0GB Form 278e (March 2014)

US. Of?ce of Government Ethics; 5 part 2634 Form Approved: OMB No. (3209-0001) I ATE or 

Report Type: Candidate GOVERN ENT ETHICS

Year Annual Report only): 

Date oprpointmenthermjnation: Prevonlung Con?icts of Interest
in the Etc-Cutwc Bra 

 

 

 

 

 

 

 

 

Executive Brainylifmegpnnel Public Financial Disclosure Report (0GB Form 278a)

 

Filer's Information

 

 

Last Name First Name MI Position Agency
Stein Jill Candidate for President NIA

 

 

 

 

 

Other Federal Government Positions Held During the Preceding, 12 Months:

 

 

Name of Congressional Committee Considering Nomination (Nominees only]:

 

 

Filer?s Certi?cation certify that the statements I have made in this report are true, complete and correct to the best of my knowledge:

 

Signature: Date:

9420 Sg?w a/ao/wze

 

 

 

gency Oittcmi?s Dpinton - On me basrs ot mtonnatton contained to tilt?? report, I conclude that the trier IS In compliance With applicable laws and regulations
{subject to any comtnents below)

Signatury1 Date:  79 

 

 

Other Review Conducted By:
Signature: Date:

.
NC. (ELL 

 

   

 

"Ali/A 

 

 

us. Certi?cation (ifreqnired):
.Date'



1/

 

 

 

Comments of Reviewing Of?cials:

 

WM new, noel/em 
Reviewed for Apparent Comphance 
with the Federal Election Campaign Act

 

 

 

OGE Form 2786 (March 2014)
Instructions for Part 1
Note: This is a public form. Do not include account numbers, street addresses, or Family member nannies. See instructions for required information.

 

Filor?s Name Page Number

 

Jill E. Stein 1

 

Part 1: Filer's Positions Held Outside United States Government

 

Organization Name? Citya?State Organizatiou Type Position Held From To

 

1, Liberty Tree Foundation Madison. WI non pro?t. education Board of directors 1032013 ?2014

 

2_ Green Shadow Cabinet Portland ME project of Green Action (an educational spokesperson 4.2013 ?201 5
non pro?t organization)

 

 

 

 

 

 

 

 

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068 Form 2780 (March 2014)
Instrucn'ons for Part 2
Note: This is a public form. 00 not Enclude account numbem, street addresses, or family member names. See instructions for recluired information.

 

 

Filer's Name Page Number

 

Jill E. Stein 2

 

 

Part 2: Filer?s Employment Assets Income and Retirement Accounts

 

Description EIF Value Income Type Income Amount

 

TIAA heatinnal Annuity 401(k) WA 315.001 - $50,000 Income not readily
ascertainable

 

CREF Stock R2 401(k) 315.001 - $50,000 income nut readin
ascertainable

 

 

 

 

 

 

 

 

 

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OGE Form 3% (March 2014)

lli'?ititl'iuli?s for Part .i 9A) 
Note: This is a public l'orm. Do not include account numbers, street addresses, or tisunil'.r member names. See instructions for required information
Filer's Name
Jill E. Stein

Part 3: Filer's Employment Agreements and Arrangements

E'mployer?or Party? City/Stator? Status andJ?I?erms Dare?
Harvard Community Health Wellesley. MA TIM Traditional Annuity (Listed in Part 2. line Continuod participation in 401(k) plan. No contributions from 10/82 

Plan (former employer. now former employer.
known as Harvard Pilgrim
Health Plan)

 

Page Number
3

 

 

 

 

 

 

 

2. Harvard 50mmunity Health Wellesley, MA CREF Stock R2 (Listed in Part 2. line Continued participation in 401(k) plan. No contributions from former 10f32
Plan (former employer, new employer.
known as Harvard Pilgrim
Health Pian]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OGE Form 278: (March 2014)
Instructions for Part 4
Note: This is a public form. Do not include account numbers, street addresses, or family member names. See instructions for required information.

