SF2?8·(Rev.

0312000) Fonn Appro\'eu:

S C.F.R. Part 2634 Executive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORT OMS No. 3109·0001
U.S. Offioc ofGOWInIJDcJl1 Ethius
~
o Calendar Yesr Tcrmif181ipn Date (fllfimU::'-----Fee forl",Ble IillimJ
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o lncumbont Covered by_Rep_ort
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mOl: Now Entrant. Nomine&.
Candidato 0
TcmUnation
Filer
caDle) (.'4(Jnffl, vay. rear)
I
Any individual who is required to
file this repQrt aDd docs so more than
30davsafterthodllt~thereDonis
..sst Name IFirst Name and Middfe Initial reQui.ced 10 be filed, or. iran extension
Reporting Individual's Name CARSON JOHNNIE is granted, more ~ 30 ~ ~ the
I last d4y of the films cxtetlS10ll perIod
ITitle of POSItiOn iDeoartment or A£tmcv llfADDlicablel shell bo subiect to a $200 fee..
Pos~on for Whicb Filing Assistant Secretary of State for African .Mfairs State Department U 'j I.; P rl ds
...~eDoJ'...Dg e 0
A..ddreu {NumbsT 'Street ('J1J!. St.1!Je luulZJP (,orIe~ TelCJ)honeNo.llnt:iude Area Code) Incumbents: lherOflortina period is
Location of Present Office 703 •82 ? 741 the plCCCding calendar year except
(or forwudingdchess) Office of the Director of Nationsl intelligance, 7E62 01-18, langJe~/: Va • .q - v PartU ofSchedulc C and Part {of
. Schedule D whete you must ~o
Position(s) Held wjth theFed~ral Title ofPositioc!$} an!~J)~s..lH~ . •. . . include !he filing,,~ ""to tho dAte
OavemmoctDuriDg the Preceding lute1J:lgence U!'llCer. l'.or !.il'rlCa, . Nat~6n~J. -.. .....:
,N{l.~;onal.. you~e. PartnofSch~u1C';Disnot
12Mon~(IfNotSamcasAbove) Intelligence 'C ouncil, Director, September 2000 '- 'preGent atrl)lieabla.
. . Termination Filers: Tho nmorting
PnlidendU Nnminlu Sabifd tn INII.ttlC of ( oD1!I'CSSlonaJ ( ommtttee (";onSldenne:Nominatlon IDo YOIl llltel\d to Creete AQualified Djv:emtied Trust'? period be¢na at:1bc end oftha period
IStJla~CODflrmatioD
• • ' .
Senate Foreign Relations Committee
• •
0 ~ 0$
I'X1
L:.JNO
covered bVVOut l'1Cvious filiilgand cnds
at the date 9f tcmUnatkln. Part n
of Schedule D i5 not aDplic:ablc.
~ ..llill.!llaturc_~t>~lIi:dul!!.__ ~. _ _ 1 .u"",~~ ~~~
1CERT.IFY that thO statomauts ha.vo ~---- lam'aty 20 2009 NomiDtu. New Entrants snd
Imlclo GO this form and aU a~hed Y' • Candidates for President and Vice
u schedules are trut. complete and correct Pruident:
to the best afmv knowlcdltc.
~ ~------------------------~~~~rm~r.m~~--------------~-------------------r~~~~,,-~~~------------~ScheduleA-Th~noortme~riod~r
________________________________
.~~~~~~~~~ ______ ____ -r~~~~~~~~ ~ ~m~memLOCKC)6ilicp~~

Il.. caIeru1ar vear and the CUlfeni calendar

..... year up to Uae date offiUa}t. Value
t-I
assets as of any date you choose that is
within 31 days oftbc dlU;offilinB.
~~~~~~~~~~----~~~~~~~~~~~~~~~~~~~-----------tf).~~~~~~~------------;SmedulcB-Nota~li~'~

Schedule C. Part I ttiabilitle$\-

~
The reporting period is the 'Pr~~
co calendar year and abc cuneD! ca.lcndar
o
00 t=-=-..:=::.;.:;;;;;.;;.c.;..-------m~d:...r--_r_--""""':=__"t"'T"----~---------+'1"I>:it:'7'rr.:_.r~::'""iit::~-------Ive&ruP to any date you choose !hal is
~~~~~~--~--~~~--___,~__~~------------~~~~~~~~~------------~m~Jl~wor~edtteofffim~.
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10
~ Sc:heduJe C. Part n (AercClnOllw or
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~~~~~~~~~~~~~~r=~~~~~~~==~~~r.r.~~~~~~------------~----~--~~--_T~-----------4Amm~em~u)-Showmy~~
.~~~~~~~~~==~~~~~==~~~~~~ ~~~~~~~ ________________________________________________ ~~mnm~~uo!~c.~o£

tiling.
N
p.cj
(Check box !fJlltng extension granfed &- tndicote number ofdays )0
Schedule D-The JcoortiDs: ueriod is
rz the pn:ce<iing two calendar years and
Ii) the cUll"eDt calendar year LIS) to the
It) Idateoffilinl!. .
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82:b V bZ NVr bDDZ AlteDev Ui~O.lv

