Robert S. Mueller - public financial disclosure report

Robert S. Mueller’s public financial disclosure — along with those of seven members of his team — was released on Aug. 8 by the Justice Department.

New Entrant Report US. Office of Government Ethics; 5 C.F.R. part 2634 Form Approved: OMB No. (3209-0001) (March 2014)
Executive Branch Personnel
Public Financial Disclosure Report (OGE Form 278e)

Filer's Information
Mueller, Robert
Special Counsel, Department ofJustice

Date Of Appointment: 05/19/2017

Other Federal Government Positions Held During the Preceding 12 Months:
None

Electronic Signature - I certify that the statements I have made in this form are true, complete and correct to the best of my knowledge.

ls/ Mueller, Robert [electronically signed on 07/19/2017 by Mueller, Robert in Integrity.gov] - Filer received a 30 day ?ling extension.

Agency Ethics Official's Opinion - On the basis of information contained in this report, I conclude that the filer is in compliance with applicable laws and regulations
(subject to any comments below).
Schools, Scott, Certifying Of?cial [electronically signed on 08/08/2017 by Schools, Scott in Integrity.gov]

Other review conducted by
Shaw, K, Ethics Of?cial [electronically signed on 08/08/2017 by Shaw, in Integrity.gov]

US. Office of Government Ethics Certification

Data Revised 08/08/2017

Data Revised 08/07/2017
Data Revised 08/04/2017
Data Revised 08/03/2017
Data Revised 07/25/2017
Data Revised 07/24/2017

Comments of Reviewing Officials (public annotations):
PART

#

REFERENCE

COMMENT

N/A

N/A

General

(08/08/2017, Shaw, Cynthia K): Revisions made per filer clarifications. Filer received ethics guidance
on criminal conflicts of interest and Standards of Conduct. No apparent conflicts of interest.

1. Filer's Positions Held Outside United States Government

ORGANIZATION NAME CITY, STATE ORGANIZATION POSITION HELD FROM TO
TYPE
1 WilmerHale Washington, Law Firm Partner 3/2014 5/2017
District of
Columbia
2 Robert S. Mueller Associates, LLC (Now Washington, LLC Sole Member 9/2013 Present
Inactive) District of and Managing
Columbia Member
2. Filer's Employment Assets Income and Retirement Accounts
DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1 WilmerHale (law firm)
1.1 WilmerHale (partnership share and draw) $3,455,876
1.2 WilmerHale (reserve for tax liabilities) $50,001 - None (or less
$100,000 than $201)
1.3 WilmerHale (partner income tax $1,001 - $15,000 None (or less
preparation) than $201)
1.4 WilmerHale - Savings and Retirement Plan - Yes $100,001 - $2,501 - $5,000
Vanguard Target Retirement 2010 Fund $250,000
1.5 WilmerHale Moderate Portfolio (no longer Yes None (or less $5,001 - $15,000
held) than $1,001)
1.6 WilmerHale (defined benefit plan) No $50,001 - None (or less
$100,000 than $201)
2 Filer's IRA (10)
2.1 Vanguard Dividend Appreciation ETF (vig) Yes $50,001 - $1,001 - $2,500
$100,000
2.2 Doubleline Core Fixed Income Fund Yes $50,001 - $1,001 - $2,500

$1 00,000

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
2.3 Vanguard Target Retirement 2020 Yes $50,001 - $1 ,001 - $2,500
$100,000
2.4 TCW Total Return Bond Fund Yes $15,001 - $1,001 - $2,500
$50,000
2.5 Ridgeworth SEIX Float Rate High Income Yes $50,001 - $5,001 - $15,000
Fund (sambx) $100,000
2.6 Brokerage Government Money Market Fund Yes $1,001 - $15,000 None (or less
than $201)
3 Filer's SEP IRA (43)
3.1 Vanguard Target Retirement Fund 2020 Yes $15,001 - $1 ,001 - $2,500
Fun $50,000
4 Filer's IRA (67)
4.1 US Treasury In?ation Indexed Notes 0.125% WA $50,001 - None (or less
due 4/15/21 (912828060) $100,000 than $201)
4.2 Doubleline Total Return Bond Fund Yes $50,001 - $2,501 - $5,000
$100,000
4.3 Vanguard 500 Index Admiral Shares Yes $50,001 - $2,501 - $5,000
$100,000
4.4 Brokerage Bank Deposit Account Yes $50,001 - None (or less
$100,000 than $201)
5 Panetta Institute for Public Policy (Seaside, Award $5,000
CA) 2016Jefferson-Lincoln Award
6 Robert Mueller Associates, LLC Honoraria for
(Washington, DC) Honoraria through Washington
Washington Speakers Bureau Speakers
Bureau events
6.1 Insurance Information Institute (New York, Honorarium $37,600
NY) - 1/12/2016
6.2 Ford Motor Company - 2/3/2016 Honorarium $24,000
6.3 Citi (Rye Brook, NY) - 2/4/2016 Honorarium $40,000
6.4 Jewish United Way of Metropolitan Chicago Honorarium $40,000

(Chicago, IL) - 6/7/2016

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
6.5 Banamex (Punta Mita, MX) - 6/16/2016 Honorarium $52,000
6.6 International Bar Association (Washington, WA Honorarium $24,000
DC) - 9/20/2016
6.7 Enterprise (Washington, DC) - Honorarium $24,000
3/7/2017
3. Filer's Employment Agreements and Arrangements

EMPLOYER OR PARTY CITY, STATE STATUS AND TERMS DATE

1 WilmerHale Washington, Pursuant to firm ractice, following my withdrawal 5/2017
District of from the firm, Wi merHale returned capital
Columbia contribution calculated and fixed as the date of my

withdrawal.

2 WilmerHale Washington, Pursuant to firm ractice, following my withdrawal 5/2017
District of from the firm, Wi merHale paid my partnership share
Columbia calculated and fixed as oft date of my withdrawal.

3 WilmerHale Washington, Pursuant to firm ractice, following withdrawal 5/2017
District of from the firm, Wi merHale reimburse my 2017
Columbia contribution to the firm?s defined benefit plan. I will

retain my interest in the plan.

