FINANCIAL DISCLOSURE REPORT - Judicial Watch€¦ · I A . . r wc re r1b 2. Pennsyvania blsd. Mun...

9
' ' ) ' · ))A - 0) 1 0)))-- 1 2. DIS, JAN E U. S. D. C . . E. O., PA 4. Title (Artic l e m Jud_d: indic te act i ve or snior SL'tUs: 5. Rerl' (check approprim e 1 y) c ( 5 U. S.C. app. §§ 10111) 8120.5 6. Repting Peo IZ/3 1/0 7. Chamb or Ofce Ad drs 8. On the b a sis oflhe in fomt3lion con t ained in t his Report and ay a ca d . , , h where yu hav e no rle if ormation. Sign on last page :. : - ' . - .. - _-. ' ' ORGOJ ( PAR T A DTRMS . 0 ( <. , ., _ o > ., 0 - I ' ; f .. -. .. . H ., Uev. l004 FINANCIAL DISCLOSURE REPORT FOR CALENAR VEAR 2004 I. Pn Reorting (Lat na1ne, Firt name, Middle initial) Courl o Orgizntion magstnejudges indi ate full- o pan-time) t') N1Ó Date JGE U.S.D.C. I . ; lti fÔ) AuI ' I Fhml Rtport Required by lhe f:lhics in Govn1mtnl .A.Cl or 1918 3. OaeofReport 111120 1 12613 U.S. COUROUSE moificatio ping ther u is, in m opinin. rn cpli nc with apli ble laws an rutions. 61 MR SE Reviewing Ofce Date PHIADElPHlA, PA 19106 IPORTA NO: T insctios acmpnyg t i s fn mut b folio£. Comple all p, c eking t NONE bx fr e part . - Ñ . . . ' POSION I. NA OF C ! -,r m - I. POSITIONS. (epridivid u only; see p. 9·13 of filing instctjons) I! NONE - (o reporble poition.) I. AGREEM. (ng indjvidual oly; se pp. 1416 offn,in$t1Cons) 6 NONE - No rle agment.) I. ,., o- ( :: ·:: > : = " & N : : c: <. << r;i c

Transcript of FINANCIAL DISCLOSURE REPORT - Judicial Watch€¦ · I A . . r wc re r1b 2. Pennsyvania blsd. Mun...

' '

)'-· A-0- 10 --' 1

2 .

DUBOIS , JAN E U.S. D.C .. E . O., PA

4. Title (Article m Jud_gd: indicate act i ve or senior S L'ltUs: 5 . Reportl) 'J)C (check approprime 1ype) c

( 5 U.S.C. app. §§ 101·111)

81121200.5

6. Reporting Period

IZ/31/2004

7 . Chambers or O ffice Ad dress 8 . O n the basis oflhe infomt3lion contained in t his Report and any a

ca d

.

, , h

where you have no reportable info rmation. Sign on last page.

:. :- ' . -.. -_-,._. '": '

ORGAN!ZATIONIENJJTY

(

PARTIF.S AliDTERMS

.

0 (/)

<..n

, .,, _

o >

..,, 0

-

I '

;s fTl ... -... ..... .,

Uev. l/2004

FINANCIAL DISCLOSURE REPORT

FOR CALENDAR VEAR 2004

I. Person Reporting (Last na1ne, First name, Middle initial) Courl or Org<Ulizntion

mag.istnnejudges indi ate full-or pan-time) t') Noin1t1 Date

JUDGE. U.S.D.C. I . ; lnitiil f ) AMu;,I ' I Fhml

Rtport Required by lhe f:lhics

in Goven1mtnl .A.Cl or 19'18

3. Oa1eofReport

11112004

10

12613 U.S. COURTHOUSE modifications penainingtherero. u is, in my opinion. rn compli nce

with appli ble laws an regulations.

6-01 MARKET STREET Reviewing Officer Date

PHILADElPHlA, PA 19106

IMPORTANT NOTES: The instructions accompanying thi s fonn must be folio . Complete all pans:, c ecking the NONE box for each part

. - . . . '

POSITION

I.

NAME OF

C'>

-,,r-

m

-�

I. POSITIONS. (ReportingindividuaJ only; see pp. 9·13 of filing instructjons)

Ii!! NONE - (No reportable positions.)

IT. AGREEMENTS. (Reporting indjvidual only; see pp. 14�16 of ftlin,&in$tn1Ctions)

621 NONE - No reportable agr<ements.)

I.

