FINANCIAL DISCLOSURE STATEMENT gig? STATES HOUSE OF REPRESENTATIVES Form A For Use by Members, Of?cers, and Employees JAN 7 23} Page1of?2 9 LATIVE RESOURCE Daytime Telephone; ?tweet-"ll FH A 5206' B?d?wlsmeSSed against any individual who ?les m??f??ttian .30 gays late. I .. . FILER Member of the U.S. State: 50 Of?cer or Employing Of?ce: Staff Filer Type: (If Applicable) STATUS 7( House of Representatives District: 42 I Employee SheredE, Principal Assistant CI Rage" 201? Annual (Due: May 15. 201 8) Amendment Termination a Luv-i Date of Termination: '10 I. PRELIMINARY INFORMATION ANSWER EACH OF THESE QUESTIONS A. Did you. your spouse. or your dependent child: the current calendar year up through the date of ?ling? 3. Own any reportaP'e 33?? that was worth more than $1300 at the F. Did you have any reportable agreement or arrangement with an end the reporting 99mg? o_r . Yes outside entity during the reporting period or in the current calendar Yes "0 b. Receive more than $200 in unearned income from any reportable year up through the date ofI ?ling? I asset during the reporting period? B. Did you. your spouse. or your dependent child purchase, sell. or G. Did you, your spouse. or your dependent child receive any exchange any securities or reportable real. estate in a transaction Yes No reportable 9W8) totaling more than $390 in value from a single Yes No exceeding $1.000 during the reporting period? - source during the reporting period? c. Did you or your spouse have ?earned? income (9.9.. salariesendent child receive an honoraria. or'pensionllRA distributions) of $200 or more during the Yes Na reportable tryavel travel totaling more than Yes No reporting period? $390 in value from a single source during the reporting period? . . I. Did any individual or organization make a donation to charity in 0. Did you, your spouse. or your dependent child have any reportable Yes liability (more than $10,000) at any point during the reporting period? I ?o?sggengo??: for a speech. appearance. or article during the 1? E. Did you hold any reportable positions during the reporting period or in 93 "0 ATTACH THE CORRESPONDING SCHEDULE IF YOU ANSWER IPO AND EXCLUSION OF SPOUSE. DEPENDENT, OR TRUST INFORMATION - ANSWER EACH OF THESE QUESTIONS the Committee on Ethics for further guidance. IPO Did you purchase any shares that were allocated as a part of an Initial Public Offering during the reporting period? If you answered ?yes? to this question. please contact Yes No Kl TRUSTS Details regarding ?Quali?ed Blind Trusts? approved by the Committee on Ethics and certain other ?excepted trusts? need not be disclosed. Have you excluded from this report details of such a trust that bene?ts you. your spouse. or dependent child? Yes I: No EXEMPTION - Have you excluded from this report any other assets, ?unearned? income. transactions. or liabilities of a spouse or your dependent child because they meet all three tests for exemption? Do not answer ?yes? unless you have ?rst consulted with the Committee on Ethics. Yes El No IX SCHEDULE A ASSETS Name: iI Whig? 6W0 ND Page 1/ of (0 For all IRAs and other retirement plans (such as 401(k) plans) provide the value for each asset held in the account that exceeds the reporting thresholds. For bank and other cash accounts. total the amount in all interest-bearing accounts. If the total is over 35.000, list every ?nancial institution where there is more than $1,000 in interest-bearing accounts. For rental and other real property held for investment. provide a complete address or description. ?I'ental property.? and a city and state. For an ownership interest in a privately-held business that is not publicly traded. state the name of the business. the nature of its activities, and its geographic location in Block A. Exclude: Your personal residence, including second homes and vacation homes (unless there was rental income during the reporting period); and any ?nancial interest in. or income derived from. a federal retirement program. including the Thrift Savings Plan. If you report a privately-traded fund that is an Excepted Investment Fund. please check the box. If you so choose, you may indicate that an asset or Income source is that of your spouse (SP) or dependent child (DC). or iointly held with anyone (JT). In the optional column on the far left. For a detailed discussion of Schedule A requirements. please refer to the instruction booklet. child in which you have no interest. 