4 WilmerHale Washington, Pursuant to firm practice, after my departure, 5/2017
District of WilmerHale will pay for the preparation of my partner
Columbia tax returns for 2016 and 2017.

5 Robert Mueller Associates, LLC Washington, My LLC will be inactive during my service as Special 5/2017
District of Counsel, with the exception of required corporate
Columbia filings.

6 WilmerHale Washington, I will continue to participate in this defined 5/2014
District of contribution plan. The plan sponsor will not make
Columbia further contributions after my separation.

7 WilmerHale Washington, Pursuant to firm practice, WilmerHale will reimburse 5/2017
District of any remaining money from withheld income to cover
Columbia estimated partnership taxes, within 3 years of my

separation.

4. Filer's Sources of Compensation Exceeding $5,000 in a Year

SOURCE NAME CITY, STATE BRIEF DESCRIPTION OF DUTIES

1 WilmerHaIe Washington, Partner
District of
Cdumbb

2 Goldman Sachs New York, New Washington Speakers Bureau (WSB) speaking engagements in 2015
York

3 The Women's Board of Wolfson Children's Jacksonville, 2015 WSB speaking engagement

Hospnal Honda

4 Cambridge St. Louis Series, LLC St Louis, 2015 WSB speaking engagement
Missouri

5 Payment Systems for Credit Unions Washington, 2015 WSB speaking engagement
District of
Cdumbm

6 Symantec/O'Keefe Co. Washington, 2015 WSB speaking engagement
District of
Cdumbb

7 Jewish Federation of Greater LA Los Angeles, 2015 WSB speaking engagement
California

8 FISERV, Inc. Brook?eld, 2015 WSB speaking engagement
VWsconsn1

9 Nuclear Energy Institute Washington, 2015 WSB speaking engagement
District of
Cdumbb

10 The Richmond Forum Richmond, 2015 WSB speaking engagement

11 Fidelity Information Services/Speak, Inc. Washington, 2015 WSB speaking engagement
District of
Cdumbb

12 Group New York, New 2015 WSB speaking engagement
York

13 Insurance Information Institute New York, New 2016 WSB speaking engagement

York

York

SOURCE NAME CITY, STATE BRIEF DESCRIPTION OF DUTIES
14 Ford Motor Company Washington, 2016 WSB speaking engagement
District of
Columbia
15 Citi Rye Brook, New 2016 WSB speaking engagement
York
16 Jewish United Way of Metropolitan Chicago Chicago, Illinois 2016 WSB speaking engagement
17 Banamex Punta Mita, MX, 2016 WSB speaking engagement
Outside US.
18 International Bar Association Washington, 2016 WSB speaking engagement
District of
Columbia
19 Enterprise Washington, 2017 WSB speaking engagement
District of
Columbia
20 Stanford University Stanford, Arthur and Frank Payne Distinguished Lecturer and Consulting
California Professor for 2013-2014 academic year, compensation was received in
2015
21 National Football League Nevlv( York, New Legal services (client of WilmerHale)
Yor
22 3002 Allen Hamilton, Inc. McLean, Virginia Legal services (client of WilmerHale)
23 Volkswagen MDL - Settlement Master San Francisco, Le al services (paid by Plaintiffs' Steering Committee and Volkswagen to
California Wi merHale) Court-appointed Settlement Master, MDL Litigation 2672
CRB (JSC), IN RE: VOLKSWAGEN, US District Court, Northern District of
California.
24 Sony Pictures Entertainment, Inc. Culver City, Legal services (client of WilmerHale)
California
25 Intel Corporation Santa Clara, Legal services (client of WilmerHale)
California
26 Facebook, Inc. Menlo Park, Legal services (client of WilmerHale)
California
27 Apple, Inc. Cu ertino, Legal services (client of WilmerHale)
Ca ifornia
28 The College Board New York, New Legal services (client of WilmerHale)

SOURCE NAME CITY, STATE BRIEF DESCRIPTION OF DUTIES

29 Blue Cross/Blue Shield of Massachusetts, Boston, Legal services (client of WilmerHale)
Inc. Massachusetts

30 The Hershey Company Hershe Legal services (client of WilmerHale)

Pennsy vania

5. Spouse's Employment Assets Income and Retirement Accounts

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1 Spouse IRA (03)
1.1 Vanguard Target Retirement 2020 Yes $15,001 - $201 - $1,000
$50,000
2 TIAA CREF Plans
2.1 TIAA Traditional Annuities $15,001 - None (or less
$50,000 than $201)
2.2 CREF Stock Yes $50,001 - None (or less
$100,000 than $201)
2.3 CREF Global Equities Yes $15,001 - None (or less
$50,000 than $201)
6. Other Assets and Income
DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1 Share of Family Trust (3) No
1.1 ACCENTURE PLC-CL A $1,001 - $15,000 Capital Gains $201 - $1,000
Dividends
1.2 AGILENT TECHNOLOGIES INC $1,001 - $15,000 None (or less
than $201)
1.3 AIR PRODS CHEMS INC $1,001 - $15,000 None (or less

than $201)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1.4 ALPHABET A $1,001 - $15,000 None (or less
than $201)
1.5 ALPHABET INC-CL $1,001 - $15,000 None (or less
than $201)
1.6 AMAZON.COM INC $1,001 - $15,000 None (or less
than $201)
1.7 AMERICAN EXPRESS CO $1,001 - $15,000 None (or less
than $201)
1.8 AMERIPRISE FINANCIAL INC $1,001 - $15,000 None (or less
than $201)
1.9 AMGEN INC $1,001 - $15,000 None (or less
than $201)
1.10 AON PLC $1,001 - $15,000 None (or less
than $201)
1.11 APPLE INC $1,001 - $15,000 None (or less
than $201)
1.12 APPLIED MATERIALS INC $1,001 - $15,000 None (or less
than $201)
1.13 A56 GLOBAL ALTERNATIVES FUND-Y Yes $1,001 - $15,000 None (or less
than $201)
1.14 ASG MANAGED FUTURES STRAT-Y Yes $15,001 - None (or less
$50,000 than $201)
1.15 INC $1,001 - $15,000 None (or less
than $201)
1.16 BANK OF AMERICA CORP $1 ,001 - $15,000 None (or less
than $201)
1.17 BAXT ER INTERNATIONAL INC $1,001 - $15,000 None (or less
than $201)
1.18 BERKSHIRE HATHAWAY INC DEL CL $1,001 - $15,000 Capital Gains $201 - $1,000
1.19 BEST BUY INC $1,001 - $15,000 None (or less

