Page Number 12 Valuation of Assets at close of reporting period Assets and Income BLOCK A no other entry is needed in Block for that item. BLOCK Income; type and amount. If "None (or less than $201)" is checked, A (x412 11?: .v-I e. ?5 1?1 a TcPriv?te' Diagnostic Clinic ProfitSharing and 401(k) Plan {Con'd}: - Spartan Extended Market Index Fund Fidelity Advantaoe Class . Amount None (or less than $201) 93$, ?9 rag/x?? - 1n. I '?vi?uE-L $5,001 - 015,000 $50,001 - $100,000 Dividends Interest Over $1,000,000* . xvrg? Over $5,000,000 Other Income (Specify Tvpe Actual Amouuti Date (Ma. Dav. Yr.) Onlv it: Honorana 2 - Morgan Stanley Institutional Fund Trust Mid Cap Growth Portfolio Class 1 3 - Wells Fargo Advantage Opportunity Adm Ciass 4 Duke "Faculty and Staff Retirement Pian (Defined Contribution Plan): - Fidelity Contra Fund Class 5 Fidelity Mid Cap Stock Fund Class Fidelity Blue Chip Growth Fund Class A 7 - Fidelity Equity lnc?me Fund Ciass Fidelity international Capital Appreciation Fund 9 Portola Pharmaceuticals Stock ?his categmy assc?t?ncemeis-so ely'zhat 'of't 1'0 111683 spouse or dcp?nc cnt?eh?iic if ?we we? FYI-.15. 30300009: 'or decendenz- chiidmm mark'the valueas anemones. that. 010' meter 301111)" held OGE Form 278 (Rev. 12/2011) 5 C.F.R-. Part 2634 U.S. Of?ce of Government Ethics Reporting lndiwdual's Name Califf, Robert M, SCHEDULE A continued (Use only if needed) Page Number 13 Assets and Income BLOCK A Valuation of Assets at close of reporting period BLOCK 13 Income: type and amount. If "None (or lees than $201)? is checked, no other entry is needed in Block for that item. 4 University {WI-Chicago, 'Ci?iicago, 1L Other Date I: A Income Dav. '1 (Specify Yr) c, . a Type& a 3. a; Actual C)Amount) Honoraria Gig-,ACCU Conference, Emery University, Honoranum Recewea Atianta, GA (St. Jude Medicai Center $2500 SIM inc. sponsor) 2 University of Chicago, Chicago, IL. Honorarium EAC Meeting) $1000 3 Premier Health Dayton, OH Honorarium 9194214 $2500 Horictari'um $2500 138114 - hm: committee tenure and pmmotien review consult} A. .u EAC Meeting} 119/14 5 University of Caiifornia Davis, Honorarium 3/5114 - Sacramento, CA EAC Meeting) - $1000 3f6r?t4 6 University of Gatorade-Benita, Honorarium 51121?14 - Denver, CO $1000 5(132'14 7 University of Alabama Honorarium 8(111144 Birmingham, Al. (Grand Rounds) $1500 8f12!14 8 Heart Failure Sticiety of America, I Honorarium 9:13:14" Las Vegas, NV $2500 9 Harvard,'cambridge, MA {ad Honorarium 2/2014 $500 ?his category-applies on}? i f- the is $0131}: that-arise spiouse or by the ?le: with the spouse or dependent children, mark the other higher categoriesof mine. as: aaprop'riate. if. {lye-assemncomc' OGE Form 278 (Rev. 12/2011] 5 C.F.R. Part 2634 U5. 0503 of Ethics SC Page Number- cah?' RDbert (Use only if needed) 14 Valuation of Assets at close of reporting period and Income income: type and amount. If "None (or less than $201)" is checked, no other entry is needed in Block for that item. by the ?ler the. spouse or dependent children. mark the other hi gher categories of value, as appropriate. BLOCKA BLOCK 3 BLOCKC . . . 35; . if, . .: Amount ME Other Date 5, Income (Ma, Dav, gr 3 [Specify Yr.) a I - . 95 TypeActual Onlyif' - 3 E. :11 a: Amcnunt) Honoraria ,.In 5? Wm6'University of Colorado?Denver, Honcirariurn 1/1 3,114 Denver, CO $2000 1/14l14 2 Kai Research, Rbc'kVille, MD Hahere'r's'um 5122;14 (National Institute of Aging CTAP $1500 Training) . .. 