8/3/2019 Jennifer W Elrod Financial Disclosure Report for 2010
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AO 1 0
Rev. 1/2011
FINANCIAL DISCLOSURE REPORT
FOR CALENDAR YEAR 20 10
Report Required by the Ethics
in Government Act o f 1978(5 U .S. C. app. ~~ 101-111)
I . P e r s o n Report ing (last nam e, f i rst , middle ini t ia l)
EIro d , J en n i fe r W.
4. Tit le (Ar ticle III judges ind ica te active or sen ior s ta tus ;
magist rate judges indicate fu l l - or p ar t - t ime)
Circui t Co ur t o f Ap p ea l s , Ac t ive Jud g e
7. Chambers or Off ice Address
515 Rusk Aven ue , 12 th Flo o rH ouston , TX 77002- 2603
2. Court or Organizat ion
F i f t h C i r c u i t C o ur i o f Ap p ea l s
3. Date of Report
5/15/2011
5a . Repor t Type (check appropr ia te type)
] Nominat ion , D a t e
[] Initial [] Annual [] Final
5b. [] Amended Report
’ 8. On the bas is o f the in form ation conta ined in th is Repor t and anymodif ica tions per ta in ing the re to , i t is , in my opin ion , in compliance
with appl icable l aws and regulat ions .
Reviewing Officer Date
6. Repor ting Per iod
01/01/2010
to
12/31/2010
I M P O R T A N T N O T E S : The instructions accompanying this form must be followed Complete all parts,
check ing the NONE box for each par t where you hav e no repor table in formation . Sign on las t page.
I. POSITIONS. C R c p o r , in g i n d i v ~ d a a l o n i y ; s~,, ~,~,. 9-13 of filing instructions.)
D N O N E (No reportableposi t ions.)
I. B o a r d M e m b e r a n d C h a i r - E l e c t
2. B o a r d M e m b e r
3.
4.
5.
P O S I T I O N N A M E O F O R G A N I ZA T I O N / EN T I T Y
Texas Cen ter f o r Legal Eth ics
H o u s t o n U r b a n D e b a t e L e a g u e
I I . A G R E E M E N T S . r e c k o n i n g individual only; seepp. 14-16 oyfiling instructions.)
[~] N O N E (No reportable agreements .)
1 .2010
2 .2010
3.
D A T E P A R T IE S A N D T E R M S
Emp lo yee Re t i remen t Sys tem o f Tex as (s in ce 2002) , n o co n t ro l - n o t ves ted
Tex as Co un ty an d Dis t r i c t Re t i remen t Sys tem (s in ce 2002) , n o co n t ro l - n o t ves ted
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FINANCIAL DISCLOSURE REPORT
Page 2 of 7
N a m e o f P e r s o n R e p o r t in g
Elrod, Jennifer \V.
D a t e o f R e p o r t
5/15/201 I
I I 1 . N O N - I N V E S T M E N T I N C O M E . (Repo.ing individualandspouse; seepp. 17-24 of f i l ing instruct ions. )
A. Flier’s Non-Investm ent Incom e
~] (No reportable income.)O N E non-investment
DATE SOURCE AND TYPE
2.
3.
4.
INCOME
(yours , no t spouse ’s )
B . S p o u s e ’ s N o n - I n v e s tm e n t I n c o m e - If you were married during any portion of the reporting year, comp lete this section.
(Do l la r a m o u n t not required except for honorar ia . )
N O N E ( N o reportable non-investment income.)
1.2010
2 .2010
3 . 2 0 1 0
4.
DATE SOURCE AND TYPE
Sel f -emp lo yed so f tware co n sul t an t
Pr imary Serv ices - sa lary
Whi tef ence Inc . , - sa lary
I V . R E I M B U R S E M E N T S - transportation, lodging, food, entertainment.
(Includes those to spouse and dependent children; see pp. 25-27 of filing instructions.)