than $201)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1.20 BNY MELLON ABS INSIGHT Yes $1,001 - $15,000 None (or less
than $201)
1.21 BNY MELLON EMERGING MKTS-M Yes $15,001 - None (or less
$50,000 than $201)
1.22 BNY MELLON INTERNATIONAL-M Yes $15,001 - $201 - $1,000
$50,000
1.23 BNY MELLON INTL EQUITY INCOME FUND Yes $1,001 - $15,000 None (or less
than $201)
1.24 BNY MELLON MULTI-STRATEGY FUND Yes $50,001 - $1,001 - $2,500
$100,000
1.25 BNY MELLON MUNI OPPORT-M Yes $15,001 - $1,001 - $2,500
$50,000
1.26 BNY MELLON NAT MUNI BD-M Yes $50,001 - $201 - $1,000
$100,000
1.27 BNY MELLON NATL INTM MUNI-M Yes $15,001 - $1,001 - $2,500
$50,000
1.28 BOEING CO $1,001 - $15,000 None (or less
than $201)
1.29 BURLINGTON STORES INC $1,001 - $15,000 None (or less
than $201)
1.30 GLOBAL INC. $1,001 - $15,000 None (or less
than $201)
1.31 CARNIVAL CORP $1,001 - $15,000 None (or less
than $201)
1.32 CELANESE CORP -SER A $1,001 - $15,000 None (or less
than $201)
1.33 CELGENE CORP $1,001 - $15,000 None (or less
than $201)
1.34 CHEVRON CORPORATION $1,001 - $15,000 None (or less
than $201)
1.35 CIGNA CORP $1,001 - $15,000 None (or less

than $201)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1.36 CIMAREX ENERGY CO $1,001 - $15,000 None (or less
than $201)
1.37 CISCO SYSTEMS INC $1,001 - $15,000 None (or less
than $201)
1.38 CONAGRA BRANDS INC $1,001 - $15,000 None (or less
than $201)
1.39 CVS HEALTH CORPORATION $1,001 - $15,000 None (or less
than $201)
1.40 DANAHER CORP $1,001 - $15,000 None (or less
than $201)
1.41 DARDEN RESTAURANTS INC $1,001 - $15,000 None (or less
than $201)
1.42 DELTA AIR LINES INC $1,001 - $15,000 None (or less
than $201)
1.43 DISCOVER FINANCIAL SERVICES $1,001 - $15,000 None (or less
than $201)
1.44 DREYFUS DIVERSIFIED EM MK-Y Yes $1,001 - $15,000 None (or less
than $201)
1.45 DREYFUS GLOBAL REAL RET -Y Yes $1,001 - $15,000 $201 - $1,000
1.46 DREYFUS INTERNATIONAL STOCK-Y Yes $1,001 - $15,000 None (or less
than $201)
1.47 DREYFUS INTL SMALL CAP-Y Yes $15,001 - $201 - $1 ,000
$50,000
1.48 DREYFUS OPPORT SM CAP-Y Yes $1,001 - $15,000 None (or less
than $201)
1.49 DREYFUS SELECT MGER GR-Y Yes $1,001 - $15,000 None (or less
than $201)
1.50 DREYFUS SELECT MGER VL-Y Yes $1,001 - $15,000 None (or less
than $201)
1.51 DREYFUS SELECT MGR EQ-Y Yes $15,001 - None (or less
$50,000 than $201)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1.52 DREYFUS YIELD ENH STRA T-Y Yes $15,001 - $1,001 - $2,500
$50,000
1.53 INTERN EQTY-Y Yes $1,001 - $15,000 None (or less
than $201)
1.54 EATON VANCE CORP $1,001 - $15,000 None (or less
than $201)
1.55 EBAY INC $1,001 - $15,000 None (or less
than $201)
1.56 EQUITY RESIDENTIAL $1,001 - $15,000 None (or less
than $201)
1.57 EVEREST RE GROUP LTD $1,001 - $15,000 None (or less
than $201)
1.58 EXPRESS SCRIPTS HOLDING CO $1,001 - $15,000 None (or less
than $201)
1.59 EXXON MOBIL CORP $1,001 - $15,000 None (or less
than $201)
1.60 F5 NETWORKS INC $1,001 - $15,000 None (or less
than $201)
1.61 FACEBOOK INC-A $1,001 - $15,000 None (or less
than $201)
1.62 FIRSTENERGY CORP $1 ,001 - $15,000 None (or less
than $201)
1.63 GENERAL ELECTRIC CO $1,001 - $15,000 None (or less
than $201)
1.64 GILEAD SCIENCES INC $1,001 - $15,000 None (or less
than $201)
1.65 GREAT PLAINS ENERGY INC $1,001 - $15,000 None (or less
than $201)
1.66 SUPPLY HOLDINGS INC $1,001 - $15,000 None (or less
than $201)
1.67 INGERSOLL-RAND PLC $1,001 - $15,000 None (or less

than $201)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1.68 INTERNATIONAL BUSINESS MACHINES CORP $1,001 - $15,000 None (or less
than $201)
1.69 JOHNSON $1,001 - $15,000 None (or less
than $201)
1.70 JP MORGAN CHASE CO $1,001 - $15,000 None (or less
than $201)
1.71 KIMBERLY CLARK CORP $1,001 - $15,000 None (or less
than $201)
1.72 LAM RESH CORP $1,001 - $15,000 None (or less
than $201)
1.73 LEAR CORP $1,001 - $15,000 None (or less
than $201)
1.74 COMPANIES INC $1,001 - $15,000 None (or less
than $201)
1.75 RES GROUP INC $1,001 - $15,000 None (or less
than $201)
1.76 MARSH MCLENNAN COS INC $1,001 - $15,000 None (or less
than $201)
1.77 MELLON OPTIMA US STRATEGY FD LLC Yes $15,001 - $201 - $1,000
$50,000
1.78 MERCK CO INC $1,001 - $15,000 None (or less
than $201)
1.79 MICROSOFT CORPORATION $1,001 - $15,000 None (or less
than $201)
1.80 MOTOROLA SOLUTIONS INC. $1,001 - $15,000 None (or less
than $201)
1.81 CORP NEW $1,001 - $15,000 None (or less
than $201)
1.82 ONEOK INC $1,001 - $15,000 None (or less
than $201)
1.83 OSHKOSH CORPORATION $1,001 - $15,000 None (or less