 

Fi lcr's Name Page Number

 

 

Jill E. Stein 4

 

Part 4: Filer?s Sources of Compensation Exceeding $5,000 in a Year

 

Source Name- - - Bria-{DescriptionofDutics

 



 

 

 

 

 

 

 

 

 

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OGE Form 27 Be (March 2014) .
Instructions for Part5

Note: This is a public form. Do not include account numbers, street addresses, or family memb

or names. See instructions for required information.

 

Pilot's Name

Page Number

 

Jill E. Stein

 

 

5

 

Part 5: Spouse?s Employment A3scts Income and Retirement Accounts

 

Description EJF Value

Income Type

Income Amount;

 

Employment - Pratt Surgical Assoc NIA

Salary

 

2. 401(21): plans Traditional Annuity WA $100,001 -$250.000

Income not readily
ascertain able

 

3, CREE: Equity index - 401(3) $250,001 - $500,000

Income not readily
ascertainable

 

4, CREF Global Equities $100,001 $250,000

Income not readily
ascertainable

 

5, CHEF In?ation Linked Bond - 401(3) $1,001 - $15,000

Income not readily
ascertainable

 

6. TIAA Traditional Annuity - I101(k) WA $100,001 - $250,000

Income not readily
ascertainable

 

CREF in?ation Linked Bond 401 $100,001 - $250,000

Income not readily
ascertainable

 

3, TIM Real Estate - 401(k) $50,001 - $100,000

Income not readily
ascertainable

 

9_ Vanguard 2020 Fund 401(k) $50,er - $100,000

Income not readily
ascertainable

 

10, Vanguard Total Bond Market Index-401(k) VBNIFX $500,001 -$1,000,000

Income not readily
ascertainable

 

11, Vanguard 500 Index Fund - 401(k) VFINX $250,001 $500,000

Income not readily
ascenainable

 

12, Vanguard Total Bond Market Index - 403(0) $100,001 - $250,000

Income not readily
ascertainable

 

13_ Vanguard 2020 Fund - 403th) $15,001 $50,000

Income not readily
ascertainable

 

14. CREF In?ation Linked Bond 4570:) $50001 - $100,000

Income not readin
ascertainable

 

15, International Equity Index- IRA 

Income not readily
ascertainable

 

 

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OGE Form 2780 (March 2014)

Note: This is a public form. Do not include account numbers,

Instructions for Part 6

street addresses, or famiiv member names, See instructions for required information-

 

Filer?s Name

Page Number

 

Jill E. Stein

0

 

 

Part 6: Other Assets and Income

 



Description Value

 

Income Type

Income Amount

 

u.s. bank account #1 (cash) NKA $1,001 - $15,000

inte rast

None {or less than $201}

 

U.S. bank account #2 (bash) $1,001 - $15,000

i nte rest

None (or less than $201]

 

Precious Metals Gold coins A $1,001 - $15,000

None (or less than $201)

 

- Platinum bars NXA $1,001 - $15,000

None {or less than $201}

 

intenionally left blank

 

INDIVIDUAL STOCKS Disney Corporation DIS NI A $100,001 - $250,000

Dividend

$201 - $1.000

 

Home Depot HD $100,001 - $250,000

Dividend

$2,501 - $5,000

 

IBM NIA $15,001 - $50,000

Dividend

$1,001 - $2,500

 

Intel one NXA $50,001 $100,000

Dividend

$2,501 - $5,000

 

10

Johnson EL Johnson JNJ $15,001 - $50,000

Dividend

$201 - $1,000

 

11

Merck MRK NKA $50,001 - $100,000

Dividend

$1,001 - $2.500

 

12

China 25 Index Fund FXI, lShares China Large-Cap $15,001 - $50,000

Dividend

$21,001 - $2,500

 

13

Mutual Funds

Vanguard 500 Index Admiral VFLAX $500,001 $1,000,000

Dividend

$5,001 - $15,000

 

14

Vanguard 500 Index VFIAX $50,001 a $100,000

Dividend

$1,001 - 52,500

 

15

Vanguard Total Bond Market Index - $50,001 - $100,000

Dividend

$1,001 - $2.500

 