,-..,,o-(/) ::: ·::: >

:t:>o= ""

& N :=-::ic:

• c::><..n

<<: r;i c

SOURCE AND TYPE GRC>SS INCOMt;"

SOURCE AND D'Pt

I.

PlNANCTAL DISCLOSURE REPORT

DUBOIS, JANE

m. NON-INVESTMENT INCOME. CRcporung1ndMdualondspou$<.-pp.17-24offiJona1nS1ructions)

A. f'iler's Non-Investment Income

NONE · (Norcp0rtablenon·1nvc�1mc111 incoinc)

8112/200.S

(youn, 8(lf apotM'J)

B. Spouse's Non-Investment Income-(lf)'OU """'imm<4c1ut111&111y ponion orlhen:pomnoa1·. p1ea1c complete dussection. Doli.r .._..1

no< ,....,red aeepl lir""""•ia.)

0 NONE . (No rqxirtabk DOIMll\'<Slmenl meomc.)

I.

fV. REIMBURSEMENTS -irMsponlllion, lodging. food, cn1ertammcn1

(JneludcsLbose to spouse and dcpc-ndcnl children. Sec pp 2S·27 of innruc1ions)

&'.! NONE · (Nosudln:ponablcrc1mbuncmcnts.)

SOURCE QESCRIWO!i

SO!JRCE

CRRQ!TOR QFSCRJPTI<)N

D a te or RepM

811212005

VALUE CODE

FINANCIAL DISCLOSURE REPORT Name of f'crSQn Rcportifl&

DUBOIS, JAN E

V. GIF1'S. (lncludcs those LO spouse and de1,cndcnt children. See pp. 28 31 of inslructio-ns.)

0 NONE - (}/O$uchrep<Jnablegills.)

DESCRIPTION

I.

VI. LIABILITIES. (Includes chose of spouse and dependent children. See pp. 32-34 of insauctions.)

NONE (No reportable Liabilitfos.)-

l.

I

A.

m-. pnor ckscioRwc

re r1 b

2. Pennsytvania blsd. Mun tne. Bond Trusl ( I )

4 V enzon Cormwnicadons (37)

S. Bell South Corp.

10. General Eleccri c Co.

11 Gillette Co.

15. Bristol-Myers Squ™i Co

28. Altoona PA. Arca Sch. Dist. Au1h. 6.5 % 1 11/08

47. Roy al Dutc.h PeL

S S Home Depot Inc. (5) IRA

59. Intel Corp. (5) IRA

64 . Mo rgan Stanley Dean Witter Uquid Asset Fund

(5) IRA

65. Marg. SW>. Dean Wit tor O lob . Div. Glow. (D) IRA

66. Morgan Sanf cy On.n Witter Uqu1 d Asset FU:nd

6 8 . Motorola, In c. (S} IRA

69. Merck & Co. (5) (42) IRA

15. Americ>n Electric Po""' Co. (9)

78 Bristol Mym Sq uib b Co. ( 9)

8 0. Emerson Electric Co. (9)

Name of PCB011 RepMt/15 DUBOIS, JAN E

D. c .

re:poitini; period tq)Of'ling peric>d

(I) (2) OJ (2 )

- T)"" Vu Cod<I div. fCM_ Of Codd l'>�d.hod

;,,, ) (1-P) (C}W)

Jn tcrcst J T

Dividend

B Dividend L T

D Dividend N T

c Dividend M T

B Dividend l. T

A Interest J T

B Dividend K T

Dividend l. T

Dividend l. T

Dividend M T

None

A Dividend ] T

Dividen d

c Dividend l. T

Dividend ]

Dividend K T

Divjdend K · r

I A R c

(1

" 0 .. .s 1.000.001 ... s.ooo, ooo

D>I< o f Repon

811212005

t

(I ) II noc Cll'.M1Jll rmm dooiosure

(2) Cl) " ' .,..,,. ( • .. Dole: v .... °""' ..., ..... Moot!I- Cocle l °"" _. ... -""· (J-P) I (A-

rn

Sell 1m K E

Sell 3123 l.