than $201)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1.84 PEPSICO INC $1,001 - $15,000 None (or less
than $201)
1.85 PFIZER INC $1,001 - $15,000 None (or less
than $201)
1.86 PUBLIC STORAGE INC REIT $1,001 - $15,000 None (or less
than $201)
1.87 GLOBAL INC $1,001 - $15,000 None (or less
than $201)
1.88 SIRIUS XM HOLDINGS INC $1,001 - $15,000 None (or less
than $201)
1.89 SPECTRUM BRANDS HOLDINGS INC $1,001 - $15,000 None (or less
than $201)
1.90 SPIRIT AEROSYSTEMS HOLD CL A $1,001 - $15,000 None (or less
than $201)
1.91 STATE STREET CORP $1 ,001 - $15,000 None (or less
than $201)
1.92 STRATEGIC GLBL STOCK-Y Yes $15,001 - $201 - $1,000
$50,000
1.93 TEXAS INSTRUMENTS INC $1,001 - $15,000 None (or less
than $201)
1.94 THE TRAVELERS COMPANIES INC $1,001 - $15,000 None (or less
than $201)
1.95 THERMO FISHER SCIENTIFIC INC. $1,001 - $15,000 None (or less
than $201)
1.96 TIME WARNER INC $1,001 - $15,000 None (or less
than $201)
1.97 UNITEDHEALTH GROUP INC $1,001 - $15,000 None (or less
than $201)
1.98 VALERO ENERGY CORP NEW $1,001 - $15,000 None (or less
than $201)
1.99 VERISIGN INC $1,001 - $15,000 None (or less

than $201)

than $1,001)

Capital Gains

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1.100 VERIZON COMMUNICATIONS INC $1,001 - $15,000 None (or less
than $201)
1.101 VMWARE INC-CLASS A $1,001 - $15,000 None (or less
than $201)
1.102 WAL MART STORES INC $1,001 - $15,000 None (or less
than $201)
1.103 WALGREENS BOOTS ALLIANCE INC $1,001 - $15,000 None (or less
than $201)
1.104 WALT DISNEY $1,001 - $15,000 None (or less
than $201)
1.105 WELLS FARGO COMPANY $1,001 - $15,000 None (or less
than $201)
1.106 3M CO $1,001 - $15,000 None (or less
than $201)
1.107 ACTIVISION BLIZZARD INC None (or less Capital Gains $201 - $1,000
than $1,001) Dividends
1.108 DREYFUS DIVERSIFIED Yes None (or less $201 - $1,000
than $1,001)
1.109 MOODYS CORP None (or less Capital Gains $201 - $1,000
than $1,001)
1.110 PRUDENTIAL FINANCIAL INC None (or less Capital Gains $201 - $1,000
than $1,001) Dividends
1.111 SOUTHWEST AIRLS CO None (or less Dividends $201 - $1 ,000
than $1,001) Capital Gains
1.112 VISA INC-CLASS A SHRS None (or less Dividends $201 - $1,000
than $1,001) Capital Gains
1.113 VISTEON CORP None (or less Dividends $201 - $1,000
than $1,001) Capital Gains
1.114 DOW CHEMICAL CO None (or less Dividends $201 - $1,000
than $1,001) Capital Gains
1.115 HOME DEPOT INC None (or less Dividends $201 - $1,000

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
1.116 MARRIOTT INTL INC NEW CL A None (or less $201 - $1,000
than $1,001) Capital Gains
1.117 U.S. Brokerage, bank deposit account (cash) WA $15,001 - None (or less
$50,000 than $201)
2 Share of Family Trust (2) No
2.1 APPLE INC $1,001 - $15,000 None (or less
than $201)
2.2 ASG GLOBAL ALTERNATIVES FUN D-Y Yes $1,001 - $15,000 None (or less
than $201)
2.3 ASG MANAGED FUTURES Yes $1,001 - $15,000 None (or less
than $201)
2.4 BNY MELLON INCOME STOCK-M Yes $1,001 - $15,000 $201 - $1,000
2.5 BNY MELLON INTERNATIONAL-M Yes $1,001 - $15,000 None (or less
than $201)
2.6 BNY MELLON INTL EQUITY INCOME FUND Yes $1,001 - $15,000 None (or less
than $201)
2.7 BNY MELLON UC MKT OPP-M Yes $15,001 - $2,501 - $5,000
$50,000
2.8 BNY MELLON MULTI-STRATEGY FUND Yes $15,001 - $201 - $1,000
$50,000
2.9 BNY MELLON MUNI OPPORT-M Yes $1,001 - $15,000 $201 - $1,000
2.10 BNY MELLON NAT MUNI BD-M Yes $1,001 - $15,000 None (or less
than $201)
2.11 BNY MELLON NATL INTM MUNI-M Yes $15,001 - $1,001 - $2,500
$50,000
2.12 DREYFUS GLOBAL EMRG MKTS-Y Yes $1,001 - $15,000 None (or less
than $201)
2.13 DREYFUS GLOBAL REAL RET -Y Yes $1,001 - $15,000 None (or less
than $201)
2.14 DREYFUS INTERNATIONAL STOCK-Y Yes $1,001 - $15,000 None (or less

