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Theresa L Springmann Financial Disclosure Report For 2009
Theresa L Springmann Financial Disclosure Report For 2009
Rev. 1:2010
.~o ~o
I
[] Initial
I. Person Reporting (last name, first, middle initial) Springmann, Theresa I,. 4. Title (Article III judges indicate active or senior status; magistrate jt~dges indicate fil[I- or part-time) Active [] A .... I [] Final
5b. [] Amended Report 7. Chamber~ or Office Address U.S. Cotlrt|louse 131)0 South Harrison Street Fm~ Wayne, IN 46802 8. On the ba~i~ of the information contained in this Report ~tnd any modifications pertaining thereto, it is, in my opinion, in compliance wllh applicable laws end regulations.
Reviewing Officer
Date
IMPORTANT NOTES: The instructions accompa,oing this form must be fi~llowed. Complete all par~, ~hecking the NOzVE box for each part ,~here you ha~,e no reportable informatlort. Sign on last page.
NAMF, QF QRQAN1ZAIION/ENTITY
i~_,
II. AGREEMENTS. (#:~,o.a,, ~,,~,,~..~ o,,~.; .e: ~,~,. ~4-~ of /Ui~# ,.~e~..i,,~.,:) .....
Springmann, Theresa L.
[ D~t~ of R~po~,
05;I~2010
III. NON-INVESTMENT INCOME. ~po,,~ indivldual andspouxe; seepp. 17-24 o/filitrg in ........ ion,.)
A. Filers Non-Investment Income NONE 0Vo reportable non-investment income.) DATE
1. 2. 3. 4.
INCOME
(yours, not spouses)
B. Spouses Non-I nveslment Income - t.t~,ou were married during an)porion of the reportlng year, complete this secKon.
( Dolktr amou~tt nut r~qutred t, rcept for hon~raria.}
~
I. 2. 3. 4.
"~v. REIMBURSEMENTS (Jt~ htdes t]n~ to spouse ~nd ~&p~m &tt ~hildr~,n; see pp. 2~-27 o filling in~tru~tion~.)
DATES
LOCATION
PURPOSE
5.
DateofReport
I
~
05/1,~L2010
V. G l FTS. a, c~,,~,,., ,,o,, ,o ,po,],l~ ~,,d d~p~"d~nl (hilaren; .,ee pp. 2~-3 l of filing instruction&) NONE (No reportable gy?s.) SOUR~
I.
DESCRIPTION
3.
4. 5.
VI. LIABILITIES. a.,-i.a.~ ,ho.,.,,y~p ...... d a,,p..z~., ,.ua ........ pp. 32.33 of filing in~tructions.)
---] NONE (No reporlable liabilities.) CREDITOR
I. Chase Mas=er Card credit card
DESCRIPTION
VA~IE CODE
J
3. 4. 5.
VII. INVESTMENTS an d TRUSTS - ~ ........ ~,,, t ........ ions (Includes those of xp ...... d depet, dent children; see pp. 34-60 Drilling instructions.)
NONE (No reportable income, assets, or transactions.)
Descnpfio~ of Assets (including ,rest assets) [ [ Place "(X;" after each .... t exemp~ from prior disclosure ~ I~come during ~_r~0~in~ pedod I [A ...... Code 1 : (A-II) Type{e.g., div., ~nk or int) Gross ~alue al end of r~o~ing period ~ Value Code 2 O-P) Value [ Method : Code 3 (Q-W) I :: i Type ~e.g., buy, sell, redemption) Tran~ction~ during reporting period
I 2.
A A
Dividend Dividend
M K
T T Redeemed 12/05/09 K E
(par0
3. Annuity with IDSiAmerican Express -~ A Dividend K T
4. 5. 6. 7. 8. 9. 10. 11 12.
13
IRA - Keough rollover with IDS!American Express - self Savings account wilh Chase Bank Estate I -Chase Bank (Checking) -Centier Bank (CDs) -Citizens Financial (CDs) -Fifth Third (CDs) -First Financial (CDs) -Catholic Foresters (annuily)(no control)
T.Rowc Price Summit (.ash Rcserve
A A D
M K M
T T T
Int./Div.
14.
16. 17.
P4 =More than
f NameofPe~on Reporting
l)a~ of Report
[N ....
I
DateofRep0rt
Page 6 of 6
IX. CERTIFICATION.
! eerti[y 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 was withheld because it met applicable statulory prosisions permitting nou-disclosure. I further certify that earned income from outside employment and honoraria and the acceptance of gifts which have been reported are in compliance ssith the provisions of 5 U.S.C. app. 501 et. seq., 5 U.S.C. 7353, and Judicial Conference regulatioos.
NOTE: ANY INDIVIDUAL WIIO KNO\VINGLY AND WILFULLY FALSIFIESORq~~ILS TO FILE T|IISRE~ORT/~,I~4,~r BICSSUB~ECT 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 Stales Courts Suite 2-301 O~e Columbus Circle, N.E. Washington, D.C. 20544