3 In?nity Conference Group Inc. Honorarium 9j9l14 - Bethesda, MD (NHLBI Board of External $400 9/10l14 . . Experts Meeting) 4 Palladian Partners, Bethesda, MD Honorarlum 5112/14 - Conference) $200 5H 3M4 5 Private Diagnostic Clinic, Durham, NC Fees 2014 5530.528 2015 $3,675 6 Elsevier B.V., Philadelphia, PA Fees (American Heart Journal Position) 2014 $24,577. I 2015 $5349 7 Faculty Connection, LLC, DUrharn, Partnership Distrib (See II for consulting clients) 2014 $47,994, 201535.681 8 Duke University, Durham, NC Salary? 2014 3556.826 2015 $88,075 9 GlaxaoSmithKline PLC Consulting Fees Philadelphia, PA $2700 ?his category applies only if the 'asee?i?coi?eissolelythat of. ?ler?s sponge? or If he asset/income 15 cf er' OGE Form 278 (Rev. 124?2011) 5 CFR Do not complete Schedule if you are a new entrant, nominee, or Vice Presidential or Presidential Candidate U..S. Of?ce of Government Ethics . REpcrting individuals Name Page Number Califf. Robert M. SCHEDULE 15 Part Transactions None Report. any purchase, sale, or exchange by you, Do not report a transaction involving property transaction . your spouse, or dependent children during the reporting used solely as your personal residence, or a Type Amount 0? no? period of any real property, stocks, bonds, commodity transaction solely between you, your spouse, or Date funn?es'mnd other securities when the amount of the . dependent child. Check the "Certi?cate of (Mnamaction exceeded $1,000. Include transactions that divestiture" block to indicate sales made pmsuant a Bro), Yrtesti?ed in a loss. to a certi?cate of divestiture from OGEreassessment: Example {Central Airlmes Cammon 2!]!This category applies only if the underlying asset resoler ?lers spouse or dependent children. If. the is either held. by-the- ?ler" or spouSe-or'dependenl chiidren." {use the other higher categories of value, as appropriate.- Part H: Gifts, Reimbursements, and Travel Expenses For you, your spouso and dependent children, report the source, a brief descrip- the U.S. Government; given to your agency in connection with of?cial travel; ttion, and the value of: (1) gifts (such as tangible items, transportation, lodging, received from relatives; received by your spouse or dependent child totally food, or entertainment) received ?om one source totaling more than $350 and - independent of their relationship to you; or provided as persona] hospitality at (2) travel?related cash reimbmsements received ?om one source totaling more the donor?s residence. Also, for purposes of aggregating gifts to determine the than $350. For con?ics analysis, it is helpful to indicate a basis for receipt, such total value from one source, exclude items worth $140 or less. See instructions as personal ?iend, agency approval under 5 U.S.C. 4111 or other statutory for other exclusions. authority, etc. For travel-related gifts and reimbursements, include travel itinerary, None dates, and the nature of expenses provided. Exclude anything given to you by I . Source (Name andAddress) I . Brief Description Value 2 Examples ?Ros-scatterers; - .. . Airliniticl?kb??j?nt surest in), - $500 - .. CA feather briefcase (personal friend), I wjiiES-IW OGE Form 278 (Rev. 12i'2011) 5 GER Part 2634 U.S. O?ice of Government Ethics rReportn'lg Indlvidual's Name Celiff, Robert M. SCHEDULE Page Number 1 Part I: Liabilities Report-liabilities over $10,000 owed to any one creditor at any time during the reporting period personal residence unlesrs it is rented out; loans secured by automobiles, household None Category of Amount or Value reported on Schedule A. Neither Diagnostic nor 1 will make further contributions to this 401(k) plan. by yet}, your-'spouse-cr dependent childten; furniture or appliances; and liabilities owed to I I . Check the highest amount owed dufing?le. certain relatives listed ininstruotions. I I I "g a importing period. Exclude amortgage'on your See instructions for revolving charge