Mark A Goldsmith Financial Disclosure Report for Goldsmith, Mark A

8/3/2019 Mark A Goldsmith Financial Disclosure Report for Goldsmith, Mark A

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2/7

FINANCIAL DISCLOSURE REPORTPage 2 of 7

N a m e o f P e r so n R e p o r t i n gGoldsmith, M a r k A .

D a t e o f R e p o r l05/12/2011

I I I . N O N - I N V E S T M E N T I N C O M E . m~ po,~ng ~ ndi..id, at an~s, ous~; ~ ~ . IZ-Z of, ling i,s,rucaons.)A. Fliers Non-Investment IncomeD N ON E (No reportable non-investment income.)

D A T E S O U R C E A N D T Y P E INCOME( y o u r s , n o t s p o u s e s )I . 2010 S t a t e o f M i c h i g a n / O a k l a n d C o u n t y - w a g e s $74, 412.002 . 2 0 1 0 H o n ig m a n M ille r S ch w a r tz an d C o h n se p a ra tio n a g re e m e n t $5 3,85 5.003.4.

B . S p o u s e s N o n - I n v e st m e n t I n c o m e - i f y o u w e r e m a r r i e d d u r i n g a n y p o r t l o n o f th e r e p o r t i n g y e a r , c o m p l e t e th i s s e c t io n .(Dollar amount not required exce pt for honoraria.)[-~ N O N E ( N o reportable non-investment income.)

DATEI . 2Ol02.5.4.

S O U R C E A N D T Y P Es e l f- e m p l o y e d s o c i a l w o r k e r

I V . R E I M B U R S E M E N T S - transportation, Iodglng, food, entertainment(Includes those to spouse and dependent children; see pp. 25-27 of f iling instructions.)

1~] N O N E (No reportable reimbursements.)

2.3.4.5.

SOURCE DATES LOCATION PURPOSE ITEMS PAID OR PROVIDED


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N a m e o f P e r so n R e p o r t i n gG o l d s m i t h , M a r k A .

D a l e o f R e p o r t05/12/201 I

3.4.5.

S O U R C EFedera l Bar A s s oc ia t i on , E .D. M ich.Cha p t e r Invest i ture

D ESC R IP T IO N V A L U E$ 1,000.00

V I . L I A B I L I T I E S . (lncludes those of spouse and dep endent children; see pp. 32-33 of filing instructions.)N O N E ( N o reportable liabilities.)

CREDITOR DESCRIPTIONI.2.3.4.5.

VALUECODE


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N a m e o f P e r s o n R e p o r t in gG o l d s m i t h , M a r k A .

D a t e o f R e p o r t05/12/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - income, v alue, transactions (Includes those of spouse and dependen t children; see pp. 34-60 of filing instructions.)N O N E (No reportable income, assets, or transactions.)

D e s c r i p t i o n o f A s s e t s I n c o m e d u r i n g( i n c l u d i n g t r u s t a s s e t s ) r e p o r t in g p e r i o d

0) (2)P l a c e " ( X ) " a f t e r e a c h a s s e t A m o un t T y p e ( e .g .,exempt from prior disc losure Code I d i v . , r e a t ,(A-H) o r i n t . )

G r o s s v a l u e a t e n do f r e p o r t i n g p e r i o d(l) (2)

V a l u e V a l u eC o d e 2 M e t ho d

( J - P ) C o d e 3

(] )T y p e ( e . g .,b u y , s e l l ,

r e d e m p t i o n )

T r a n s a c t i o n s d u r i n g r e p o r t in g p e r i o d(2) (3) (4)

D a t e Value Gainmm/dd/yy Code 2 [ 2 o d e I

(J-P) (A-H)

(5 )I d e n t i t y o fbuyer/seller

( i f p r i v a t et r a n s a c t i o n )

1. I nves c o C ha r t e r f ka AI M C har t e r ( I R A- A D i v i d e n dB r o k A c c t # 1 )2. C a la m o s G ro w th ( I R A -B r o k A e c t # 1 ) N o n e