16



Fidelity MA Muni Bond Fund $500,001 - $1,000,000

Dividend

$15,001 - 550,000

 

17

US Treasury Bills 3 mo. $1,001 - $15,000

Interest

None {or less than $2010

 

18

US Treasury Notes 10 yr. NXA $15,001 - $50,000

lnte rest

None {or less than $201]

 

19,

Worcester: MA Muni Bond Government Obligation 425% WA $15,001 $50,000
08/15/22

I nte rest

$1 100'1 - 52,500

 

 

Cambridge, MA Muni Bond Government Obligation 4.00% WA $50,001 - $100,000

 

02/ 20/ 21

 

 

 

nterest

 

$1.001 - $2,500

 

 

OGE Form This (March 2014)

instructions for Part 6



 

WNotethhisjsa public form. Do not include account numbers, street addresses, or famiiy member names. See instructions for required information.

 

Fi let's Name

Page Number

 

Jill E. Stein

7

 

 

Part 6: Other Assets and Income - (2nd page of Part 6)

 



Description

EIF

Value

Income Type

Income Amount

 

21

U.S Bank account CDs - total



$15,001 - $50,000

interest

None {or less than $201}

 

22

Schwab Money Fund 

$15,001 $50,000

interest

None (or less than $201]

 

23

Iu'anguard Total Bond Market Index IRA, 

$100,001 - $250,000

 

24

Vanguard Total Bond Market Index IRA, 

$50,001 $100,000

income not readily ascertainable

 

income not readily ascertainable

 

25

Vanguard 500 Financial Index Fund - IRA, VFIAX

$50,001 - $100,000

income not readily ascertainable

 

26

Vanguard 500 Financial Index Fund - IRA, VFIAX



$15,001 - $50,000

income not readily ascertainable

 

27

3M



$50,001 - $100,000

Dividends

$2,501 - $5,000

 

28

Bessemer Trust - SEI Daily Income Trust, Government II Fund,
Class A

$1,001 $15,000

income not readily ascertainable

 

29

Bessemer Trust Old Westbury Fixed Income - Bond Funds

$100,001 - $250,000

income not readily ascertainable

 

30

Bessemer Trust Old Westbury Large Cap Core Global

$50,001 $100,000

income not readily ascertainable

 

31

Bessemer Trust Old Westbury Large Cap Strategies

$100,001 - $250,000

income not readily ascertainable

 

32

Bessemer Trust Old Westbury Small Mid Cap

$15,001 - $50,000

income not readily ascertainable

 

33

Bessemer Trust Old Westbury Strategic Opportunities



$50,001 - $100,000

income not readily ascertainable

 

34

0.8. Credit Union account #1 (cash)



$15,001 $50,000

interest

None (or less than $201)

 

 

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U.S. Credit Union account #2 (cash)

 

 



$50,001 - 5 100,000

 

i nte rest

None (or less than $201)

 

 

 

 

OGE Form 2780 ("March 2014)
nstructions for Part 7

Note: This is a public form. Do not include account numbers, street addresses, or family member namEs. SEE instructions for rEqulred information.

 

 

Filer?s Name I Page Number

 

Jill E. Stein 8

 

Part 7: Transactions

 

Description??m Type he Ame unt

 

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OGE Form 2783 (March 2014) 
Instructions for Part 8
Note: This is a public form. Do not include account numbers, street addresses, or family member names. See instructions for required information.

 

 

Filer's Name Page Nmnber

 

Jill E. Stein 9

 

Part 8: Liabilities

 

red no amc Type nt Year Incu rred Rate Term

 

I. NONE

 

 

 

 

 

 

 

 

 

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0GB Form 278:: (March 2014)

Note: This is a public form. Do not include account numbers, street addresses, or famin member names. See instructions for required information.

instructions for Pq?

 

 

Filer's Name

Page Number

 

Jill E. Stein

 

 

Part 9: Gifts and Travel Reimbursements

 



Source?Name 

Citnytate

Brief Description

Value

 

1.

MIA

 

 

 

 

 

 

 

 

 

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