accountsDate Interest Tennif g. a. a. g. 6.8" Co; a? 9:meditate. Type ofLiability Incurred Rate applicable 135 mitigating eager: . .Iohn Jones..Washington. DC . Promissorynote 10 on demand - n15" category appliesonly ifihe. liability'issmely that o?fthe'?ler's spouse or dependent children. we liability: 15 hat o'f?the are or a' ty arme- titer. with the spouseor dependentchiidl?en. mark the other higher Part II: Agreements or Arrangements Rem-n your agreements or arrangements for: continuing participation in an of absence; and (4) future employment. See instructions regarding the reporting employee benefit. plan 401k, deferred compensation); (-2.3 continuation of negotiations for any of these arrangements or bene?ts. of payment-by 'fcmetfelmployiir (including- li?avee . . None Status_;and are Agreement or Arrangement Parties Date Ie Pursuant to partnership agreement, will receive lump sum payment of capital account partnership share Doe Jones Smith, Hometown, State W85 calculated on serviceperformed through 1/00. 1 . . lwili remain on an unpaid leave of absence from my tenured professor position at Duke University. My leave of absence is Duke University, Duke University Medical Center, 2? 5 authorized to last until 2(28r'19. At the end of that time, i may apply for extension of the leave or resign from that position. Durham, NC 2 During my leave-cf absence. I will maintain my interest in the Duke Faculty and Staff Retirement Plan (de?ned contribution plan) the holdings of which are reported on Schedule A. Neither Duke University not i will make any further contributions to Duke University. Durham NC 2MB thisi?ian during mvappointment With FDA . . . 3 retain my interest In the Private Diagnostic Clinic (Diagnostic) Pro?t Sharing and 401(k) Plan. the of which are Private Diagnos?c Clinicl Durham NC 2 I1 5 OGE Form 278 (Rev, 123% 1 1) 5 GER. Part 2634 US. Of?ce of Government Ethics Reporting Individuals Name Caiiff, Robert M. SCHEDULE Page Number 17 Part 1: Positions Held Outside US. Government Report any positions held during the applicable reporting period, whether compensated or not. Positions include but are not limited to those of an of?cer, dimmer, trustee, general partner, proprietor, representative, employee, or consultant of any corporation, ?rm, partnership, or other business enterprise or any non-pro?t organization or educational institution. Exclude positions with religious, social, fraternal, or political entities and those solely of an honorary nature. None Position Held I Organization (Nadia andAddl-ess) tilled Organization I I I I I From (Mn, Yr.) 'To (Mow-Yr.) a; 'ou-?m .. u? wi'm n- n. dam on u- nun-DOeJones Hometown. State Law?rm Partner 7/35 1100 1 Duke University, Durham, NC University Professor 1982 Present 2 . . . . Vice Chancellor for Clinical Duke UnivelSity, Durham, NC Universny Transiatgonal Research 2012 2522115 3 American Heart Journal {Eisevier BN2), Durham, NC Medical Journal Editor in Chief 1998 2122115 4 Private Diagnostic Clinic, PLLC, Durham, NC (af?liate of Duke Health Medics; and Healthcare Clinics Physician 1994 21,22? 5 System). 5 Clinical Trials Transformation Initiative, Durham, NC PublioPriVate Partnership Co?Chair 2008 2122(15 6 David H. Murdock Research institute. Kannapolis. NC Not for Pro?t Institute President 2012 2022115 Part 11: Compensation in Excess of $5,000 Paid by One Source Report sources of more than $5,000 compensation received by you or your business a?iliation for services provided directly by you during any one year of the reporting period. This includes the names of clients and customers of any partnership, or other business enterprise, or any other non-pro?t organization when