550001-8100000 31301-315300 'mattmm 32500014500000 comm None snowman? cum SpurselDC Asset over 51.000000" TRUST (Specify: 9.9.. Partnership Income or Farm Income) OtherTypeoilnoome TM 0090le . DIVIDENDS . INTEREST SW 51001-52500 5001-3150011 5503015100000 the 314200 mm mm Sim-01m 51.000.001-85.000.000 Over XII SpomelDC Asset with Income over 51.000000" BLOCK A BLOCK BLOCK 0 BLOCK BLOCK Assets andl'or Income Sources Value of Asset Type of Income Amount of Income Transaction Identify each asset held for investment or Indicate value of asset at close of the reporting period. If you use a Check all columns that apply. For accounts that For assets for which you checked ?Tax-Deferred? in Block 0. you lndicateifthe production of income and with a fair market value valuation method other than fair market value. please specify the method generate tax-deferred income {such as 401(k). IRA. or may check the ?None' column. For all other assets indicate the asset had exceeding $1.000 at the end of the reporting period. used. 529 accounts). you may check the 'Tax-Deferred' category of income by checking the appropria: box below. purchases (Pi. and any other reportable asset or source of - - . . column. Dividends, Interest, and capital gains. Dividends. interest, and capltal gains. even reinvested. sales or income that generated more than $200 in 'uneemed" mag?ntmf .?hhgv??rg?gu?e?e?mls 'ndumd only even it reinvested. must be disclosed as Income must be disclosed as income for assets held In taxable exchanges (E) income during theyear. 9? for assets held in taxable accounts. Check'None' accounts. Check 'None? If no income was earned or exceeding $1.000 ?Column is for 353615 he'd hit your 890089 0' dependent Child in which if the asset generated no income during the reporting generated. in the reporting Provide complete names of stocks and mutual funds you have "050130351. period. period. (do not use oniy ticker symbols). *Column XII is for assets held by your spouse or dependent It only a portion of an asset was sold. please indicate as follows: (8 (part)). Leave this column biank ifthere are no transactions that exceeded $1.000. P, s. Bipart}, or EIF SP MegaGorp.Stock 3-: >6 3030?} 5'38 Examples: Simon Schuster Inde?nite ABCI-IedgeFmd Partnership income {an lam 6? ser oF Mamet Bro 1mg ah. the snub we. ll-IL . [?ts Metal *3 we We? Use additional sheets If more space ls required. SCHEDULE A ASSETS 8: Name: Mkfeml?hmu? 6W0 Page 2 of '0 Use additional sheets If more space ls required. BLOCK A BLOCK BLOCK BLOCK BLOCK Assets andlor Income Sources Value of Asset Type of Income Amount of Income Transaction 3'3 "gt-:3:?3,3,3 ASBETNAIE tl? Rules rungWit?21 coo 33 3 11/ 3?94!me qugc 3 ,3 Ta. 35? 7.?3 km; Mug)1st PM). mm. mm M. . mt) $6fSo. 6W, ?Having . 5 one 3 3 SCHEDULE A ASSETS A Mm: Mar Income Sources a E: 3 ?erFa?rb IT I Pagei of [0 0 ourde (Specify: 9.3.. WWUlemune} BL Amount of Income $5 uponmusmomo BLOCK Transaction SCHEDULE TRANSACTIONS Mh$kall ,1 Name: hi4, smug. Page 5" of [0 Report any purchase. sale. or exchange transactions that exceeded 51.000 mpartv he? by you. your spouse. or your Type of Transaction Date Amount of Transaction dependent child for investment or the production of income. Include transactions that A I resulted in a capital loss. Provide a brief description of an exchange transaction. Exclude transactions between you. your spouse. or dependent children. or the purchase or sale of your personal residence. unless it generated rental income. If only ii a portion of an asset is sold. please choose 'parlial sale? as the type oftransaction. Warmly. 3: Capltal Galns: If a sales transaction resulted in a capital gain in excess of 5200. check a weakly. if the "capital gains' box. unless it was an asset in a tax-deferred account. and disclose a l? mplicable 4 .L 3. . mempitalgaininoomeonScheduleA'Column Kis for assets solely held by your spouse or dependent childAsset SP I ?999?? 3m 3mm caveman st some it lot wilson st Duvetnloneo Use additional sheets if more space is required. SCHEDULE EARNED INCOME we lull 5?:an Isa List the source, type, and amount of earned income from any source (other than the ?ler's current employment by the US. government) totaling $200 or more during the reporting period. For a spouse, list the source and amount of any honoraria; list only the source for other spouse earned income exceeding $1,000. See examples below. EXCLUDE: Military pay (such as National Guard or Reserve pay). federal retirement programs, and bene?ts received under the Social Security Act. INCOME LIMITS and PROHIBITED INCOME: The 201? limit on outside earned income for Members and employees compensated at or above the "senior staff" rate was $27,765. The 2018 limit is $28,050. In addition, certain types of income (notably honoraria, director?s fees, and payments for professional services involving a ?duciary relationship) are totally prohibited. Source (include date of receipt for honoraria) Type Amount Keene State Approved Teaching Fee $6.000 State of Maryland Legislative Pension $13,000 Examples. Civil War Roundtable (on. 21 390089 Speech 51-00? I Ontario County Board of Education Spouse Salary NIA pout-t Use additional sheets If more space is required. SCHEDULE LIABILITIES