I'I' _____ _ e N NE f ATY S D S -·-· ..• 'J r ---r-• . A-tO " v. 204 NNCL DISLOSRE REPORT alnr...
Transcript of I'I' _____ _ e N NE f ATY S D S -·-· ..• 'J r ---r-• . A-tO " v. 204 NNCL DISLOSRE REPORT alnr...
I'
_________ _ Date ___ _
POsmON NAME Of QRGANJZATION/ENTITY
fARTIES AND TERMS
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" Rev. 112004 FINANCIAL DISCLOSURE REPORT
Calendar Year 2003
I. Person Reporting (Lastname, FiISt name, Middle initial)
Vadan, Thomas A
2. Court or Organization
U.S. District Court, E. Tenn.
4. Title (Article ID Judges indicate active or sc:oior Slatus; magistrate judges indicate full-or part-time)
S. ReportType (check appropriate type)
Q Nomination. Date U.S. DistrictJudgc-Active
0 Initial @ Ammal 0 Final
Report Required by the Ethics In Government Act of1978 (5 U.S.C. app. §§ 101-111)
3. Date of Report
4127/2004
6. Reporting Period.
l/lfl003
to
1213112003
7. Chambers or Office Address
u. s. District Court
8. On ihe basis of the information COJJtaincd in this Report and my modifications pertaining therero, it is. in my opinion. in compliance with applicable laws and regulations.
800 Market Street
Knoxville, TN 37902 Reviewing Officer
IMPORTANT NOTES: The instructions llCCOlllpllDYin this form must be fullowcd. Complete all parts, checking the NONE box far each part when: you have no rq>artable information. Signcm last page.
I. POSIDONS. (Rcportingmvidualaaly; 1eepp. !l-13 of filing instructions)
D NONE - (No lqlOl1able positions.)
1.
2.
3.
Dircdor Board ofVJSitom, University of Tennessee, College of Arts & Sciences
Beanlca High School Foundation
Bass, Bmy &. Sims PLC
JI. AGREEMENTS. (Reporting individual only; sec: pp. 14-16 offiliDginstructi.ons)
D NONE - (No reportable )
1. 2003 Bass Deny & Sims RdiJanent and Saviass Plan (rolledto U.S. Governmmt Thrift Savings Plan in 2003)
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SOUR.CE AND TYPE GRQSS INCQME
SOQRCE AND TYPE
SOURCE DESCRIP'I1QN
IV. REIMBURSEMENTS -transportation, 1oc1ging. food, ente:rtaimneat.
FINANCIAL DISCLOSURE REPORT l:' I
Varlan,. Thomas A
Date of Report
4127/2004
III. NON-INVESTMENT INCOME. (R.eporling individual and spouse; see w. 17-24 of filing instructions)
A. Filer's Non-Investment Incom
D NONE - (No reportable nan-investment income.)
1. 2.003 Bass, Berry lllld Sims PLC . .Attorney
(youli, not spouse's)
60,603.00
B. Spouse's Non-Investment Income-(Ifyou wcremmiedduringanypartionofthcrcpOrting year, please complete this acction. (dollar amount not required cx.ccpt far bonoraria)
D NONE - (Notepmtablcnon-investmmtincomc.)
1. 2003 The Envision Group, LLC, facili1atar
(lm:ludes tbo8c to &pOUSC lllld depcodmt childrm. Sec pp. 25-27 of instructicms.)
NONE - CNosuchrcpor1ablcreimbwscmcnts.)
1.
SOURCE DESCRIPTION
VAUffiCODE
FINANCIAL DISCLOSURE REPORT NameofPccsonRcporting Date of Report -•,
Varian, Thomas A '412712004
V. GIFTS. (Includes those to spouse and dependent children. See pp. 28-31 of instructions.)
D NONE - (No such reportable gifts.)
l. Knoxville Bar Association Judge's Robe $300
2. Bass, Berry & Sims, PLC SS,218
3.
VI. LIABILITIES. (Includes 1hose ofspouse and ckp:ndent cbildmL See pp. 32-34 of instructions.)
NONE (No rcponable liabilities.) -
CREDITOR
1.
\=rn:=-.-INVE=-===-s=TMENTS=-=:-:::=--an -d-:-:lR= U=S::T:-S::----inco-mc-, va..1.1uc-. llllnsc:aliolls--. -cmc1u_c1cs_tbose __ or_tbe_spouse __ -and-dcpcudent---childreo.-. __ Sec_p_p._34--s?-o-rfiling..1. __ instructi __ · _ons._>
__ -..J
s.