LL

TT

3. Fide l i t y Cont ra ( IRA-Brok Acc t #2) A D iv id en d K4. Fide l i t y In t l Di s cove ry ( IRA-Brok Acc t #2) A D iv id en d K5. Fide l i t y In t l Sma l l Cap ( IRA-B rok Acc t #2) B D iv id en d K6. Fide l i t y Cas h Res e rves ( IRA-Brok Acc t #2) A D iv id en d J7. T R o w e P r ice G ro w th (401 K -B ro k A cc t #3) N on e N8. I n v e s co V a n K a m p e n G r o w t h I n c o m e N o n e N(401K -Brok A cc t #3)9. J P M o r g a n S m a l l C a p V a l u e S e l e c t (4 0 1 K - N o n e MBrok Acc t #3)1 0 . V a n g u a r d M i d - C a p I n d e x ( 4 0 1K - B r o k A c c t N o n e M#3 )1 I. Ss gA R us s e l l 2000 Index (St o f M ich 401 K ) N o n e M1 2 . P a c i f i c O n e V a r i a b l e A n n u i t y N o n e K1 3 . TRoweP r ice Blue Chip Growth A D iv id en d K1 4 . Barron As s e t (Brok Acc t #4) A Dividend L1 5 . Fidel i ty Int l Discovery (Brok Accl #-4) A D iv id en d1 6 . Janus Ente rpr i s e (Brok Acc t #4) N o n e1 7 . Jan us 20 (Bro k Accl #4 ) A Dividend K

TTTTTTTTTTTT

So ld

So ldT So ld(par t )

05/18/10 J

05/18/10 J C05/18/10 K D

I. In co m e G ain Co d es: A = $1,000 o r less B = $1,001 - $2 ,500 C = $2 ,501 - $5 ,000 D = $5,001 - $15,0~0(Se e Co lumn s B I a n d 04) F =$50.001 - $10~.00~ G =$10O,0Ol - $1.000.000 HI =$1.000.001 - $5.000,000 H2 -More tha n $5.000.0~O

2. Value Codes J -$15,1~0 or less K = $15,001 - $ 50.0~0 L -$50,001 - $ 100,000 M = $ 100,001 - $250.000(Se e Co lumn s CI a n d D3) N =$250.0~1 - $500.0~0 O =$500,001 - $1,0~0,000 PI =$1,0~0,001 - $5.000,000 P2 = $5,009.0~1 - $25,0~),000

P3 -$25,000,0~1 o $50.000.000 P4 =More than $50,000,0~03 , Value Method Codes Q =Ap p r a i sa l R :Cos t ( R eal [~s t a te Only ) S : Asse s sme n t T = Cas h Mar ket1See Column C2) U = Book Value V = Other W = Es t imated

E =$15,0OI - $50.000


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N a m e o f P e r s o n R e p o r t in gGoldsmith, M ark A.

D a t e o f R e p o r t05/12/201 I

V I I . I N V E S T M E N T S a n d T R U S T S - income, ralue, transactions (Includes those of spouseand dependent children; seepp. 34-60 of filing instruction&)N O N E (No reportable income, assets, or transactions.)

D e s c r i p t i o n o f A s s e t s I n c o m e d u r i n g( i n c l u d i n g t r u s t a s s e t s ) r e p o r t i n g p e r i o d

(i) (2)Place "(X)" after each asset A m o u n t Type (e.g.,

exempt from prior disclosure Code I d i v . , r e n t ,( A - H ) or i n t . )

G r o s s v a l u e a t e n do f r e p o r t i n g p e r i o d(I) ( 2 )V a lu e V a lu e

C o d e 2 M e t h o d(J-P) C o d e 3

( Q - W )

(I)Type (e.g.,buy , s e l l ,

r e d e m p t i o n )

T r a n s a c t i o n s d u r i n g r e p o r t i n g p e r i o d

(2) (3) (4)D a t e Value G a i n

m m / d d / y y C o de 2 C o d e I( . I - P ) ( A - H )

( 5 )I d e n t i t y o f

b u y e r / s e l l e r( i f p r i v a t e

t r a n s a c t i o n )

1 8 . M anagers Fremont Microcap (Brok Acct #4) None M1 9 . Vangu ard 500 Index B Dividend L

2 0 . F ide li ty M u n i M o ney (UGM A- Brok Acc t A Dividend J#5 )

21 . Ishares TR S&P 500 Index (UGMA -B rok A Dividend JAcct #5)22 . TIAACREF 100% Equity (UGM A 529) None M23 . Ann Taylor Stores Corp Common Stock None J24 . Fidelity Cash Reserves (IRA-Brok Acc t #6) A Dividend J25 . Life insurance (surrender value) None J26 . Congregation Beth Shalom Bond None2 7. Isr ae l B o nd s ( Y)28 . Bank of America account (X) A I n t e r e s t J

TT Sold I 1/04 /10 K(par t )TTTTTT

Redeemed 06128110 J

T29 .30 .