Name: prrf?q Pageiof [0 Report liabilities of over $10,000 owed to any one creditor at any time during the reporting period by you, your spouse. or your dependent child. Mark the highest amount owed during the reporting period. Members: Members are required to report all liabilities secured by real property including mortgages on their personal residence. Exclude: Any mortgage on your personal residence (unless you rent it out or are a Member); loans secured by automobiles. household furniture. or appliances; liabilities of a business in which you own an interest (unless you are personally liable); and liabilities owed to you by a spouse or the child. parent. or sibling of you or your spouse. Report a revolving charge account credit card) only if the balance at the close of the reporting period exceeded $10,000. *Column is for liabilities held solely by your spouse or dependent child. Amount of Liability A a I Date SP Liability . . . Cre it be Incurred Type of Liability s?aae-se? -58??88_ Example First Bank of Wilmington. DE 5i15 Mortgage on Rental Property. Dover, DE 3km: 0F Lamar/i, W?mi. Emit: SCHEDULE POSITIONS Position Report all positions, compensated or uncompensated. held during the current or prior calendar year as an of?cer. director trustee of an organization partner, proprietor. representative. employee. or consultant of any corporation, rm partnership or other business enterprise, nonpro?t organization, labor organization, or educational or other institution other than the United States. Exclude: Positions i anizations); and positions solely of an honorary nature. Name of Organization Use additional sheets if more space is required. Name: SCHEDU EMENTS A am, A mi [a Identify the date, parties to, and general terms of any agreement or arrangement that you have with respect to: future employment; a leave of absence during the period of government service; continuation or deferral of payments by a former or current employer other than the US. government; or continuing participation in an employee welfare or bene?t plan maintained by a former employer. Date Parties to Agreement Terms of Agreement (Noble) SCHEDULE - GIFTS Report the source (by name), a brief description, and the value of all gifts totaling more than $390 received by you, your spouse, or your dependent child from any source during the year. Exclude: Gifts from relatives, gifts of personal hospitality from an individual. local meals, and gifts to a spouse or dependent child that are totally independent of his or her relationship to you. Gifts with a value of $156 or less need not be added towards the $390 disclosure threshold. Note: The gift rule (House Rule 25. clause 5) prohibits acceptance of gifts except as speci?cally provided in the rule and some gifts require prior approval of the Committee on Ethics. Source Description Value Example: Mr. Joseph Smith. Arlington. VA Silver Platter {prior determination of personal friendship received from the Committee on Ethics} $400 (Haida) Use additional sheets if more space is required. SCHEDULE TRAVEL PAYMENTS and REIMBURSEMENTS In; it Name: 5 Page a of {0 Identify the source and list travel itinerary, dates, and nature of expenses provided for travel and travel-related expenses totaling more than 3390 received by you, your spouse, or your dependent child during the reporting period. Indicate whether a family member accompanied the traveler at the sponsor?s expense. Disclosure is required regardless of whether the expenses were paid directly by the sponsor or were paid by you and reimbursed by the sponsor. EXCLUDE: Travel?related expenses provided by federal. state. and local governments. or by a foreign government required to be separater reported under the Foreign Gifts and Decorations Act (FGDA. 5 U.S.C. 7342); political travel that is required to be reported under the Federal Election Campaign Act; travel provided to a spouse or dependent child that is totally independent of his or her relationship to the ?ler. Family Member Source Dams} any of Dopamre-Des?na?on-Clty of Return ?(19:39? F333: Included? cwanmlarcnina Aug. e11 DEE-Beijing, China-DC Examples: Habitat for Humanity (charity lundraiser] 3.4 DC-Boslon-DC No Me) Use additional sheets If more space is required. SCHEDULE -- PAYMENTS MADE TO CHARITY IN Mm ha? LIEU OF HONORARIA I, Name: Page i of A List the source. activity (119.. speech, appearance, or article), date, and amount of any payment made by the sponsor of an event to a charitable organization in lieu of paying an honorarium to you. A separate con?dential list of charities receiving such payments must be ?led directly with the Committee on Ethics. Source Activity Date Amount Exam {93' Association of American Associations. Washington, DC Speech Feb, 2, 2017 $2,000 9 XYZ Magazine Article Aug. 13,2017 $500 None) Use sheets if more space is required.