-
11 ll'Om
(4)
C -£2.501-.SS.OOO D =SS,001 S15,000 E -$!5.0GJ-$50.000 HJ = Sl,OOu.001-$5,000.000
FINANCIAL DISCLOSURE REPORT Name of Penwn Reporting Date of Ri:port _Page 1 of3 Varbm. Thomas A 4/2712004
A. Description of Assets
(includingtrust Weis)
Place "(X)" after each 11S1Ct eiumipt&om priordiBclOBlll'C
DNONE (No tqlOIUlble im:ome, assets, ortnmsactiOllS)
1. AmSouth Bank. Accounts
2. Cola Common S1DCk
3. BB&T Common Stock
4. City of Knoxville Dd'cl:rcd Co Program(457)
- Fidelity Coatrafimd
6. - Nationwide Fixed Accoullt
7. - mesc:o 0yn. Fnd. 1nc.
8. -Janus Fund
9. - Gartumura Tot. Return Fund D
10. - Temp. Foreign fund Cls. A
11. Wachovia Securities - IRA 1
12. - Evcqn:cm US Govt.
13. - Alliance Bc:mstc:in Growlh & IDcomc Fcl CL C
14. - Dreyfus Pn:mier Woddwidc Growth Fd Cl. C
IS. - Ea1on Vance Growth Tr. Worldwide Health Science Fd. C
16. - Evei:grem. Omega Fd. 0. C
17. - Fidelity Advisor Ser. J Mid-Cap Fd. a.. C
18. - Ivy Fd. European Opportunities Fd. a. c
B. Income ckaring IqJOrlil1gperiod
(I) (2)
Amount Type (e.g.Code l div. l1:lll or (A-H) int.)
A lntm:st
A Dividend
A Dividend
A Dividend
A Dividend
c. D. Gross value at end of Tnmsactioos during iqxining period n:poning period
(l) (2) {1) not exempt(2) (3) (S)
Value Value Type (e.g. Date: Value Gain Identity of Code2 Method buy, sell, Month- Codc2 Code l buyer/seller(J-P) Code3 merger, Day (J-P) (A-H) (ifprivate
(Q-W) ndcmption) transaction)
L T -
K T
J T
L T
J T
K T
J T
J T
K T
J T
L T
J T
J T
J T
J T
J T
J T
J T
H:! =-More than SS.000.000 r- Jncmne!Gain Codes: A .... Sl ... 000 or icss B - $1.00l-S2.SOU
L(See Columns Bl and D4) i:- : S50.001-S lO[i.000 G = SlOG,OOl-Sl.000,000
:. Value Co : Sl5.(1{)(10,-icso M = SIOO.OOJ-S:'.!50,(1(){\ = S.5.0 '" '.OO:J,000
J K $15,001-$50,000= = !50,001-S IOO.(){IO l'l = s; i.ooo.o; -SS.OOD.OOD P'.!rSee Columns c: aru::m; N ; SZ5o.o:Jll-S50 .()()(I (1 = S50U.00i-k0,Kl,OOO
sz:' ,, .oo;-$SU.OOO.<X! !'4 =$More than $S{J.000.00:l p; = T ' ':asirMarkc:
A.
(1) ii lIDIIl aisciosurc
Gain
�cmneiGairi
--
)
Type
(A-H)
33.
36.
C = S2,50l"I5.000 D =S5,001-Sl5,000
P4 = More !han 5(;.(J(l(),000
FINANCIAL DISCLOSURE REPORT Name ofPcn;on Reporting Date ofReport _Page2 of3 Varian, Thomas A 4/27/2004
VIL JNVESTMENTS and TRUSTS - income, value, lrlnscltiODS (includes those of the spouse and dependent children. Sec pp. 34-57 of filing iDstnictions.)
