FORMA Page 105 For use by Members, officers, and employees UNITED STATES HOUSE OF REPRESENTATIVES CALENDAR YEAR 2012 FINANCIAL DISCLOSURE STATEMENT Ben Ray Lujan (Daytime Telephone} jy) Member of the U.S. State: NM () Officer OF House of Representatives pytict 93 Employee Employing Office: ‘A.$200 penalty shall be assessed against = anyone who files more than 30 days Filor Status Report dite © Annual (May 15) Termination Date: 1 Amendment | LJ Termination complete and attach Schedule Vi. ou, yout spouse, ora dependent child recelve ay reportable travel oF reimbursements for travel in the reporting period (wortnmore than $360" Yes ["] No 7) {from one sours)? Plate and attach Schedule VIL Each question in this part must be answered and the appropriate schedule attached for each “Yes” response. (Did you purchase any shares that were allocated as a part ofan Inlal Public Offering? Detals regarding “Qualified Blind Trusts” approved by the Committee on Ethies and certain other "excepted trusts” need not be disclosed. Have you excluded trom this report details of such a trust benefiting you, your spouse, or dependent child? Yes] Now fions-- Have you excluded from this report any other assets, “uneamed” Income, tansactions, or lablties of a spouse or dependent child ‘because they meet all three tests for exemption? Do not answer “yes” unless you have first consulted with the Committge on Ethics, Y°° [] No)SCHEDULE Ill - ASSETS AND "UNEARNED" INCOME BLOCK A Asset and/or Income Source Provide complete names of stocks and mutual funds (donot use tcke symbols) Fora RAs and other retirement plans (suchas 41() plans) prove the vale for ‘ach sant bed nthe account hat excoede the reporting thresholds. For rental or other rel property held for Investment, provide a compete address or ‘eteriton, eg, “rental propery," anda ery and sate, For an ownarship interest in aprivatly-held business tha sno pubicly traded, ‘State te name ofthe business, the nature of hs activites, and Ws geographic locaton n Block A. ‘Savings Pan. you 20 choose, you may indicate that an asset or income source Is that of your ‘spouse (SP) or depanent cil (00), oi Jolndy held wih your spouse (JT) inthe ‘ptional column on the fale For dtaied stscuasion of Schedule requirments, please afer to the Inetructon booket, Name Ben Ray Lujan BLOCK B Year-End Value of Asset “This column efor assets hal Slay by your spouse or dapendent i Page 20f 5 Congressional Federal Credit $1,001 - None NONE Union $15,000 EI Rancho Home $100,001 - None NONE $250,000 NM Public Employees Pension | $15,001 - INTEREST $1,001 - $2,500 $50,000 Wells Fargo Checking $15,001 - None NONE $50,000 Wells Fargo Savings $15,001 - None NONE $50,000SCHEDULE V - LIABILITIES Name Ben Ray Lijan Page 3 of 5 [Report liabilities of over $10,000 owed to any one creditor at any time during the reporting poriod by you, your spouse, or dependent child. Mark the highest amount owed during the your. Members: Members ae required to report ll lables secured by real propery including morigages on ter personal reidence, Exclude: Valley National Bank of Espanola, NM Liability Incurred Type of Liability Amount of Liability May 2008 Mortgage on El Rancho $50,001 - $100,000 | Home - Loan to the CampaignSCHEDULE VIII - POSITIONS Name Ben Ray Lujan Page 4of 5 [Report all positions, compensated or uncompensated, held during the current calendar yearas an officer, director, trustee of an organization, partner, proprietor, |representative, employee, or consultant of any corporation, firm, partnership, or any business enterprise, any nonprofit organization, any labor organization, or any leducational or other Institution other than the United States. Exclude: Positions held in any religious, social, fraternal, or political entities; positions sofely of an lhonorary nature; and positions listed on Schedule |. [Position Board Member Name of Organization Congressional Hispanic Caucus InstituteSCHEDULE IX - AGREEMENTS Name Ben Ray Lujan I Page sof § Identify the date, partios to, and general torms of any agreement or arrangement with respect to: future employment; a leave of absence during the period of lgovernment service; continuation or deferral of payments by a former or current employer other than the U.S. Government; or continuing participation in an. lempioyee welfare or benefit ptan maintained by a former employer. [dae J artiesto Terms of Agreement 12/31/2007 | Ben Lujan and NM Public Employees NM Public Employees Pension Plan - Benefit plan maintained by Pension Pian ‘State of NM