than $201)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
2.15 DREYFUS INTL SMALL CAP-Y Yes $1 ,001 - $15,000 None (or less
than $201)
2.16 DREYFUS MIDCAP Yes $1,001 - $15,000 $201 - $1,000
2.17 DREYFUS OPPORT SM CAP-Y Yes $1,001 - $15,000 None (or less
than $201)
2.18 DREYFUS SELECT MGER GR-Y Yes $1,001 - $15,000 None (or less
than $201)
2.19 DREYFUS SELECT MGER VL-Y Yes $1,001 - $15,000 None (or less
than $201)
2.20 DREYFUS SELECT MGR EQ-Y Yes $1,001 - $15,000 None (or less
than $201)
2.21 DREYFUS YIELD ENH STRA T-Y Yes $1,001 - $15,000 $201 - $1,000
2.22 INTERN EQTY-Y Yes $1,001 - $15,000 None (or less
than $201)
2.23 JOHNSON $1,001 - $15,000 None (or less
than $201)
2.24 MELLON OPTIMA US STRATEGY FD LLC Yes $15,001 - $201 - $1,000
$50,000
2.25 STRATEGIC GLBL STOCK-Y Yes $1,001 - $15,000 $201 - $1,000
2.26 U.S. Brokerage, Bank Deposit Account (cash) $1,001 - $15,000 None (or less
than $201)
3 Share of Family Trust (1) No
3.1 ACCENTURE PLC-CL A None (or less Dividends $201 - $1,000
than $1,001) Capital Gains
3.2 ACT IVISION BLIZZARD INC None (or less Dividends $201 - $1,000
than $1,001) Capital Gains
3.3 ALPHABET A $1,001 - $15,000 None (or less
than $201)
3.4 ALPHABET INC-CL $1,001 - $15,000 None (or less

than $201)

$50,000

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
3.5 AMAZON.COM INC $1,001 - $15,000 None (or less
than $201)
3.6 AMGEN INC $1,001 - $15,000 None (or less
than $201)
3.7 APPLE INC $1,001 - $15,000 None (or less
than $201)
3.8 ASG GLOBAL ALTERNATIVES FUN D-Y Yes $1,001 - $15,000 None (or less
than $201)
3.9 ASG MANAGED FUTURES STRAT-Y Yes $1,001 - $15,000 None (or less
than $201)
3.10 INC $1 ,001 - $15,000 None (or less
than $201)
3.11 BANK OF AMERICA CORP $1 ,001 - $15,000 None (or less
than $201)
3.12 BNY MELLON ABS INSIGHT Yes $1,001 - $15,000 None (or less
than $201)
3.13 BNY MELLON FOC EQ OPP-M Yes $15,001 - $2,501 - $5,000
$50,000
3.14 BNY MELLON INCOME STOCK-M Yes $15,001 - $1,001 - $2,500
$50,000
3.15 BNY MELLON INTERNATIONAL-M Yes $15,001 $201 - $1,000
$50,000
3.16 BNY MELLON INTL EQUITY INCOME FUND Yes $15,001 - $201 - $1,000
$50,000
3.17 BNY MELLON MULTI-STRATEGY FUND Yes $15,001 - $201 - $1,000
$50,000
3.18 BNY MELLON MUNI OPPORT-M Yes $15,001 - $1,001 - $2,500
$50,000
3.19 BNY MELLON NAT MUNI BD-M Yes $15,001 - $201 - $1,000
$50,000
3.20 BNY MELLON NATL INTM MUNI-M Yes $15,001 - $1,001 - $2,500

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
3.21 BOEING CO $1,001 - $15,000 None (or less
than $201)
3.22 CHEVRON CORPORATION $1,001 - $15,000 None (or less
than $201)
3.23 CISCO SYSTEMS INC $1,001 - $15,000 None (or less
than $201)
3.24 DREYFUS DIVERSIFIED INTL-Y Yes None (or less $201 - $1,000
than $1,001)
3.25 DREYFUS GLOBAL EMRG MKTS-Y Yes $15,001 - None (or less
$50,000 than $201)
3.26 DREYFUS GLOBAL REAL RET -Y Yes $1,001 - $15,000 $201 - $1,000
3.27 DREYFUS INTERNATIONAL STOCK-Y Yes $1,001 - $15,000 $2,501 - $5,000
3.28 DREYFUS INTL SMALL CAP-Y Yes $15,001 $201 - $1,000
$50,000
3.29 DREYFUS MIDCAP Yes $15,001 - $2,501 - $5,000
$50,000
3.30 DREYFUS OPPORT SM CAP-Y Yes $1,001 - $15,000 None (or less
than $201)
3.31 DREYFUS SELECT MGER GR-Y Yes $1,001 - $15,000 None (or less
than $201)
3.32 DREYFUS SELECT MGER VL-Y Yes $1,001 - $15,000 None (or less
than $201)
3.33 DREYFUS SELECT MGR US EQ-Y Yes $1,001 - $15,000 None (or less
than $201)
3.34 DREYFUS US EQUITY FUND-Y Yes $15,001 - $2,501 - $5,000
$50,000
3.35 DREYFUS YIELD ENH STRA T-Y Yes $15,001 - $2,501 - $5,000
$50,000
3.36 INTERN EQTY-Y Yes $1,001 - $15,000 $201 - $1,000
3.37 EXXON MOBIL CORP $1,001 - $15,000 None (or less

than $201)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
3.38 FACEBOOK INC-A $1,001 - $15,000 None (or less
than $201)
3.39 GENERAL ELECTRIC CO $1,001 - $15,000 None (or less
than $201)
3.40 HOME DEPOT INC None (or less Dividends $201 - $1,000
than $1,001) Capital Gains
3.41 INTERNATIONAL BUSINESS MACHINES CORP $1,001 - $15,000 None (or less
than $201)
3.42 JOHNSON $1,001 - $15,000 None (or less
than $201)
3.43 JP MORGAN CHASE CO $1,001 - $15,000 None (or less
than $201)
3.44 MELLON OPTIMA US STRATEGY FD LLC Yes $15,001 - $201 - $1,000
$50,000
3.45 MERCK CO INC $1 ,001 - $15,000 None (or less
than $201)
3.46 MICROSOFT CORPORATION $1,001 - $15,000 None (or less
than $201)
3.47 PEPSICO INC $1,001 - $15,000 None (or less
than $201)
3.48 PFIZER INC $1,001 - $15,000 None (or less
than $201)
3.49 PRUDENTIAL FINANCIAL INC None (or less Dividends $201 - $1,000
than $1,001) Capital Gains
3.50 SOUTHWEST AIRLS CO None (or less Dividends $201 - $1 ,000
than $1,001) Capital Gains
3.51 VERIZON COMMUNICATIONS INC $1,001 - $15,000 None (or less
than $201)
3.52 VISA INC-CLASS A SHRS None (or less Dividends $201 - $1,000
than $1,001) Capital Gains
3.53 WAL MART STORES INC $1,001 - $15,000 None (or less