.B. c. l>. Income dariq: Gross value at end of 'JiansactiDD& during reporting period
Description of Assets reportiug period n:portingperiod(including trust mets) wt exempt(1) (2) (1) (2)
(3) (4) (S)(2) PlllllC •cx1• after each assetexempt Amount (e.g. Date:Value Value Type (e.g. Value Identity of from prior disclosuR buy, sell, Mondi-Codc2 MelhodCode 1 div. rmit. or Codc2 Code 1 buycrtscllcr
int.) (J..P) Codc3 (Q-W)
lllClglCr, Day (J-P) (A-H). ftfprivatelraDsacticm)
19. -(X) Goldman Sachs Research Select Fd. Cl C
20. - Pimco Small Cap Value Fund Cl. C
21. - Pimco High Yield Fund Cl C
22. - Seligman Communication & lnfmmation Fd Inc. Cl. D
23. - VIC Emerging Growth 0. C
24. Wachovia Securities IRA 2 A Dividend
25. - Evcrgrcc:n U. S. Govt. Money Mam:t Fd. Cl. A
26. - Evcrgrcc:n Omega Fd. Cl C
27. - Goldman Sachs Tr. Growth Opps. Fd. Cl C
28. - John Hancock lnvt. Tr. n Small Cap F.quity Fd. c
29. - Ivy Fd. European Opportunities Fd. Cl C
30. Bass, Baty & Sims Pension Plm A DMdml
31. - AmSoulh Pooled Funds
32. Bass, Baty & Sims Savings Plm A Dividend
J T
-
J T
J T
J T
J T
K T
J T
J T
J T
J T
J T
K T
K T
K T
34.
K T-AmSouth Pooled Funds A Dividend
J TUBS Retiremc:at Account A Dividmd
J T35. - UBS R.ctin::mcDt Money Fund A DMdml
J wu. s. Savings Bond A Interest
Codes: A Sl.OOD or less B s Sl.001-Sl.500 =E $15.001-SS0.000
(See Col=: Bl midD4) F = S5u.001-S100,000 G = s100,001 s1.ooo.ooo H1 - Sl,OOO.OOH.5.000.000 lU =More thanS5.00U.000
:. \'a' ' - Codes: .1 SlS,UO -0r less 1: = SlS,OOl- 50.(}(}(l L = $50,00J,5;100.000 M = SJOD.OOJ-s:!S0,000
fSe: Columns C: an.: m; :K SZ50.000-S:50l:,: 0 = $500.(1()1-:bl.OOO.OOO Pl = 1.000.001-£5,000.()(lO r: =S5.0()0.00i-S:!5.000.(100
P3 S:!5,000.001-$5G,D0U.0[1Ll
r A.;ipraisal P. Cos; <Rea: Eslllt:: Oniy,' Assessmem T = Cnsh'Markc:
W ' Estimated
B. c.
(2) JI osun:
(4) (S)
Monlh-
-
ssoo,oo;.s:.oct0,oo( ..
:
38.
(l)
Type
C S2,501-S5.000 D = $5,0UJ-SlS,000 E = Sl5.001-S50.00(1
div.
FINANCIAL DISCLOSURE REPORT Date of ReportName of Person Reporting
Page3 of3 Varian, 1bomas A 4/27/2004
VII. INVESTMENTS and TRUSTS -income, value, tnmscatioos(includcs lhoseoftbespouseanddepc:udcDtchildren. Secpp.34-57 offilinginsttuclions.)
A. D. Gross value at end ofIncome during TnmsactiClllS dwing reporting paiod
Description of Assets lqlOlting period rc:porting period (including lnl5t assets) DOI exempt (1)(I) (2)
(2) (3)Plaee "(X)" after each ISSd cxerq>t from prior losun:
Type (e.g. ValueValue IdentityofAmount Value Gain(e.g. buy, sell, Mc:lhodCodc2Code 1 buyer/sellerCode2 Codeln:ut. or
Jnel'gm',Code3 Day(J-P)(A-H) inl) nxlcmption){Q-W)
(if private {J-P) {A H)-tramactioa)
TJ37. STRIPS TINT - U.S. Treasury - lnte:restA
J TCATS InterestA
39. Tn. State School Board Aulharity Higher Ed. Facilities
A lnte:rest J T
40. Tc:nnCssee's BEST Prepaid Tuition AccouDls A lnte:rest K w
41..
= =1. ln::ame'Gain Colics: A Sl.000 or less B $t,OQJ.£::500 G iJ00,001..:bl.000,000 Hl = s1.ooo.001-ss,ooo.-00:i H1 = Moft' thm ss.ooa.ooo
:::. Value Codes: Sl5,00G or l s K $! 5.001-SSO,OOO L = !>StLOOl-$100.000 M = $!00.00l-S'.!50,000
' mwnnr.Cl i1I1dD3; l\ =$ 50.00'J-5500,0\)(1 o = Pl = 1,00u.IKll-$5.000.00 P2 = S:5.0 0.00J-1::!5.0ll0.00:J
p = S:'.!5,(l()O,OQ].$50.QO[l.0(1(1 P = More lilan 150.000.000
R :: ost (Kea: Esmtt (Jnl,· 1 S = A.ss:ssru m T = Cash'lvlari:e.