Sell 1127 K c

0 E

Kl

1'2

Q i S« t'ohnnn C ) u l(;k Valu t v Yi' -r...sc1mil l l.:d

trar.saction)

llINANCIAL DlSCLOSURE REPORT

Page I of 4

D. lnOCH'l)t durmg Gl'O$ll value Mend of' TraBS&ccions during 1epot ing pu1odDescription ofA!llic:ll

(mcludin& rrust •Hell)

(S)Pboo'(J(j" >fitt __ ......,,. v-c· ldooriryof

CldeJ(A·H) (ifprivue:r«£em1>t1on)

Do)•

DNONE (No po a le moornc, lls$eb, or tr:uuac1ioru:)

A

A

(6) IRA

A

A

A

A

A T

A

A

1 .. codc:s: • Sl, OOO«less • Sl.001..$2.SOO -S"...SOl.SS.000 • ss.001-s1s.ooo -S-IS.001-SSO.(l(lO

(Sec C..� 81znd04) f SjOOOJ-SI00.000 $100,001.S 1.000,000 HI -11.000.001-U.000.000 �iorc ._ SS,000,000

2 v .. 1..,. l'udea J •SIS.OOOork:ss Sli,001-SSO.OOO I SlO.OOl.SI00,000 M $100.00l·J.?SO,OOO

(Sol!: C..•lunu1l1 Cl <mdI.>�) SllU,000-S;-OO. OOO s.soo.001 1.000.000 Pl SS.000 .00 I·S1S.O()(l .f)(l0

P'.\ .. S2S,OOO,OOl·S50,000 01)0 1'4 SMorc lit.in. $50,000,000

' V•h1.., f\ c-thod Codes Apvnuul " C,;cnt (Rot.I E.sunc Only) ' N!IC1SfJIQ!t I' 0.- i'M.tllktt

{llhC..'f

A.

82. Po r d Mooor Co . (9)

86. Royal Dul t h Pel (9)

88 . Somh Jersey Ind. Inc. (9)

8 9 Que&• Com. In11 Inc: (9)(34)

94 . FiDI Umon N ational Bank (10)

96. Libcny All Stu E q uity FD SBI (9)

99. N C R C orpomion ·

I 02. CiliOroup (5) IRA

106. C1pi1>l Ot>Po"Unily TR B (6)(28)JRA

109. Morgan Stanley Dean Winer High Yield B

I J O Acnvc AMets Money Tnast (17)

111 Ae<i><: AsleU Moocy Trusl (17)(9)

112 AcrivcAslels MoneyT ruSI (17)

120. Morg:on Stanle y Dean W i tter S&P 500 In dex B(S)lRA

123. Yahoo, I n c .

13). NJ $1. Housing & M ort. 5. 2% Due4/IA:> 7 IRA

132. M ICH ST H OSP. f1N AUTH REV REF·

I A B

F G

K

" 0

Q

($.tt Col u mn Cl) IJ Book Va lu e v

N a m e of Pen.I)!• Ktpo'll ing

DUBOIS, JANE

8. c. ........... -pmod - "'"""

I ll (l) (I) ( 2)

Ty .. ( g C o<k l

11 'it)

A Div iden d

8 Dividend K T

A Dividend T

None J T

A '"'""" ' J T

B Dividend J T

No ne J T

c D ividend M T

None

A Dividend J T

DI..,_, L T

A DIVldcnd L T

A O.vKlcnd K T

8 Dividend M T

No ne

Dividend J T

B lnteres- t K

B lnlet<SI K T

c

L

811211005

o .

(l) If llOt C:Xcntp( rrnm

(2) (3) (4 ) (S) - Value o ...

Codel Codo bu)'-erlsdk'l' l (A·

Sell 9120 K

Se n 7123

S.11 1211 K B

D E - SIS.00 1-SlO. OOO

I

T

01hc:r w Est11 u11u :d

IHNANCIAL DJSCLOSURli: REPORT

Page2 of4

o(-Ci•flMllll lnlll useu)

PlllQI ·cxr llfln each iSKt ¢'(c:nij)t frc11n prior disclo11uc

(6)1RA

125. Ci1igTOu 9)(3S)

TRINrrY HEALnt.SERA

111come1Gait1 Codc:e.. .. 1.000 (llfkss

{Sec Clll1"1"J SI ""d l)C) -sso.001..1100.000

2 Value t"od.u: , $1.S.000 or kss

1Sc:i: c..�1uinr11t t'I aod 0]) mo.(J(J().S5 0.oou I';\ •• S.'25,000,VOl·S�0, 000.000

' V;\IU" f\ic1hod (.''ock A.ppt:ii"31 •

Gross q1uc ..cm cf

"'"""'" VaNc Val"' Codo I <bv rcnr or Metl.od (A•H) (J-P) Codc3

(Q-W)