than $201)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
3.54 WALT DISNEY $1,001 - $15,000 None (or less
than $201)
3.55 U.S. Brokeraie Account, Bank Deposit WA $15,001 - None (or less
Account (Cas $50,000 than $201)
4 Share of Family Trust (4) No
4.1 BNY MELLON EMERGING MKTS-M Yes $1,001 - $15,000 None (or less
than $201)
4.2 BNY MELLON GOVT MMK-M Yes $15,001 - None (or less
$50,000 than $201)
4.3 BNY MELLON INCOME STOCK-M Yes $1,001 - $15,000 $201 - $1,000
4.4 BNY MELLON INTL EQUITY INCOME FUND Yes $1,001 - $15,000 $201 - $1,000
4.5 BNY MELLON MULTI-STRATEGY FUND Yes $15,001 - $201 - $1,000
$50,000
4.6 BNY MELLON NAT MUNI BD-M Yes $1,001 - $15,000 None (or less
than $201)
4.7 BNY MELLON NATL INTM MUNI-M Yes $15,001 - $1,001 - $2,500
$50,000
4.8 DREYFUS ALTERN DIVERS STR-Y Yes $15,001 - $201 - $1,000
$50,000
4.9 DREYFUS DIVERSIFIED EM MK-Y Yes $1,001 - $15,000 None (or less
than $201)
4.10 DREYFUS DIVERSIFIED INTL-Y Yes $1,001 - $15,000 None (or less
than $201)
4.11 DREYFUS INTL SMALL CAP-Y Yes $1 ,001 - $15,000 None (or less
than $201)
4.12 DREYFUS EQUITY FUND-Y Yes $15,001 - $2,501 - $5,000
$50,000
4.13 DREYFUS OPPORT SM CAP-Y Yes $1,001 - $15,000 None (or less
than $201)
4.14 DREYFUS OPPORTUNISTIC Yes None (or less $201 - $1,000

than $1,001)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
4.15 DREYFUS SELECT MGER GR-Y Yes $1,001 - $15,000 None (or less
than $201)
4.16 DREYFUS SELECT MGER VL-Y Yes $1,001 - $15,000 None (or less
than $201)
4.17 DREYFUS YIELD ENH STRA T-Y Yes $15,001 - $1 ,001 - $2,500
$50,000
5 Virginia 529 Plan (31) No
5.1 American Funds EuroPacific Growth (ceufx) Yes $1,001 - $15,000 None (or less
than $201)
5.2 American Funds Intermediate Bond Fund of Yes $1,001 - $15,000 None (or less
America (cbofx) than $201)
5.3 American Funds the Growth Fund of Yes $1,001 - $15,000 $201 - $1,000
America
5.4 American Funds The Income Fund of Yes $1,001 - $15,000 $201 - $1,000
America (cimfx)
5.5 American Funds Washington Mutual Yes $1,001 - $15,000 $201 - $1,000
Investors
6 Virginia 529 Plan (40)
6.1 American Funds Europaci?c Growth Fund Yes $15,001 - $201 - $1,000
(ceufx) $50,000
6.2 American Funds Intermediate Bond Fund of Yes $1,001 - $15,000 None (or less
America (cbofx) than $201)
6.3 American Funds The Growth Fund of Yes $15,001 - $201 - $1,000
America $50,000
6.4 American Funds The Income Fund of Yes $1,001 - $15,000 $201 - $1,000
America (cimfx)
6.5 American Funds Washington Mutual Yes $1,001 - $15,000 $201 - $1,000
Investors Fund
7 Virginia 529 Plan (37)
7.1 American Funds Europaci?c Growth Fund Yes $1,001 - $15,000 $201 - $1,000

(ceufx)

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
7.2 American Funds The Growth Fund of Yes $15,001 - $201 - $1,000
America $50,000
7.3 American Funds The Income Fund of Yes $1,001 - $15,000 $201 - $1,000
America (cimfx)
7.4 American Funds Washington Mutual Yes $1,001 - $15,000 $201 - $1,000
Investors Fund
8 Virginia 529 Plan (35)
8.1 American Funds Europaci?c Growth Fund Yes $1,001 - $15,000 None (or less
(ceufx) than $201)
8.2 American Funds Intermediate Bond Fund of Yes $1,001 - $15,000 None (or less
America (cbofx) than $201)
8.3 American Funds The Growth Fund of Yes $1,001 - $15,000 $201 - $1,000
America
8.4 American Funds The Income Fund of Yes $1,001 - $15,000 $201 - $1,000
America (cimfx)
8.5 American Funds Washington Mutual Yes $1,001 - $15,000 $201 - $1,000
Investors Fund
9 Brokerage Account (58)
9.1 Procter Gamble WA $15,001 - Dividends $201 - $1,000
$50,000
9.2 Johnson &Johnson WA $15,001 - Dividends $201 - $1,000
$50,000
9.3 Amgen Inc. - Common Stock WA $15,001 - Dividends $1,001 - $2,500
$50,000
10 Brokerage Account (1 1)
10.1 Intl Business Machines Corp WA $50,001 - Dividends $2,501 - $5,000
$100,000
10.2 Inc $1,001 - $15,000 Dividends $201 - $1,000
10.3 Automatic Data Processing (adp) WA $15,001 - Dividends $1,001 - $2,500