FINANCIAL.DISCLOSURE REPORT Name of Person Reporting
Varian, Thomas A
VIII. ADDffiONAL INFORMATION OR EXPLANATIONS (lndicatepmtofReport.>
Date of Report
4127/2004
1. Part VIl - In Part VD. line 30, in my 2002 report, I listed "Wachovia Sccmitics Money Market.• That llCCOllllt is still owned but is now. exempt ftom disclosure due to reduction in income and value.
2. Part Vil -Page 2, Line 32- The Bass, Berry and Sims Savings Plan was rolled over to 1he Thrift Savings Plan during 2003.
Administrative
Name of Petson Reporting Date of ReportFINANCIAL DISCLOSURE REPORT
Varlan; Thomas A 4127/2004
IX. CERTIFICATION.
I certify that all information given above (including infonnation 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 statutory provisions permitting non-disclosure.
I further certify that ea.med 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. § 5() 1 et seq., 5 U.S.C. § 7353, and Judicial Conference regulations.
Signature
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FAILS TO FILE TIIlS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. § 104)
FlllNG INSTRUCTIONS
Mail signed original and 3 additional copies to:
Committee on Financial Disclosure Office of the United States Courts
Suite2-301 One Columbus Circle, N .E.
Washington, D.C. 20544
"
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Thomas
_________ _ Date. ___ _
NAME OF QRGANIZATIQN/ENTITY POSIDON
PARTIES AND TERMS
r- ..c.
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2.
JI. AGREEMENTS. (Reporting individual only; see pp. 14-16 of filing iDslructions)
.. :. .
Report Required by the EthicsA0-10 FINANCIAL DISCLOSURE REPORT .in Government Act of 1978 Rev.1/2004
Calendar Year 2003 (5 U.S.C. app. §§ 101-111)
1. Person Reporting (Last name. First name, Middle lni.tial) 2. Court OT Organization 3. Dateof
_ . V arlan, A U.S. District Court, E. Tenn. 41271.2004
4. Title (Article m Judges indicate active or seaior status; 5. ReportType (check approp:iate type) 6. Reporting Period magistrate jud,.aes indicate full-or part-time}
Q Nominatioo, Date 1/1/2003 . U. S. District Judge -Active to0 JnitiaJ @ Annual 0 Final 1213112003
: 7. Cbambc:s or Office Address 8. On the basis of the iDformationcontainedin this Report and any modifications pertaining theret<i, it is, in my opinion, in compliance
U. S .. District Court with applicable laws andreglll.ations. . 800 Marla:t Street
Reviewing Officer · Knoxville, 1N 37902
IMPORTANTNOTES: The instructioos accompanying this form. most be followed. Complete all parts, checking the NO}llE box for each part where you have no reportableinformation. Sign anlast page.
I.' POSIDONS. (Reportingindivldualonly; see pp. 9-13 offiling:instructions)
0 NONE - (No reportable positions.)
' 1. Director Board ofVisitms, Univei:sity of Tennessee. College ofArts & Sciences
Director Bearden Scbool Fouodation
3: Bass, Beo:y & Sims PLC
:0 NONE - (No reportable agreemems.)
....- ..... 1. . 2003 Bass Beery & Sims Retirement and Savings P1an (rolled to U.S. Govemment Thrift Savings PJanin 2003)
o ":::IC: · ....·en ·- :a•C')
mo:!! (/) :z C') s :r:::; m
-·.r;;2 U1 0 <o> -0""Tl r- ·::S:: m-rt
0 - c
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SOUR.CE AND TYPE GROSS INCOME
SOURCE .AND TYPE
SOURCE DESCRIP1JON
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FINANCIAL DISCLOSURE REPORT Nam.eotPersonReporting
'Varlan, Thomas A
Date of Report 4fl.1n.004
ill. NON-lNVEST11ENT INCOME. (Reporting individual and spouse; see pp. 17-24 offilinginstructi=) A. Filer's Non-mvestment Incom 0 NONE (No reportablenon-investmmiucome.) -
1. 2003 Bass, Berry and Sims PLC. Attorney (yams, not spouse's)
60,603.00
B. Spouse's Non-Investment Income- (If you were married during any portion of the reportingyear, please complete this section. (dollar amount · not required except forhlmoxaria) 0 NONE - (Noreportahlenon-investmcatiDcome.)