K

A

A

T

•Sl,OOl·Sl.lOO -$2,501..15,000

1100,00l·SI 000,000 HI SI.OOO.QOl..!5,000.000

lll.OOl·SS0,000 $50.001.SIOO, OOO

isoO,Ulll-SI ,000,IJOO Pl $t ,000,00l ·S5,000.-0<)(}

Date ofRepon

T .:mcbwf:•�period

Type (CJ Cdefttity of buy, sell, i\to11rh. mcr�r. On) (J·•) (tfprivue�ctll):Mion) "' nansai:tionl

J

SS,OOl·Sll.000

Hl • Mt>r11 rho11 ,, 000,000

M -s100.001.mo. ooo

l'l SS,<l'JU.<l(lJ.1lS.OOO,<l(IO

I'd ...!More th.."\ll $50,000,000

C'•SI (Reul l''<Jh\111 Only) $ As ssmm1.1 <.'11�l\fMurl:e1

Name o f Person R cpo11ing

DUBOIS. J AN E

Date ofReport

811212 005

• • iti ooo.e . "<'llm: , t ranscations (jn icl u dcs t hose of lbe spous e and depe1lliel'll <: b il dreo. S«: pp . J ·i-5 7 of filing tnsin1C1io 1\S,)

A. B. c. o. c a g

re pcning period (CJXX'lin& peri¢d

t ll ) (I) (2) ( I ) II no1 exempt from disclosure

( 4 ) · r>'J>I! (e.g. Val ue adiv. rmt. or C ode :? i uL ) ) 1 ( A·

m

134. Orac l e Corp. ( 5) IRA None K T

135. M i crosoft co.,,. (5) IRA None Sell l/27 L

136. Nokia CP ADR (5) IRA Dividend

137. Cisco Sys Inc. (5) IRA None L T

138. MorpnSWlleyDeanWittcr (Trust) (9) Dividend L T

139. Visteon Corp. (Trust) (9X J6) Dividend J T

L 40. Biogen (6) IRA None Sell 2120 K

141. Zirrun er Hld g;< . l nc.(Tr ust) (38) None I T

142. Zimme.-Hld g;<. Inc. (38) None J T

14). Travelers PPT CAS CP B (4-0) None Sell 4/12 J A

144. Traver.rs PPTY CAS CPA (40) N one Sell 4 11 2 J

145. IL ffi.T H FAS·A BB(07·0 1 ·10) B Interest T

146. Travelers PPTY CAS C P B (40) (TRUS T) () i.., idend Sell 4112

1 47 . Travelers PPTY CAS CPA (40) (TR UST) Dividend Sell 4/12 J

148. Duke Energy Co'l'· B Dividend L T

149. West morel and Cn ty PA Genl 4A5 12101/05 B interest K T

150. Owen J. Ro be ns Seh Dis t PA 5. 375 5115118 B fntcrest K T

1 5 1 . Do w Chemica l Co. (5) IRA B Dividend Sell 11/18 K E

A 8 c D G

l

... -.'C

Q ( S... >e Co l u.nn C 2) u - Book Value: v (); h<.:1 w ,,.. l :$ I TI11:itc J I

...J

FINANCIAL DISCLOSURE REPORT

Page 3 of 4

VII. INVESTMENTS and TRUSTS

1'>$riptlon otAssc.:ts ln ..1me d1.lfU11: (i1oss•• .lue at end of irnn,_l;;letiofis durin reportins pe:1'tod

(iocludins tn1s1 assers)

Pince "(X)" :ifier eaeb asset e.'<etnpl (2) (3) (S)

Alnount Value V.Wc Type (c.,_ l).a1�: G io Identity of llvm prior disc\ 1rc C<xle I C<xlc 2 }.fe1hod buy, sell, Mo1ith• Cod4 b11yct/$1ellt:T

(A·H) (J.P) Codcl mctge:r, Dny (J·P lif privatc (Q-W) 1edtntJ1<ioo) cransaetion)

A K T

A

A

A

K

A I A

A A

1. lnc.,metCilin Code.1.: -=$1,000orless -s 1,001-52.500 - Sl,501-55.000 .. SS,O(l> -Sl5,000 • $15.CIOl·SSO,OOO

($c:cCt>lunlm: Bl :md 1)1.} F -$50,00J-SJ00.000 G -:=\100,001 ·SJ.(X)(l.000 HI = $1,000.001,\5.000.<'<JO ID (I.fore 1bou 55, 000,000