D (No reportable reimbursements.)ONE
S O U R C E
I. Fed era l i s t Sc ty fo r Law/
Publ ic Po l icy @ S tan fo rdL a w S c h o o l
D A T E S L O C A T I O N P U R P O S E
1/25-2/26/10 Stanford, CA Speaking at law school
I T E M S P A ID O R P R O V I D E D
Tran sp o r ta t io n , mea l s
2. W a s h i n g t o n a n d L e e 3131-4/01/10 L e xin g to n , V A S p e a kin g a t la w sch o o l Tran sp o r ta t io n , ho te l , mea l s
Universi ty
3. Univer s i ty o f I l l ino is Col lege 4/I 3-4/14/10 C h ic a g o , IL Jud g in g m o o t co u rt a n d Tran sp o r ta t io n , ho te l , mea l so f Law speaking a t l aw schoo l
4. S ta te Ba r o f T exas 5 /28/10 Austin, TX S p e a k i n g a t S t a t e B a r C L E T r a n s p o r t a t i o n , m e a l ss e m i n a r
8/3/2019 Jennifer W Elrod Financial Disclosure Report for 2010
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FINANCIAL DISCLOSURE REPORT
Page 3 of 7
N a m e o f P e r s o n R e p o r t i n g
Elrod, Jennifer W.
D a t e o f Report
5/15/201 I I5. Texas Cen ter f o r Legal Eth ics 6/04/10 Austin, TX M ee tin g an d T e xas T ran sp o rta tio n , m ea ls
Sup reme Co ur t His to r ica lS o c i e ty D i n n e r
6. S ta te B a r o f T e xa s 7 /15/10 Sa n A n to n io , T XSpeaking a t S ta te Bar CLE Tran sp o r ta t io n , mea l s
s e m i n a r
7. FR E E Fo u n d a tio n 8 /09-8 /12 /10 Gal l a t in Ga teway, M T A t t e n d i n g e d u c a t i o n a l Tran sp o r ta t io n , ho te l , mea l ss e m i n a r
8. Bay lo r U n ive rs ity 9/I 7 /10 W aco , T X S p e ak in g a t U n ive rs ity Tran sp o r ta t io n , ho te l , mea l s
9. H a r v a r d L a w S c h o o l 10/08- I 0/I 0/I 0 C a m b r i d g e , M A S p e a k i n g a t l a w s c h o o l Tran sp o r ta t io n , ho te l , mea l s
1 0 . W a s h i n g t o n a n d L e e 10/29-10/30/10 L e xin g to n , V A Jud g in g m o o t co urt Tran sp o r ta t io n , ho te l , mea l sUniversi ty
I I . T e x a s T e c h U n i v e r s i t y 1 I/I 2/2010 Lubbo ck , TX S p e a k i n g a t l a w s c h o o l Tran sp o r ta t io n , mea l s
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FINANCIAL DISCLOSURE REPORT
Page 4 of 7
N a m e o f P e r s o n R e p o r t in g
El r o d , J e n n i f e r W .
Date of Report
5/15/2011
V . G I F T S . a n c l , , d e s th o s e t o ~ p o ~ s e a n d dependent children; see p p . 2 8 - 3 1 of filing instructions.)
N O N E (No repor tab le g~s . )
S O U R C E DESC RI P T I O N
I.
2.
3.
4.
5.
VALUE
V I . L I A B I L I T I E S . ( Inc lude s those o f spouse a nd de pe nde n t ch i ldre n; se e pp . 32 -33 o f f i l ing ins t ruct ions .)
D N O N E (No reportable l iabi l it ies .)
CREDITOR
I. Amer ican Express
2.
3.
4.
5.
Cred i t Card
D E S CR I P T I O N V A L U E C O D E
K
8/3/2019 Jennifer W Elrod Financial Disclosure Report for 2010
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FINANCIAL DISCLOSURE REPORT
Page 5 of 7
N a m e o f P e r s o n R e p o r t in g
Elrod, Jennifer W .
D a t e o f R e p o r t
5/15/2011
VII. INVESTMENTS and TRUSTS - i . . . . e , value, t ......tions (Includes those of sp ......d depend ent ch ildren; see pp . 34-60 of f i l lng ins truc tions .)
D (No repor tab le incom e , a s se ts , or transac t ions . )ONE
A. B. C.Description of Assets Income during Gross va lue a t e n d
( i n c l u d i n g trust assets) reporting perio d of reporting period
(I) (2) (l) (2)
Place "(X)" after each asset Am oum Type (e.g. , V a lu e V alue
exempt f rom prior disc losure Code I div. , rent, C ode 2 Method
(A-H) o r i n t . ) ( J - P ) Code 3
(Q-W)
(] )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)
Dat e V a l u e G a i n
m m / d d / y y Code2 C o d e I
(J-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 )
I. DREYFUS BOND MKT INDEX (IRA)
2. BlackRock Bond Index
B Dividend K
A Dividend K
T
4.