I. 2003 The Envision Group, U.C, facilitatDr
. ·N. ·'REWBURSEMENTS -transportation. lodging, food.
(InCJ.udes those tO spouse and depc:odmt cbildrcc. See pp. 25-27 ofinstructions.) , 0 NONE - (No such reportable rc:imbwscmea!s.)
·I.
SOUR.CE DESCIUPTIQN
• >
DESCRIP1JON VALuECODE
V. GIFTS.
D NONE . (No such repartable gifts.)
2 .
'0 NONE - (No reportable liabilities.)
4127/2004
. FINANCIAL DISCLOSURE REPORT Name of Person Reporting
Varlan, Thomas A
Date of Report
(Includes those to spouse and dependent children. Seepp. 28-31 of instructions.)
Knoxville Bar Association Judge's Robe $300
Bass, Berry & Sims, PLC Reception following investiture $5,218
. 3 .
. ,. :
·. i . Vl LIABILITIES. (Jm:ludes those of spouse and depe:Ddmt children. See pp. 32-34 ofinstructicms.) · · ·.. .. : .
. CREDITOR . 1.
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Type
(1) ll from disclOSUII'>
(2) (3) (4) (5) Gain
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FINANCIAL DISCLOSURE REPORT Date of Report Name of Person RepartiDg Page 1 of3 Vazian, '1homasA 411.112.004
VII. INVESTMENTS and TRUSTS - iDcomc, value, transcatiom (includes those of the spouse and dependentchildr= See pp. 34-57 of :filing iosttuctions.)
A. B. c. D. Income daring Gross value at end of Transactioos duri.og reporting period
Description ofAssets mportiDg period rq>ortillg period (including trust assets)
not exempt(1) (2) (2) (I)
Place "(X)" aft=" each asset exempt Value Value Tl'Pe Dam:Amount (e.g. (e.g. Value Identity offrom p.tior disclosum Code I div. n:nt. or Code2 Method bay, sen. Mondi- Code2 Code I bttyerlseller(A-H) int.) {1-P) Code3 merger, Day (1-P) (A-H) (if private
(Q-W) 1*mption) transaclion)
DNONE (No n:portable income, assets, or tl'lmsactiODS)
AmSouth Bank Accounts A Interest L T
2. Cola Common Stock A Dividelld K T ·-
BB&T Common Stock A . Dividelld I T
4. City ofKmxville Defcired Com_peosatioD.Program 'A Dividend T(457).' '
. .. -Fidelity Coatrafund T'' . 5.
..
6.. - Nationwide Fixed A.ccouut K T
: :' 7. - Invesco Dyn.. Fnd. Inc. ] T
-JanusFUDd ] T
K T., 9. - Gartomma Tot. Rctum.FundD
T10 . - Temp. Foreign fund Cls. A I . ..
11. Wachovia Securities· IRA 1 A Dividcnd L T . . ·
12 . - Eve:rgreen. US Govt. I T
·. ·· - .Alliauce .Bemstein Growth & Income Fd. a. C I T
. .
:.,·, 14 .. . - Dreyfus Premier Worldwide GrowthFd Cl. C I T
15. - Eaton Vance Growth Tr. Worldwide Health I T Science Fd. C
16. - Eve:rgreen. Omega Fd Cl. C I T
17. - Fidelity Advisor Se:r. I Mid-Cap Fd a. C I T
18. . - Ivy Fd European Opportuuitics Fd. Cl. C I T
--
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"
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-
ll rrom
(2) (3) (4) (S) Amount Gain
Method Coclc l
(Q-W)
-
J
T
!
?
' ,\ ·
30.
36.
reporting period IqJOrting period
(e.g. (e.g.
(J-P)
-
· . . FlNANCIAL DISCLOSURE REPORT NameofPersonReporting ofR.eport •Page 2of3 · Varlan. Thomas A 4127/2004
yn. INVESTNIBNTS and 1RUSTS -iD:ome, vaiue. transcations (includes t1ioseoftbespouseanddependentchildr= Secpp. 34-s1 of filing instructions.)