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o (Check box if commtmtf ()1'~ "Continued on the 1'i!V(1rse s,ith) I:l
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........
00
MAR 2 3 2009
N
........ SUDClsedes Prior Editions. WhiClh Cannot He Used. 278·112 Form Desiencd in Microsoft 1:xce12000 NSN 7540-01.070-8444

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SF27U (Rev. 0312000)
5 C.F.R Part 2634

SCHEDULE A 2

Assets and Income Valuation of Assets e: type and amount. If "None (or less than $201)" is checked, no
at close of entry is needed in Block C for that item.
reporting period
BLOCK A BLOCKB
For you, your spouse, and dependent children,
rep011 each asset heJd for investment or the
, Production of income which had a fair market
value exceeding $1.000 at the close of the report-
r;",4, or which generated more than $200
; . . IY ..... Other ' Date
during the reporting period, together Income (Mo .. Dav.
such income. (SpecifY Yr.)
Type &
yourself. also report the source and actual Actual Only if
of earned income exceedin-g $200 (other Amount) Honoraria
the U.S. Government). For your spouse.
source but not the amount of earned
of more than $1,000 (except report the
aeount of any honoraria over $200 of
spouse).

spouse or

Prior Editions Cannot be Used.

SF278 (Rev. 0312000)
5 C.F.R. Part 2634

I .... U~I~II-= CARSON

SCHEDULE A continued 3

Assets and Income Valuation of Assets I1ncome: type and amount. If"None (or less than $iOI)" is checked, no
at .close of other entry is needed in Block C for that item.
reporting period
BLOCK A BLOCKB

Other Date
Income (Mo .. Dall.
(Specify Yr.)
Type &
Actual OnlY if
Amount) Honoraria

spouse or
SF 278 (Rev. 03/2000)
5 C.F.R Part 2634 Do not Complete Schedule B if you are a new entrant, nominee, Vice Presidential or Presidential Candidate
U.S. Office ofGovemmenr Ethics
Repoltlng Individual's Name Page Number
SCHEDULEB '4
JOHNNIE CARSON

Part I: Transactions None D

Report any purchase, sale, or exchanp;e by you, your spouse, report a transaction involving property \1sed solely as your Transaction Amount of Transaction (x)
or dependent children during the reporting period of anv real personal residence. or a transaction solely between vou. Type (x)
property, stocks, bonds, commodity fumres, and other your spouse, or dependent child. Check the "Certificate of Date (Mo. ,
~§ 88
... 0
securities when the amount of the transaction exceeded divestiture" block to indicate sales made pursuant to 8 4)
~ Dn),. Yr.) ':8 §8§ § '0
:q c .... ·0 ... 0
' 0
-8 08
80 o 0 6§ 88 g I::~ ::;~
~g
'0
$1,000. Include transactions that resulted in a loss. Do not certificate of divestiture from CGE. o · g. 0
00
.s::. o q ~g
lOS 0
- 0
u ..c:;
8 o. o o.q ~ 0.
~~ on..,. ... ~:; 8 8..,.
~ u 00
8.
~ ]
lOci Il'i ano
Identification of Assets
S
Q..,
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II)
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II)
fo't
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fo't fo't
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fo't ..,. fo't ..,.
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Example: ICentral Airlines Common x 211/99 x
1

... This category applies only if the underlying asset is solely that of the filer's spouse or dependent children. If the underlying asset is either held
by the filer 01' jointly held by the filer with the spouse or del)endent children, use the other higher cate~ories of value; as appropriate.
Part n: Gifts, Reimbursements, and Travel Expenses
For YOU. vour spouse and dependent children. report the source. a brief de scrip- the U.S. Government: given to vour agencv in connection with official travel:
tion. and the value of: (1) gifts (such as tangible items. transportation. lodging. . received from relatives~ received bv your spouse aT dependent child totally
food. or entertainment) received from one source totaling more than $260: and independent of their relationship to vou~ or provided as oersonal hospitality at
(2) travel-related·cash reimbursements received from one SOUTce totaling more the donor's residence. Also. for ourooses of aggregating gifts to determine the
than $260. For conflicts analysiS. it is helpful to indicate a basis for receipt, such total value from one source, exclude items worth $114 or less. See instructions
as personal friend. agency apprpval under 5 U.S.C. § 4111 or other statutorY for other exclusions.
authoritv. etc. For travel-related gifts and reimbursements. include travel itinerarY. None c::J
dates. and the nature of exnenses provided. Exclude anvthinl! sziven to vou bv 1

Source (Nome and Addrt!.u) Brief Description Value

Examplesl~_at'l A.SS,!!:. ~f~k Col(~0!S' NyJJ:!~ _____ Airli!le tic!<~h.?~r2~ ~..!!?.~I~n~i~ntt~ti2.!!al ~n[e~~e~l.?~ {p~o..n!!..a:t~~ ~eJaled]~u!yL. ____________________ $500
. Frank Jones, San Francisco, CA Leather briefcase (personal friend) . ---$300---
1

Prior Editions Cannot Be Used.