5.
6.
8.
9.
1 0 .
II.
12 .
13 .
14 .
15 .
16 .
Schwab M ktMgr INTL (IRA)
Schwab Sm all Cap Index Fund
Schwab Total Stk Mkt-SEL
Vanguard Gro wth Index Fund (457 Plan)
Vanguard Lifestrategy Gro wth (IRA)
Vanguard College Savings Iowa (529)
Texas County and District Retirement
System
Emplo yee Retirement System of Texas
Pricelock Corporation incentive stock option
A Dividend
A Dividend
B Dividend
L
L
L
A Dividend L
B Dividend M
A Dividend J
A I n t e r e s t J
B I n t e r e s t K
None
T Bu y
(add’l)
06/14/10
T S o l d 03/02/10
( p an )
S o l d 04/12/10
(part)
B u y 06114/I 0
( a d d ’ l )
S o l d 11111/10
(part)
S o l d I 1/12/10
(par t )
T
Expired 06/03/10
J
J
J
J
J
A
A
A
1 7 .
I. In co m e G ain C od es : A = $1,000 o r less B = $1,001 - $2,500 C = $2,501 - $5,000 D -$5,001 - $15.000
(See Columns [31 and D4 ) F =$ 50.0OI - $ 100.000 G = $ 1 0 0 . 0 0 1 - $ 1 .0 O O . 0 O O H I =$1.0OO.001 - $5.000.000 H 2 -More Ih an $ 5.000.000
2. Value Codes J $15, 000 or l ess K =$15,001 - $50.000 L =$50.001 - $100.000 M $100,001 - $250.0~1
(See Co lumns CI and D3) N =$250.001 - $500,000 O -$500.001 - $1,000,000 PI -$1.000.001 - $5.000.00~ P2 =$5.000,0~1 o $ 25.000,000
P3 = $25,000.0~1 - $50.000.0’00 P4 -More than $50.000.000
3. Value Method Codes Q =Appr a i s a l R =Cost (Real Estate Only) S =A~s c s s men t T = Ca s h Ma rk e t
( s e e C o l u m n C 2 ) U = B o o k Va lue V - O t h e r W =Estimated
E =$15,001- $50,000
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FINANCIAL DISCLOSURE REPORT
P a g e 6 o f 7
N a m e o f Pe r s o n R e p o r l ing
El r o d , J e n n i f e r W .
V I II . A D D IT IO N A L I N F O R M A T I O N O R E X P LA N A T I O N S . ~indir,Uepartol’report.)
D a l e o f R e p o r t
5/15/201 I
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FINANCIAL DISCLOSURE REPORT
Page 7 of 7
N a m e o f P e r s o n R e p o r t in g
EIrod, Jennifer W .
Date of Repor t
5/15/201 I
IX. CERT IFICATION.
I c e r t if y t h a t a l l in 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 , if 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 t o 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 re .
1 f u r t h e r c e r t if 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 t s ~ v h i c h h a v e b e e n r e p o r t e d a r e i n
c 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/Jennifer W . Elrod
N O T E : A N Y I N D I V I D U A L W H O K N O W I N G L Y A N D W I L F U L L Y F A L S I F IE S O R F A I L S T O F I L E T H I S R E P O R T M A Y B E S U B JE C T T O C I V I LA 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 )
Com m ittee on Financial Disclosure
Administrative Office of the United States Cou rts
Suite 2-301
One Columb us Circle, N.E.
Washington , D.C. 20544
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AO IORev. 1/2011
FINANCIAL DISCLOSURE REPORT
FOR CALENDAR YEAR 20 10
Report Required by the Ethics
in Government Act of 1978
(5 U.S.C app. ,~§ 101-111)
I . P e r s o n R e p o r t i n g ( l a s t n a m e , f ir s t , m i d d l e i n i t ia l )
EIrod, Jennifer W.
4 . T i t l e ( A r t i c l e I ! 1 j u d g e s i n d i c a t e a c t i v e o r s e n i o r s t a t u s ;
magistrate judges indicate full- or part-time)
Ci rcu i t Cour t o f Appea l s , Ac t ive Judge
7. Chambers or O f f i c e A d d r e s s
515 Rusk Avenue , 12 th Floo rHous ton , TX 77002-2603
2 . C o u r t o r O r g a n i z a t i o n
Fifth Circui t Court of Appeals
5a. Report Type (check appropriate q, ve)
] Nomination, D a t e
[] Initial [] Annual [] Final
5b. [] Amended Report
8. O n t h e b a s i s o f t h e i n fo r m a t io n c o n t a i n e d i n t h i s R e p o r t a n d a n y
m o d i f i c a t io n s p e r t a i n i n g t h e r e t o , i t i s , I n m y o p i n i o n , i n c o m p l i a n c e
~vi th appl icab le laws and regulat ions.