A. B. c. D. Income dw:iDg Gross value at end of T.ransactions during ieporting period De$:ription af Assets
fmcluding trust assets) not exempt (1) (2) (1) (2) (1)
P!ace "(X)' after each asset exempt from prior disc! Coclc l
Typediv. rcut. or
Value Value Typebuy, sell,
Dal=: Value Identity ofMan!h-Codc2 Code2 buyedselle:rDay (J-P) (A-H) [if private
transaction)(A-H) int.) Code3 merger,
tedemption) ·
...
19.·. - Goldman Sachs Research Select Fd. Cl C J
, . 20. - Pimco Small Cap V a1ue FUDd CL C J
. ": 21. - Pimco High!ieldFund Cl C J
. .
·::: 22. . - Seligman Communication & IDfimna.ti.on,Fd.. ' J Inc. O.D
, . .
· -VIC_Emcrging Growth Cl C J'" .. 23.
. . ...
.:.,.'· 24 . Wachovia Securities IRA2 A Dividend K . . .
' .': 25 . - Ev U. S. Govt. Maney Marla:t Fd.. 0. A ]
26 . - Evergieen Omega Fd. Cl C
. .
21. - Goldman Sachs Tr. Growth Opps. Fd. a. C ]
·.·.
'28. - JohnHancock Invt. Tr. II Small Cap Equity Fd.. C J· .
. 29. - Ivy Fd.. European Oppartuu.ities Fd.. 0. C J
T
T
T
T
T
T
T
T
T
T
T
- . Bass, Bca:y & Sims PC:DSion Plan A Dividend K T . ..
:,,.
3 1. - AmSouth Pooled Funds ... -- ·-
K
.-: 32· · ,."
· Bass, Beay & Sims S Plan A Di:vidcod K T
33. - .AmSouth Pooled F1JIU!s -
A Dividc:nd K T
34_. UBS R.etirrmcJt Account A Divideod ] T
35. - UBS Retimnem Money Fund A DivideDd J T
U. S. Savings Bond A ] w
37.
-.
CA:
lf :li:om aisclo=
Value
K
'
reporting period
Code2 (J-P)
Gross value at end of
FINANCIAL DISCLOSURE REPORT Name of Person Reporting Date of Report
P·age 3 of3 VarlaD, Thomas A 4/27fl.004
VII. INVESTMENTS and TR.US TS -income, value, tmnscations (includes those oftbc spouse and dcperulent cllildi=. See pp. 34-57 of filing inslmelious.}
A. B. c. D. Income during
Description of Assets i:eportiDg period(mcludi:Dg tmst assets)
Transactions during .reportingperiod
not acmpt (1) (2) (I) (2) (I) (2) (3) (4) (S)
Place "(X)" after each asset =mpt Amoullt Type (e.g.ftompriordisclosure div. r:ent. or
Type (e.g.Value Value Date: Gain Identity of Method buy, sell, Month-Codel Code2 Codel bu seller ,fCodc3 meiger, Day
m!moption)(Q-W). (A-H) (':if private
transaction) int) (J-P)(A-H)
STRIPS -TINT -U.S. Tn:asury
38.
39 .. Tn. State School Boani Aulhority Higher Ed. Facilities
w40 . Tennessee's BEST Prepaid Tuition Accounts A Interest
A lDterest J T
A Interest J T
A lDterest J T
. ·4.1.
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-·: . . :.···
.··.·:··
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FINANCIAL DISCLOSURE REPORT NameofPcrsonR.eporting
Varlan, Thomas A
VIII. ADDIDONAL INFORMATION OR EXPLANATIONS (Indicate part of Report.)
Date of Report
4127/2004
1. Part VII- Pagel, Lines 11through18 and Page 2, Lines 19 through29 -Any changes between the priorandcurrcntyearreport in investments represent changes within IRA or retirement accounts over which I have no decision making capacity.
2. Part VII -Page 2, Line 32 - The Bass, Beay and Sims Savings Plan was rolled over to the Thrift Savings Plan during 2003.
nate_,_sif_1 J_' /_o_....4-__
FiNANCIAL DISCLOSURE REPORT Name of Person Reporting
Varian. Thomas A
Date of Report
4127/2004
IX. CERTIFICATION.
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 belie±: and that any infon:J'.!.ation not reported was
withheld because it met applicable statutory 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.
Signature
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND Wil..FULL y FALSIFIES ORF AILS TO FILE nns REPORT MA y BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. § 104)
FILING INSTRUCTIONS
Mail signed original and 3 additional copies to:
Committee on Financial Disclosure
Administrative Office of the United States Courts
Suite 2-301 One Columbus Circle, N.E.
_Washington, D. C 20544.