SF 27a (Rev. 0312000)
5 C.F.R Port 2634
U.s. Office ofOovemmcnt Ethics
Reporting Individual's Name P211C Number

JOHNNIE CARSON SCHEDULEC 5

Part I: Liabilities
Report liabilities over $10,000 owed to anyone creditor at personal residence unless it is rented out; loans secured NoneD Category of Amount or Value (x)
any time during the reporting period by you, your spouse. by automobiles, household furniture or appliances; and
,
or dependent children. Check the highest amount owed liabilities owed to certain relatives listed in instructions.
• • '8':"§':~o8 8
durinR the reporting period. Exclude a mortgage on your 'See instructions for revolving charge accounts. Date Interest Tennif
..-o.,...o..-8og800~
, I.... I.... 0 .... q8. . 0. 0·0·0
Incurred Rate appli·
cable 8.1
8. 8·1~ 8. 8. g g g g g. § ..
g § § § g. &~ .. g.
0 0 0 00

Creditors (Name and Address) . I Type of Liability

Exam les' lErs~ Dis!!'ict ~a!!t F~hjl!i!.0E, D~ ________ -.lli1.?3aS<:.£!1!~tal ~p"e!!l,pela~~ ___________
P . [JOhn Jones, 123 J St., Washington. DC lPromissory note
~9.2! _ L _8% _
1999 10 %
I- r
+_ 25 y!s..:-.
on demand
e~~~gr"-~~~~~o~~~~~~~go~~
~~~~~~~~~~~~

f---1-~~--t--­
x
0~~~~~~

--1---+----.--
~

1 IHSBC·- Oepew. New York IMortgage on rental Condo: Virginia I 1984 I 7% I 30 x

·2

• ThlSc:ategorvapplies orilyITthe fiabiHty issolelytlllifofilie-fJler's spouse or dependent children. Tfthe liability is .that of the flIer or a iointliabilitv of the filer
with the SpO'LlSe OT dependent children. mark the other higher categories, as appropriate.
Part II: Agreements or Arrangements
Report your agreements or arrangements for: continuing participation in an of absence; and (4) future employment. See instru~tions tegarding the reporting
employee benefit plan (e,g. 401k. deferred compensation; (2) continuation of negotiations for any of these arrangements 01' benefits
payment by a former employer (including severance payments): (3) leaves
None m
Example: 1 Status aod Tenns of any Agreement or Arrangement
Pursuant to partnership agreement, will receive lump sum payment of capital account & partnership share
calculated on service oerformed throul!h 1/00.
Parties
Doe Jones & Smith, Hometown. State
Date
7/85

'6

Prior Editions Cannot Be Used.

SF 278 (Rev. 0312000) .
5 C.F.R Part 2634
U.S. Office ofGovemmenl Ethics .
Reportilljt Individual's Name wage Number
JOHNNIE CARSON SCHEDULED 6

Part I: Positions Held Outside U.S. Government

Report any positions held during the applicable reporting period. whether consultant of any corporation. finn, partnership. or other business enterprise or any
comoensated or not. Positions include but are not limited to those of an officer. non"orofit organization or educational institution. Exclude oositions with religious.
director. trustee. general partner. proprietor. representative. emoloyee. or social. fraternal. or political entities and those solely of an honorary nature.
None CI
Organization (Name and Address) Type of Organization Position Held From (Mo., Yr.) To (Mo.• Yr.)
Examples' ~tl Assl'~,!t~k_Coll~c~l. NY._NJ::. ________________ ~ y-o!!:p~o!l!. e2~ti0!!- ________ . _ ___________ __6/92 ____ ~resid_e!!!...
_ ~~l).t ___

. Doe Jones & Smith, Hometown, State Lawfirm . Partner 7/85 1100
1 Trustee -- Board Member
Board of Trustees Member, Drake UniVersity, Des Moines Non -profit educational iDstitution uncompensated June 2004 Present
2

Part IT: Compensation In Excess Of $~,OOO Paid by One Source Do not.complete this part
Report sources of more than $5,000 compensation received by you or your corporation, firm, partnership, or other business enterprise. or any other non"profit if you are an Incumbent,
business affiliation for services provided directly by you during anyone year of organization when you directly provided the services ~eneratinJ1; a fee or payment Termination Filer, or
the reporting period. This includes the names of clients and customers of any of more than $5,000. You need not report the U.S. Government as a source. Vice Presidential
or Presidential Candidate
None []J
Source (Name and Address) Brief Description of Duties ,
~e Jones & Smith Hometown. State ..!:.e~~eJVice~ __________________________________________ J
Examples: Metro U~i~r;itY (cli;;;t ~fDoe Jones & s;ilih'), Mon~tow-;' Stme - - - - -- Legal services in connection with universitY construction I
i
1

Prior Editions Cannot Be Used.