R e v i e w i n g O f f ic e r D a t e
3. Date of Report
5/15/201 I
6 . R e p o r t i n g P e r i o d
OI/OI/2010
to
12/31/2010
I M P O R T A N T N O T E S : The instructions accompanying this form must be followe,! Complete all parts,
check ing the NONE box for each par t where you have no repor table information. S ign on las t page.
I . P O S I T I O N S . m e p o n l n g indiv idualonly; seepp. 9 -13 of f i l ing ins t ruc tions . )
D NONE(N o reportable positions.)
POSITION
1 . B o ar d M e m b e r a n d C h a ir -E le c t
2. B o a r d M e m b e r H o u s t o n U r b a n D e b a t e L e a g u e
3.
4.
5.
N A M E O F O R G A N I Z A T IO N / E N T I T Y
Texas Center for Lega l E th i cs
I I . A G R E E M E N T S . m e p o . i . g individual only; see pp. 14-16 of filing instructions.)
--] N O N E (No reportable agreements.)
DA T E P A R T I E S A N D T E R M S
I. 20 10 Em p loyee R etirem ent S ys tem o f T exa s (s inc e 200 2), no control - no t ves ted
2. 2010 Texas C oun ty and Di s t r i c t Re t i remen t Sys t em (s ince 2002) , no con t ro l - no t ves t ed
3.
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FINANCIAL DISCLOSURE REPORT
Page 2 of 7
N a m e o f P e r s o n R e p o r t in g
Elrod, Jennifer \V.
D a t e o f R e p o r t
5/15/201 I
II1. N O N - I N V E S T M E N T I N C O M E . (Reporting individual andspouse; seepp. 17-24 of filing instructions.)
A. Flier’s Non-Investment Income
~] (No reportable income.)ONE non-investment
DATE SOURCE AND TYPE I N C O M E(yours, not spouse’s)
B . S p o u s e ’ s N o n - l n v e s t m e n t I n c o m e - i f you were married during any portion of the reporting year, complete this section.
(Dollar amount not required except for honoraria.)
D (No reportable income.)O N E non-investment
1.2010
2 .20 10
3 .20 10
4.
DA T E S O U R C E A N D T Y P E
Sel f -employed so f tware consu l t an t
Pr imary Serv i ces - sa l a ry
Wh i t e fence Inc . , - sa l a ry
I V . R E I M B U R S E M E N T S - t ranspor ta t i on, lodg i ng , food, entertainment.
(Includes those to spouse and dependent children," see pp. 25-27 of fi l ing instructions.)
D (No reportable reimbursements.)O N E
S O U R C E
1. Federa l i s t Sc ty fo r Law/
Pub l i c Po l i cy @ S tan fo rdL a w S c h o o l
D AT E S L OCAT I ON P U RP OS E
1/25-2/26/I 0 Stanford, CA Speaking at law school
IT EM S P A ID O R P R O V IDED
Transporta t ion, meals
2. Wa s h i n g t o n a n d L ee 3/31-4/0 I / I 0 L exing to n , V A S p ea king a t la w sc h ool Transpo r t a t ion , ho te l , m ea l sUniversity
3. Universi ty of I l l inois Col lege 4 /13 -4 /14 /10 C h ic a g o , IL J ud g i n g m o o t c o u r t a n d Transpo r t a t ion , ho te l , m ea l sof L aw s p eak ing a t law sc h ool
4. S ta te B a r o f T exa s 5 /28/10 Austin, TX S p e ak i ng a t S t a t e B a r C LE Tr ans p o r t a t ion , m e a l ss em i n a r
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FINANCIAL DISCLOSURE REPORT
Page 3 of 7
N a m e o f P e r s o n R e p o r t i n g
Elrod, Jennifer W.