I . Income G ain Codes : A =$1,000 or less B =$1,001 - $2 ,500 C = $2,501 - $5 ,000 D =$5.001 - $15.000( S o e C o l t m m s B I a n d I M ) F =$50,0~1 - $100.000 G =$100,0~1 - $1,009.090 H I =$1,009.001 - $ 5 , 0 0 0 , 0 0 9 H 2 = Mor e than

2 . Value Codes J =$15,000 or less K = $15,001 - $50,000 L =$50.001 - $ 100.000 M =$ 100,001 - $250.000(Se e Co lumn s CI a n d D3) N =$250,001 - $500,000 O = $5 00.001 - $1 ,00 0,000 P I = $1 ,000 .0 01 - $5 .000 ,00 0 P2 =$5,000.001 - $25.000.000

P3 =$25.000,001 - $50,000.000 P4 = M ore than $50,000.0003 . Value Method Codes Q =Ap p r a i sa l R -C ost (R eal Esta te O nly ) S -A ss es sm en t T = C a s h M a r k e t

( S e e C o l u m n C 2 ) U = Book Value V = Olhcr W = Es t imated

E =$15.001 - $50,000


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FINANCIAL DISCLOSURE REPORTPage 6 o f 7

N a m e o f P e r so n R e p o r t i n gG o l d s m i t h , M a r k A .

Date of R e p o r t05/12/201 I

VIII. ADDITIONAL INFORMATION OR EX PLANATIONS. (~ndicatepartof report.)P a r t V I I l in e s 7 - 1 0 a r e t h e a s s e t s i n t h e H o n i g m a n M i l l e r S c h w a r tz a n d C o h n I n c o m e D e f e r r a l a n d P r o f i t S h a r i n g P l a n .


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Nam e of P e r son Repor t ingG o l d s m i t h ~ M a r k A .

Date of Repor t05/I 2/201 I

IX. CERT IFICATION.i c e r t i f y t h a t a l l i n f o r m a t i o n g i v e n a b o v e ( i n c l u d i n g i n f o r m a t i o n p e r t a i n i n g t o m y s p o u s e a n d m i n o r o r d e p e n d e n t c h i l d r e n , i f a n y ) i s

a c c u r a t e , t r u e , a n d c o m p l e t e t o t h e b e s t o f m y k n o w l e d g e a n d b e l i e f , a n d t h a t a n y i n f o r m a t i o n n o t r e p o r t e d w a s w i t h h e l d b e c a u s e i t m e t a p p l i c a b l e s t a t u to r yp r o v i s i o n s p e r m i t t i n g n o n - d i s c l o s u r e .! f u r t h e r c e r ti f y t h a t e a r n e d i n c o m e f r o m o u t s i d e e m p l o y m e n t a n d h o n o r a r i a a n d t h e a c c e p t a n c e o f g i f ts w h i c h h a v e b e e n r e p o r t e d a r e i nc o m p l i a n c e w i t h t h e p r o v i s i o n s o f 5 U . S . C . a p p . 5 0 1 e t . s e q . , 5 U . S .C . 7 3 5 3 , a n d J u d i c i a l C o n f e r e n c e r e g u l a t i o n s .

Signature: S[ M ark A. Goldsmith

N O T E : A N Y I N D I V ID U A L W H O K N O W I N G L Y A N D W I L FU L L Y F A L S IF I ES O R F A I LS T O F I L E T H IS R E P O R T M A Y B E S U B J E C T T O C I V ILA N D C R I M I N A L S A N C T I O N S ( 5 U . S . C . a p p . 1 0 4 )

Committee on Financial DisclosureAdministrative Office of the United States CourtsSuite 2-301One Columbus Circle, N.E.Washington, D.C. 20544

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Mark A Goldsmith Financial Disclosure Report for Goldsmith, Mark A