$50,000

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
10.4 Brown-Forman Corp (bfb) WA $15,001 - Dividends $201 - $1,000
$50,000
10.5 Mondelez International, Inc. - Class A $1,001 - $15,000 None (or less
Common Stock than $201)
10.6 General Electric Co WA $50,001 - Dividends $2,501 - $5,000
$100,000
10.7 Procter Gamble WA $15,001 - Dividends $201 - $1,000
$50,000
10.8 Comcast Corporation - Class A Common $1,001 - $15,000 Dividends None (or less
Stock than $201)
10.9 PepsiCo Inc $1,001 - $15,000 Dividends $201 - $1,000
10.10 Vanguard Total Stock Market ETF (vti) Yes $100,001 - $2,501 - $5,000
$250,000
10.11 iShares Russell 1000 Index ETF (iwb) Yes $250,001 - $5,001 - $15,000
$500,000
10.12 Chevron Corp WA $100,001 - Dividends $5,001 - $15,000
$250,000
10.13 CVS Health Corp (cvs) $1,001 - $15,000 Dividends $201 - $1,000
10.14 3M Co $50,001 - Dividends $2,501 $5,000
$100,000
10.15 Johnson &Johnson WA $50,001 - Dividends $2,501 - $5,000
$100,000
10.16 Microsoft Corp $1,001 - $15,000 None (or less
than $201)
10.17 CDK Global, Inc. - Common Stock $1,001 - $15,000 None (or less
than $201)
10.18 P?zer Inc $1,001 - $15,000 Dividends $201 - $1,000
10.19 Wells Fargo Bk NA (wfc) WA $15,001 - Dividends $201 - $1,000
$50,000
10.20 Vanguard Intermediate Term Tax Exempt Yes $100,001 - $5,001 - $15,000
Fun (vmitx) $250,000

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT
10.21 Vanguard Long-Term Tax-Exempt Fund Yes $15,001 - $1,001 - $2,500
$50,000
10.22 Vanguard Limited-Term Tax-Exempt Yes $50,001 - $1,001 - $2,500
$100,000
10.23 Matthews Asian Growth Income Fund Yes $15,001 - $2,501 - $5,000
(micsx) $50,000
10.24 JPMorgan Tax Free Bond (prbix) Yes $50,001 - $2,501 - $5,000
$100,000
10.25 Schwab Treasury Obligation Money Fund Yes $100,001 - None (or less
$250,000 than $201)
10.26 Exxon Mobil Corp None (or less Dividends $201 - $1,000
than $1,001)
10.27 Express Scripts Holding Co None (or less Capital Gains $1 ,001 - $2,500
than $1,001)
1 1 Brokerage Account (39)
11.1 Vanguard Dividend Appreciation ETF Yes $100,001 - $5,001 - $15,000
$250,000
11.2 Vanguard Total Stock Market ETF Yes $250,001 - $5,001 - $15,000
$500,000
11.3 iShares Russell 1000 ETF (iwb) Yes $50,001 - $1 ,001 - $2,500
$100,000
11.4 Kayne Anderson MLP (kyn) Yes $15,001 - $2,501 - $5,000
$50,000
11.5 Vanguard Long Term Tax Exempt Fund Yes $15,001 - $1 ,001 - $2,500
$50,000
11.6 Vanguard Limited-Term Tax-Exempt Yes $50,001 - $1,001 - $2,500
$100,000
11.7 Matthews Asian Growth Income Fund Yes $1,001 - $15,000 $201 - $1,000
11.8 Doubleline Core Fixed Income Fund Yes $15,001 - $1,001 - $2,500
$50,000
11.9 Metropolitan West Total Return Bond Fund Yes $1,001 - $15,000 $201 - $1,000

DESCRIPTION EIF VALUE INCOME TYPE INCOME
AMOUNT

11.10 Brokerage Muni Money Market Fund Yes $15,001 - None (or less
$50,000 than $201)

12 US Bank Account #1 (Cash) $1,000,001 - None (or less
$5,000,000 than $201)

13 US Bank Account #2 (Cash) $250,001 - None (or less
$500,000 than $201)

14 Phoenix Variable Annuity No

14.1 Virtus KAR Cap Growth Yes $15,001 - $5,001 - $15,000
$50,000

14.2 Wanger International Yes $50,001 - None (or less
$100,000 than $201)

7. Transactions

- Not required for this type of report

8. Liabilities

None

9. Gifts and Travel Reimbursements

- Not required for this type of report

Endnotes

Summary of Contents
1. Filer's Positions Held Outside United States Government
Part 1 discloses positions that the filer held at any time during the reporting period (excluding positions with the United States Government). Positions are reportable
even if the filer did not receive compensation.
This section does not include the following: (1) positions with religious, social, fraternal, or political organizations; (2) positions solely of an honorary nature; (3) positions
held as part of the filer's official duties with the United States Government; (4) mere membership in an organization; and (5) passive investment interests as a limited
partner or non-managing member of a limited liability company.
2. Filer's Employment Assets & Income and Retirement Accounts
Part 2 discloses the following:
a

a

Sources of earned and other non-investment income of the filer totaling more than $200 during the reporting period (e.g., salary, fees, partnership share,
honoraria, scholarships, and prizes)
Assets related to the filer's business, employment, or other income-generating activities that (1) ended the reporting period with a value greater than $1,000 or (2)
produced more than $200 in income during the reporting period (e.g., equity in business or partnership, stock options, retirement plans/accounts and their
underlying holdings as appropriate, deferred compensation, and intellectual property, such as book deals and patents)

This section does not include assets or income from United States Government employment or assets that were acquired separately from the filer's business,
employment, or other income-generating activities (e.g., assets purchased through a brokerage account). Note: The type of income is not required if the amount of
income is $0 - $200 or if the asset qualifies as an excepted investment fund (EIF).
3. Filer's Employment Agreements and Arrangements
Part 3 discloses agreements or arrangements that the filer had during the reporting period with an employer or former employer (except the United States
Government), such as the following:
a
a
a
a
a

Future employment
Leave of absence
Continuing payments from an employer, including severance and payments not yet received for previous work (excluding ordinary salary from a current employer)
Continuing participation in an employee welfare, retirement, or other benefit plan, such as pensions or a deferred compensation plan
Retention or disposition of employer-awarded equity, sharing in profits or carried interests (e.g., vested and unvested stock options, restricted stock, future share of
a company's profits, etc.)

4. Filer's Sources of Compensation Exceeding $5,000 in a Year
Part 4 discloses sources (except the United States Government) that paid more than $5,000 in a calendar year for the filer's services during any year of the reporting
period.