Date of Report
5/15/201 I
5. T e x a s C e n te r f o r L e g a l E t h ic s 6 / 04 / 10 Austin, TX Meet ing and Texas Transpor ta t ion , mea ls
Supreme Cour t Hi s to r ic a lSociety Dinner
6. S ta te B a r o f T exa s 7 /15 /10 S a n Antonio , TX Speak ing a t S t a t e Ba r CLE Transpor ta t ion , mea lss em i n a r
7. FREE Foundation 8109-8112110 Gal / a t in Gateway, MT At tend ing educa t i ona l Transpor ta t ion , ho te l , mea ls
s em i n a r
8. Baylor University 9/I 7 /10 W ac o, TX S p ea kin g a t U n iv er sit y T ra ns p or ta ti on , h ot el , m e a ls
9. H a r v a r d L a w S c h o o l 10/08-10/10/10 Ca m b r id g e , M A S p e a k i ng a t l a w s c h o o l Transporta t ion, hotel , meals
1 0 . W a s h i n g t o n a n d L e e 10/29-10/30/10 Lexington , VA J u d g i n g m o o t c o u r t Transporta t ion, hotel , mealsUniversity
I I . Texas Tech Univers i ty 11/12/2010 Lu b b oc k, T X S p e a k i ng a t l a w s c h o o l Transpor ta t ion , mea ls
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FINANCIAL DISCLOSURE REPORT
Pag e 4 o f 7
Na me of Person Reporling
E l r o d , Jen n i f e r W .
Date of Report
5/15/201 I
V . G I F T S . a , c tu a , s t h o s , ,o s p o u t , o n a d , p , n a , n , c h U a r c , : ~ o , p p . 2 S - 3 t of filing instructions.)
~-] N O N E (No reportable gifts.)
SOURCE DESCRIPTION
I.
2.
3.
4.
5.
V A L U E
V I . L I A B I L I T I E S . a , ~ t , d e ~ t h o s o o l s , o .~ , a n d d ~ , ,, d e , t ¢ h U d r , n ; s e ~ p p . 3 2 - 3 3 of filing instructions.)
D (No repo rtable liabilities.)O N E
CREDITOR
I. American Express CreditCard
2.
3.
4.
5.
DESCRIPTION V A L U E C O D E
K
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FINANCIAL DISCLOSURE REPORT
Page 5 of 7
N a m e o f P e r s o n R e p o r t i n g
Elrod, Jennifer W .
Date of Report
5/15/2011
V I I. I N V E S T M E N T S a n d T R U S T S - i .... e, value, t r a n s a c t i o n s (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
N O N E (No reportable income, assets, or transactions.)
A. B. C.D esc r i p t i o n o f A s se t s I n c o m e d u r i n g G r o s s v a l u e a t e n d
( 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 o f r e p o r t i n g p e r i o d
(l ) (2 ) (l) (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 . , V alu e V alu e
e x e m p t f ro m p r i o r d is c l o s u r e C o d e I d i v . , r e n t , C o d e 2 M e t h o d
( A - H ) or in t . ) (J-P) C o d e 3
( Q - W )
O)Type (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 ep o r t i n g p e r i o d
(2) (3) (4)
D a t e Va lu e Gain
m m/dd/yy Code 2 Code I( J - P ) ( A - H )
(5 )
I d e n t i ty o f
buyer/seller
( i f p r i v a t e
t r a n s a c t i o n )
I. D RE Y F U S B O N D M K T I N D E X ( I RA ) B Dividend K T
2. Bl ack R o ck Bo n d I n d ex A Div id en d K T
4.
5.
6.
7.
8.
9.
1 0 .
1 1 .
1 2 .
1 3 .
1 4 .
1 5 .
1 6 .
S c h w a b M k t M g r I N T L ( I RA )
S c h w a b S m a l l C a p I n d ex F un d
Schwab To t a l S tk Mkt -SEL
Vangua rd Growth Index Fund (457 P l an )
Vangua rd Li fes t r a t egy Growth ( IRA )
V a n gua r d C o l l ege S a v i n g s I o w a ( 5 2 9 )
Texas Cou n ty and Di s t r i c t Re t iremen tSystem
Emp loyee Re t iremen t Sys t em o f Texas
Pricelock Corporat ion incent ive stock opt ion
A Dividend
A Dividend
B Dividend
L
L
L
A Dividend L
B Dividend M
A Dividend J
A Interes t J
B Interest K
N o n e
T Bu y 06/14/10
(add ’ l )
T
T Sold 03/02 /10
( p a r t )
Sold 04/12/10
(part)
Bu y 06/14/101
( add’ l )
Sold I I/I 1/10
(par t)
Sold 11/12/10
(part)
T
T
T
T
T
Expi red 06/03/I 0
J
J
J
J
J
A
A
A
1 7 .
