Professional Documents
Culture Documents
1/2011
Report Required by the Ethics in Go vernment Act of 1978 (5 U.S.C. app..~.sq 101-111)
[] Initial
Russell B. Long Federal Bldg. 777 Florida Street, Suite 301 Baton Rouge, Louisiana 70801
8. On the basis of the information contained in this Report and any modifications pertaining thereto, it is, in my opinion, in compliance with applicable laws and regulations.
Reviewing Officer
Date
IMPORTANT NOTES: The instructions accompanying this form must be followetL Complete all parts,
checking the NONE box for each part where you have no reportable information. Sign on last page.
D
I. 2. 3. 4. 5.
NAME OF ORGANIZATION/ENTITY
General Health System
DATE
Tvson, Ralph E.
II I. NON-INVESTMENT INCOME. (Reporting individual and spouse; see pp. 17-24 of filing instruction~)
A. Filers Non-lnvestment Income
~]
DATE
2.
3.
4.
B. Spouses No n-Investment Income - if you were married during any portion of the reporting year, complete this section
(Dollar amount not required e-rcept for honoraria.)
D
I. 2010 2. 3. 4.
PURPOSE
Bench/Bar Conference
3.
4.
5.
V. GIFTS. aneludes those Io spouse a.d depe.dent children; see pp. 28-31 of filing instructions.) NONE (No reportable gifts.) SOURCE
I. 2. 3.
4.
DESCRIPTION
VALUE
5.
V I. L I A B 1 L I TI E S. a ncludes ~hose o/spouse and dependent ehltdren; see pp. ~2-~ of filing instructions.)
--] NONE (No reportable liabilities.) CREDITOR
I. 2. Sallie Mae Servicing Corporation U.S. Department of Education Student Loans Student Loans
DESCRIPTION
VALUECODE K K
3.
4.
5.
V I I. I N V E S T M E N T S a n d T R U S T S - i,come, value. ~a,~ac,ions ancludes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets (including trust asse~s) Place "(X)" after each asset exempt from prior disclosure Income during reining period Gross value at end of reporting period Transactions during reporting ptwiod
~ (I)
i Amount Code 1 (A-H)
(2)
Type (e.g., div., rent, or int.)
(0
Value Code 2 (J-P)
(2)
Value Method Code 3
(Q-W)
4.
5. 6. 7. 8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
I. Income Gain Codes: (See Columns B I and D4) 2. Value Codes IS~c Columns CI and D3) 3. Value Method Codes ~Sce Column C2)
A =$1,000 or less F = $50.001 - $ 100,00~ J =$15,000 or less N =$250.001 - $500.000 P3 =$25.00~.001 - $50.00~.0~ Q =Appraisal U =l~k~ok Value
B =$1,001 - $2,500 G =$100.001 - $ 1,000,0~0 K ~$15.001 - $50.000 O =$50~.001 - $1.000.000 R =cost (Real Estate Only} V =Olho"
C =$2,501 - $5,000 I I I =$ 1,000.0O I - $5.000.000 L =$50.001 - $100.0~) PI =$1,0~0.0~1 - $5.000,000 P4 =More than $50.000.0~0 S =Ass~ssracm W =Estimated
D =$5,001 - $15.000 112 =More than $5,000.000 M =$100.001 - $250.000 P2 =$5.000,001 - $25.0~1.000 T =Cash Market
E :$15.0~1 - $50.000
Dale of Report
Tyson, Ralph E.
06/14/2011
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 ~vas withheld because it met applicable statutory provisions permitting non-disclosure. 1 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. app. 501 et. scq., 5 U.S.C. 7353, and Judicial Conference regulations.
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544