The filer discloses payments both from employers and from any clients to whom the filer personally provided services. The filer discloses a source even if the source
made its payment to the filer's employer and not to the filer. The filer does not disclose a client's payment to the filer's employer if the filer did not provide the services
for which the client is paying.
5. Spouse's Employment Assets & Income and Retirement Accounts
Part 5 discloses the following:
a

a
a

Sources of earned income (excluding honoraria) for the filer's spouse totaling more than $1,000 during the reporting period (e.g., salary, consulting fees, and
partnership share)
Sources of honoraria for the filer's spouse greater than $200 during the reporting period
Assets related to the filer's spouse's employment, business activities, other income-generating activities that (1) ended the reporting period with a value greater
than $1,000 or (2) produced more than $200 in income during the reporting period (e.g., equity in business or partnership, stock options, retirement plans/accounts
and their underlying holdings as appropriate, deferred compensation, and intellectual property, such as book deals and patents)

This section does not include assets or income from United States Government employment or assets that were acquired separately from the filer's spouse's business,
employment, or other income-generating activities (e.g., assets purchased through a brokerage account). Note: The type of income is not required if the amount of
income is $0 - $200 or if the asset qualifies as an excepted investment fund (EIF). Amounts of income are not required for a spouse's earned income (excluding
honoraria).
6. Other Assets and Income
Part 6 discloses each asset, not already reported, that (1) ended the reporting period with a value greater than $1,000 or (2) produced more than $200 in investment
income during the reporting period. For purposes of the value and income thresholds, the filer aggregates the filer's interests with those of the filer's spouse and
dependent children.
This section does not include the following types of assets: (1) a personal residence (unless it was rented out during the reporting period); (2) income or retirement
benefits associated with United States Government employment (e.g., Thrift Savings Plan); and (3) cash accounts (e.g., checking, savings, money market accounts) at a
single financial institution with a value of $5,000 or less (unless more than $200 of income was produced). Additional exceptions apply. Note: The type of income is not
required if the amount of income is $0 - $200 or if the asset qualifies as an excepted investment fund (EIF).
7. Transactions
Part 7 discloses purchases, sales, or exchanges of real property or securities in excess of $1,000 made on behalf of the filer, the filer's spouse or dependent child during
reporting period.
This section does not include transactions that concern the following: (1) a personal residence, unless rented out; (2) cash accounts (e.g., checking, savings, CDs, money
market accounts) and money market mutual funds; (3) Treasury bills, bonds, and notes; and (4) holdings within a federal Thrift Savings Plan account. Additional
exceptions apply.

8. Liabilities
Part 8 discloses liabilities over $10,000 that the filer, the filer's spouse or dependent child owed at any time during the reporting period.
This section does not include the following types of liabilities: (1) mortgages on a personal residence, unless rented out (limitations apply for PAS filers); (2) loans
secured by a personal motor vehicle, household furniture, or appliances, unless the loan exceeds the item's purchase price; and (3) revolving charge accounts, such as
credit card balances, if the outstanding liability did not exceed $10,000 at the end of the reporting period. Additional exceptions apply.
9. Gifts and Travel Reimbursements
This section discloses:
a
a

Gifts totaling more than $375 that the filer, the filer's spouse, and dependent children received from any one source during the reporting period.
Travel reimbursements totaling more than $375 that the filer, the filer's spouse, and dependent children received from any one source during the reporting period.

For purposes of this section, the filer need not aggregate any gift or travel reimbursement with a value of $150 or less. Regardless of the value, this section does not
include the following items: (1) anything received from relatives; (2) anything received from the United States Government or from the District of Columbia, state, or
local governments; (3) bequests and other forms of inheritance; (4) gifts and travel reimbursements given to the filer's agency in connection with the filer's official travel;
(5) gifts of hospitality (food, lodging, entertainment) at the donor's residence or personal premises; and (6) anything received by the filer's spouse or dependent children
totally independent of their relationship to the filer. Additional exceptions apply.

Privacy Act Statement
Title I of the Ethics in Government Act of 1978, as amended (the Act), 5 U.S.C. app. ASS 101 et seq., as amended by the Stop Trading on Congressional Knowledge Act of
2012 (Pub. L. 112-105) (STOCK Act), and 5 C.F.R. Part 2634 of the U. S. Office of Government Ethics regulations require the reporting of this information. The primary use
of the information on this report is for review by Government officials to determine compliance with applicable Federal laws and regulations. This report may also be
disclosed upon request to any requesting person in accordance with sections 105 and 402(b)(1) of the Act or as otherwise authorized by law. You may inspect
applications for public access of your own form upon request. Additional disclosures of the information on this report may be made: (1) to any requesting person,
subject to the limitation contained in section 208(d)(1) of title 18, any determination granting an exemption pursuant to sections 208(b)(1) and 208(b)(3) of title 18; (2) to
a Federal, State, or local law enforcement agency if the disclosing agency becomes aware of violations or potential violations of law or regulation; (3) to another Federal
agency, court or party in a court or Federal administrative proceeding when the Government is a party or in order to comply with a judge-issued subpoena; (4) to a
source when necessary to obtain information relevant to a conflict of interest investigation or determination; (5) to the National Archives and Records Administration or
the General Services Administration in records management inspections; (6) to the Office of Management and Budget during legislative coordination on private relief
legislation; (7) to the Department of Justice or in certain legal proceedings when the disclosing agency, an employee of the disclosing agency, or the United States is a
party to litigation or has an interest in the litigation and the use of such records is deemed relevant and necessary to the litigation; (8) to reviewing officials in a new
office, department or agency when an employee transfers or is detailed from one covered position to another; (9) to a Member of Congress or a congressional office in
response to an inquiry made on behalf of an individual who is the subject of the record; (10) to contractors and other non-Government employees working on a
contract, service or assignment for the Federal Government when necessary to accomplish a function related to an OGE Government-wide system of records; and (11)
on the OGE Website and to any person, department or agency, any written ethics agreement filed with OGE by an individual nominated by the President to a position
requiring Senate confirmation. See also the OGE/GOVT-1 executive branch-wide Privacy Act system of records.
Public Burden Information
This collection of information is estimated to take an average of three hours per response, including time for reviewing the instructions, gathering the data needed, and
completing the form. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden, to the Program Counsel, U.S. Office of Government Ethics (OGE), Suite 500, 1201 New York Avenue, NW., Washington, DC 20005-3917.
Pursuant to the Paperwork Reduction Act, as amended, an agency may not conduct or sponsor, and no person is required to respond to, a collection of information
unless it displays a currently valid OMB control number (that number, 3209-0001, is displayed here and at the top of the first page of this OGE Form 278e).