I . In c o m e G a i n Co d e s : A -$1.000 or less B =$1,0 0 1 - $2 ,50 0 C =$2,501 - $5,000 D = $ 5 , 0 0 1 - $ 1 5 , 0 0 0
( S ee C o lu m ns B I a n d D 4 ) F =$50 .0 ~ 1 - $1 0 0 ,0 0 0 G =$10 0 .0 0 1 - $1 .0 ~ 0 ,0 ~ 0 H I =$1 .0 0 0 ,0 0 1 - $5 ,0 0 0 ,0 0 ~ H2 = M o re t h a n $ 5 . 0 0 0 . 0 0 0
2 . V a lu e Co d e s J =$15 ,0 0 0 o r l e s s K = $ 1 5 . 0 0 1 - $ 5 0 , 0 0 0 L $50,001 - $100,000 M =$100.001 - $250,00 0
(SceColumnsCI and D3) N =$250 .0 ~1 - $50 0 .0 9 0 O $5t~0.001 - $1,000,0~0 P I =$1 ,0 0 0 .0 0 1 - $5 ,0 0 0 ,0 0 ~ P 2 =$5,0 0 0 .0 0 1 - $25 ,0 0 0 ,0 0 0
P 3 =$25 ,0 0 0 ,0 0 1 - $50 .0 0 0 .0 ~0 P4 =More than $50 .1)00 ,000
3 . V a l u e M e t h o d C o d e s Q = A p p ra i s a l R =C os t tR ca l E s t a t e O n ly ) S = A s s e s s m e n t T = C a s h M a r k c l
( S e e C o l u m n C 2 ) U = B o o k V a l u e V -Other W = Es t i m a t e d
E =$15,001 - $50,000
8/3/2019 Jennifer W Elrod Financial Disclosure Report for 2010
http://slidepdf.com/reader/full/jennifer-w-elrod-financial-disclosure-report-for-2010 13/14
FINANCIAL DISCLOSURE REPORT
Pag e 6 o f 7
Nam e of Person Reporting
Elrod, Jennifer \V.
Date of Repor~
5/15/201 I
V III . AD D ITION AL IN F OR M ATION O R E XP L AN ATION S . (lndicate partofreport.)
8/3/2019 Jennifer W Elrod Financial Disclosure Report for 2010
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FINANCIAL DISCLOSURE REPORT
Page 7 of 7
Na me of Person Reporting
E I r od , J e nn i fe r W .
Date of Report
5 1 [ 5 / 2 0 1 1
IX. CERT IFICATION.
i c e r t if y t h a t a l l i n f o rm a t i on g i v e n abov e ( i nc l u d i ng i n f o r m a t i on p e r t a in i ng t o m y s p ou s e a nd m i nor o r de p e nde n t ch i l d r e n , if any ) i s
a c cu r a t e , t r u e , and com p l e t e t o t he be s t o f m y k no wl e dg e and be l i e f, and t h a t any i n f o r m a t i on no t r e p o r t e d was w i t hhe l d be cau s e i t m e t ap p l i c ab l e s t a t u t o ryp r ov i s ions p e r m i t t i ng non -d i s c l o s u r e .
1 f u r t he r c e r t i fy t h a t e a r ne d i ncom e f r om ou t s i de e m p l oy m e n t an d honor a r i a and t he a c c e p t ance o f g i f t s wh i ch ha v e be e n r e p o r t e d a r e i ncom pl iance w i th the p rov is ions of 5 U.S .C . app . § 501 e t . seq . , 5 U.S .C . § 7353, and Jud ic ia l Conference regu la t ions .
Signature: S/Jennifer W. Elrod
N O T E : A N Y I N D I V I D U A L W H O K N O W I N G L Y A N D W I L F U L L Y F A L S IF I E S O R F A I L S T O F I L E T H I S R E P O R T M A Y B E S U B J E C T T O C I V I LA N D C R I M I N A L S A N C T I O N S ( 5 U .S .C . a pp . § 1 0 4 )
Com m i t te e on F i nanc i a l D isc l o su r eA d m in is t r a t ive O f f i c e o f t he U n i t ed S t a t e s C o u r t sSu i te 2-301
O n e C o l u m b u s C i r c l e, N . E .W a sh in g to n , D .C . 20544