you directly provided the services generating a fee or payment of more than $5,000. You need not renort the US. Government as a source. Do not complete this part if you are an Incumbent, Termination Filer, or Vice Presidential or Presidential Candidate. None :1 gnome-{ntmlegm address) Brief Description of Duties a nun-I'm no.? - q?u-n-?u-n?r mar a i3 . etro University (client of Doe Jones Smith), Moneytown, State- Legal services in connection with university-construction 1 Duke Unlversitleuke University Medical Center, Durham, NC Professional services as Vice Chancellm Eisevler Philadelphia, PA (Publishing Company for the American Heart Faculty Connection LLC.. Durham. NC Board services and consulting 2 Journal) Editing services in connection with publication of the American Heart Journal I 3 Portola Pharmaceuticals. San Francisco, CA Consulting Sewiceschard of Directors I a In 5 4 PLMC, Durham, NC (affiliate of Duke Health Medica; Semcesmuke University Clinics 5 Private Diagnostic Clinic. PLLC, Durham. NC (af?liate of Duke l?lealth . . . . . System): Names of patients are con?dential under medlwi sewlcesiDUke universal? Clinics 5 OGE Form 278 (Rev. 12/2011) 5 C.F.R. Part 2634 US. Of?ce of Government Ethics indivldual?s Name Califf, Robert M. SCHEDULE Page Number 18 Part I: Positions Held Outside US. Government Report any positions held during the applicable reporting period, whether compensated or not. Positions include but are not limited to those of an of?cer, director, trustee, general partner, proprietor, representative, employee, or consultant of any corporation, ?rm, partnership, or other business enterprise or any non-pro?t organization or educational institution. Exclude positions with religious, social, fraternal, or political entities and those solely of an honorary nature. None. .EJ Type of Organization Organization (Marne andAddress} POSi?on Held .. . From .151) Exam [Societies State Law ?rm Partner was you 1 Portoia Pharmaceuticals, San Francisco, CA Pharmaceutical Company Board Member 2012 026115 2 Faculty Comedic.? Durham) NC Medical and Heaitncare Consulting Member and lif?ember of Board of 2005 2?22? 5 Firm Directors and consultant 3 Clinical Research Forum and Foundation, Durham. NC Academic Leadership Organization Chair 2010 2/22l15 4 5 Report sources of more than $5,000 compensation received by you or your business affiliation for services provided directly by you during any one year of the reporting period. This includes the names of clients and customers of any corporation, ?rm, partnership, or other business enterprise, or any other pm 11: Compensation""rangers of $5,000 Paid browsers non-pro?t organization when you directly provided the services generating a fee or payment of more than $5,000. Do not complete this part if you are an Incumbent, Termination Filer, or Vice Presidential or Presidential Candidate. You need not report the US Govornrnent as a source. None Source- mama-mt? Address) Brief Description cronies I Doe Jones 8: Smith, Hometown, State Exampics- 3515s? ?l .l Legal services Legal services in connection with university construction 1 AstraZeneca, Washington. DC, Consulting and Research Services (Faculty Connection LLC) York, NY '2 Roche Pharmaceuticas and Genentech (member of Roche Group), New Consulting and Research Services (Faculty Connection LLC) Merck Co, Inc, Kenilworth, NJ Consulting and Research Services (Faculty Connection LLC) Amgen, inc, Thousand Oaks; CA Consulting and Research Services (Faculty Connection LLC) Novartis AG, Basei, Switzerland Consulting and Research Services (Facuity Connection LLC) Medscape LLC, New York, NY Consuiting and Research Services {Faculty Connection LLC)