2 Va ue C'odes: J :o.SJS,OOQQf le$$ K =$IS,OOl·SSO,<XIO L ::$SO,OOl·Sl00,000 M = SIOOJ>!H-.S?S0.000

(SecC.•l1muu: Cl :md 03) N .. $250,000 -5500,0(10 0 $500,0lll-S 1.00Cl,llOO ,., "'$1, 0 00.001-SS, OOrJ. 000 P2 - S5.000.00l-S25.000,t10Q

i''..' -. $2SJKl0,001-.S50.000.IXl(l P4 .,,Sf\11 tlt.."m S 0.000,000

3. V;ilt1<' C-.1ctl\Ollt'ode> -Af>PC'liSaJ R =<.:o (Rt::JI t'..:sta1e:: Onl}·) s "'Asw.ssm�t T ... cash1Mz11k(,1

Namt: of Person Rtpani.ng

D UB O I S, JAN E

D ate ofRCj)On

8/12120 05

- in«Xltc. w1luc, t l'\lllSCa tioas ( indudt.1 t hose ofd 't $f>O\ISC and depe11deru: c. b ildre 1 1 . S ee pp 34 . 5 7 of filing insrruecioos.)

A B. c. 0.

rcporti nc period

1n (2) (I) (2) (I) U 001 exempt 1r d istloSUte

(3) (4 )

Type Value GaU> div. rent. or Codc2 Method Code2 Code i.:1r .) i

(Q-W)

152. P fiur, Inc . (5) IRA B Dividen d L T

153. Templeto n Foreign Fund C (6) Divi dend L T

I 54. JP Morgan Chase & Co . (9) (TRUST) Oividend Sell 1 /20 K D

155. Raytheon Co (NEW)(S ) l RA A Divi dend K T

1 56. Scudder Prcserv Plus Inc. C . (S) IRA B Dividend L T

157. Geol Blee Cap 5 118 2118133 (S) IRA c Dividend L T Buy 717. 9 K

1 58. Aim l'TtmierE quity A (5) (41) I RA A Dividen d M T

I 59. Medco HC2llh Sol utions, In c . (SX42) I RA None J T

160. J ones Soda Co. (6 ) IRA None K T Buy 3/3 J

Buy 7 123 J

1 61. lSh...., MSCI l>pan Ind ex Fund (6) IRA Dividend T Buy 3123

162. ls bsres MSCI EAFEFund (6) IRA Dividend 3123

l63. Allscripts Heal thcare Shs Jnc. (6) IRA None K T Buy 1211

.• B c D E

i F

( N

(Sec Col1r11m C2) u • Book V;ii:luc - Ocher w - FJ1im1tttd

A K K

A L T Buy L

K

FINANCIAL DTSCLOSURE REPORT

Page 4 of 4

Vil. INVESTMENTS and TRUSTS

Desmption of Assets Income durmg Gross \•atue 31 end ot Transaa:ioas duringtq>Orting period

(inc:lud:in.¥tlVSC ss«s) rcpc:wting period

(2) (S) Place "(Xt allci eacb usct e.<tempt Am-• (c.1. vu.. Valut Type (e.g. Date: tdenlit1offrootprior disclosure Code I t>v>·. seU, ,..tooth· buyerhdlct

(A ·H) (J-P) Codel ""'"'· Doy (J-P) I (A· ( fpM.-.e (tdan1>1ion) �' tranS*::tion)

A

A

I. lnoomclO;un Codes. ..,Sl.OOOcr s • Sl,001-$2.;(J() -S2,l01-Sl, OOO =S5,001·$1S,000 ... SIS,OOJ-550,000

(Ste Col,m ns Bl a� 04) = SS0,001-SIOO,OOO G = SI00,001-Sl.000,000 HI - Sl,000,001-SS,000.()IJO HJ •Mere ll\l!D $.S,000,000

2 Valne Ccxlci. -s1s,OOOorld.s K • S IS,OOJ-SlD,000 L *' SS0,001·.SIOO.OOO M -s100,001.s-iso,ooo

See Colulllns Cl .,oo 01) $250,000-S;-OO,OOO 0 ... ssoo.001-s1.ooo.ooo Pl = Sl,000.001-Sl,OOO,OOO P2 - S5,000,001-S2S.000,000

f'l •· S2S.OOO,OOJ.S50,000,000 1'4 ,...$Morethaa$St'l,000,0(10

3. V:slucl'.icthc.xJ Codes Q • Appraasal R Coss (Reul Est.;,te Only) s •A$�1M:l\I ,. "'Clashf�1afk�I

v

· · .. --- ______ ,., . .... , . . ' ....................... . ··-· , ...... .. ..

FLNANClAL DISCLOSURE REI'ORT

DUBOIS, JANE 81121200S

VIII. ADDITIONAL INFORMATION OR EXPLANA TTONS (fodieatc �w o( Report)

(I) (I.me 2) Ori&in>llyincluded 14 scpll11lte pun:hases of un>tJ of Pennsylvania Insured Mun1c1pal Bond Tnists for U1e years 1987 throogh 1991. Ten of 1he 1• groups ofunilS 1n the t\iusuC1pal Bond Trusts were JOld rn 1993 at a loss. PlRhues ofPc:nnrylvani• Insured Municipal Bond Trusts 1n 1992 arc _.tdy listed on lines :l4 tlrouaJ>J7, •O and 41, m 1993 on hnc: 45,and in 1994 on l11c: SS. The figul1'Son lmc: l 1r<for the foorrc:mam1ns8"0 of un11S in Mumopal Bond Trusts · Pc:nnsytvania lnsuml Municipal Bond TJUS!5 S4M. SSM, 68M,and I 17M All units ofsc:nes68M (S)andsc:ncs 117("1) (•)weresold on Janua:ry 3 l, I 99S, al a loss.. presently0"'11s•unrts of scnies S4M

(S) (Unes58,59,64,6S, 69.102.106, 120, 132, 134, llS, IJ6, 137. ISi,152, ISS, IS6, IS7. IS8)Secunticsm on IRAAccountwithMorpnStonley.

(6) (Unes65,66, 106,123, 131, 140, ISJ, 160, 161, 162, 163)Sccuritics in••••IRAAccountwHhMorgonStanlcy.

(9)(Lmcs 15, 11, 78, 80, 82, 86.88. 89, 96, 111, 125, 138, 139, 154) Securities in-Trust ofwhicb•••i•CO·lrtl$tec and income beneficiary.

(10) (Lane 94) Chedcing A«<>Unt.

(17) (Lines 110, Ill and 112)MoraanStsnleyMoneyMo.r1cetfunds

(28) (Llnie 106) MorganStanley Dean Witter Mid-Cap Orowth B changed name to Morgan Stanley Diean Wiltcr Mid·Cap Equity Tru.st B. Morl"n StanleyDean \Vitter }\.1id 1> Blquity Trust B changed n11no to Capital OpportunityT'rUJt D.

(34) (Unc&9>•••tof U.S. West Jnc., cxch11.11gcd for•••ofQuest Communications fntcmational, Inc

(35) (Lane 125) ••••f "'-<ia1c:s F'mt Cop CPA exchanged for •••C11i..,,..,.

(36) (Lane 139) Spin-<>fr &om Fon! MolO<Comp:my.

(37) (Linc 4) Bell Atlanuc Corporation changed its name to Veriz.on Communica1ions.

(38) (Un., 141 and 142) Spin-<>rffrom Bristol Myen.Squibb Company.

(40) (Unes143, 144. 146 and 10) Spin-<>fffiom CitiOroup.

(41) (Line 158) Aim Valoe Fund 8 changed its name to Aim Prattier Equity B. Aim Prcrnoer EquityBwasconverted to Alm Prattier Equity A.

(42) (Line159) Stoek d1YJdend diJ111buled to Mm:k & Co (Lane69).

<?\ ) I '

FlNANCIAL DISCLOSURE REPORT N•meotPt®\\Rel"'rtin

DUBOIS, JANE

IX. CERTIFICATION.

Di1t ofRqlllrt

811212005

I certify that all information given above (including information pertaining to my spouse and minor or dependent children, if any) is accurate, true, and complete to the best of my knowledge and belief, and that any information not reported was withheld because it met applicable starutory provisions permitting non-disclosure.

I further certify that earned income from outside employment and honoraria and the acceptance of gifts which have been reported are in compliance with the provisions of 5 U.S.C. § 501 et seq., 5 U.S.C. § 7353, and Judicial Conference regulations.

Signarure Date "). 0 5

NOTE: INDIVIDUALWHO KNOWINGLY AND WILFULLY FALSIFIES ORF AILS TO FILE THIS REPORT MAY BE SUBJECT TO CNIL AND CRIMINAL SANCTIONS (5 U.S.C. app. § 104)

FILING INSTRUCTIONS

Mail signed original and 3 adctitional copie s to:

Committee on Financial Disclosure

Administrative Office of the United States CourtS

Suite 2-301

One Columbus Circle, N.E.

Washington, D.C. 20544