OCC Festersen SFI

8/14/2019 OCC Festersen SFI

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NEBRASKA ( ) ( ) POSTMARK / /,;2/ trJACCOUNTABILITY AND DATE I (DISCLOSURE COMMISSION STATEMENT MICROFILM 7850~l1~t t" Floor, State Capitol NUMBEROF.o . Box 95086 OFFICE USEONLYLincoln, NE 68509 FINANCIAL " ) " 'C " - I',,'o r,~ \ c . It. v i t: fJ(402) 471-2522 INTERESTS u r ; ~ c { ) i ~ r ~ E f3 R ; \~ ; ~ {BEFORE COMPLETING n n n Y'] - M ' l 9 : 2 1 'u'[I,;. -~) f"'ti ~READ FILING REQUIREMENTS NADC FORM C-1 /~ i~~ '! 1 T Y { .I ~ .' ' l ! S S l ( '-,,) ~ . .

Candidates for designated offices and holders of designated offices and positions must file this statement. See Sections 1A and1B of the instructions. Candidates (including incumbents) subject to this filing requirement must file with the Commission and with the appropriateelection official (See Instructions). Designated officeholders and holders of designated positions must file this statement with the Commission annually, Dollar values need not be report for any item, except Item 11. Persons who fails to file as required is subject to a civil penalty of up to $2,000.ITEM 1 IYOUR NAME, ADDRESS AND PHONE NUMBERName F6STe:gSe . r i Pt;ff< I~,(oG- t< I


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ITEM 6 I SOURCES OF INCOME OF OVER $1,000Income includes money or anv other form of recompense constitut ino income under the Internal Revenue Code. (See definitions)Name and address-of any source" (including an individual, business, I List the nature of the source's business and the nature of the services youbody of government, political subdivision or body corporate) from rendered or the circumstances under which income was received, NOTE: Dowhom income of over $1 ,000 was received, l ist the amount of the income.1.) G e . (5; r t - r c - - . (9.6/\ I-fA Ct(t\J'~16M ta.) E.""fLo'1F~ ~ Vf of FlAtf/ t-: /oL'7-lJ-IAv.Ob r : : CO/YIJ'v} c -&C-C !'.bJl11l-11A IV -::r~0CI/l:!:-; J .J P/I1.CNI1 " ' S o } RA6-WF 1 >1'. ,O ll1 ,it j..(A f / 1 2 : . 'R iO 2_ ( ) A.N ~ (V(AY


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'"".; . ..ITEM 8 I REAL PROPERTY OF' .if FILER IN NEBRASKA (Real property L,~ed at less than $1,000 and yourpersonal residence need not be reported.) .List a/ l real property in your name orin which you have a direct ownership interest. The description required mustbe sufficient to identhe location of the property. Exceptions: You need not report real estate owned by a business listed in Item 6 or 7, your persoresidence of real property valued at less than $1,000, Personal residence refers to your principal dweliinq-house and adjacent land. ufor house-hold purposes, such as lawns. and gardens.

Location of Property Nature of Property(Description or Address (such as: agricultural, commercial, industrial, residential-rental)

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ITEM 9 I OTHER FINANCIAL INTERESTS AND PROPERTY HELD DUR,NGTHE PERIOD OF THIS STATEMENTWHICH EXCEEDED A FAIR MARKET VALUE OF $1,000 AT ANY TIME DURING THE REPORTING PERIOD(a) List the names and addresses of the institutions in which you had checking and savings a~counts and certificates of deposit.

Financial Institution Address

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(b) List the names of the issuers of all stocks, bonds, and government securities, not otherwise listed under Items 6 or 7.- r : , < . ,VI'i i"{ 6'-1-f\,e-tl r~ L;j 0Vj)

! J 61:-,-2 .- F "u .. .., vO S(c) Describe other property owned or held for the production of income not otherwise disclosed in Items 6, 7, a or 9(a)(b). Includeleaseholds and other interests. in real estate, promissory notes and other obligations owed to you, benetlclal interests in trusts andestates, cash value life insurance, IRAs, deferred income and retirement plans, Exception: Do not include accounts receivable,inventory, fixtures and equipment owned or used by a business listed in Items 6 & 7 or household goods, personal automobiles andother tangible personal property unless such property was held primarily for sale or exchange.

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~ .ITEM 10 I CREDITORS TO WHOM $1,000 OR MORE WAS OWED OR GUARANTEED BY YOU OR A MEMBER OFYOUR IMMEDIATE FAMILY.Exception: Loans from a relative and land contracts which have been recorded with the County Clerk or Register of Deeds need not bereported. Accounts payable, debts arising out of retail installment transactions or loans made by a financial institution in the ordinarycourse of business need not be reported.

Name Address

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ITEM 11 I SOURCES OF GIFTS OF A VALUE OF MORE THAN $100 RECEIVED EXCEPT GIFTS FROM RELATIVES.(See definitions)Name and address of Donor Occupation or nature of business of Value of Gift Description of Gift andDonor (See Key Below) Circumstances or Occasion forGiftNOI\/e. Choose Value:

Choose Value:Choose Value:Choose Value:Choose Value:Choose Value:

Choose Value:Choose Value:

The monetary value of each gift shall be categorized based on the good faith estimate of the f iler. For each reported gift insert in theValue column the letter which corresponds to the value category of the gift. The value categories are:A) $100.01 to $200; B) $200.01 to $500; C) $500.01 to $1,000; D) $1,000.01 or more.ITEM 12 I SIGNATURE OF FILER AND DATE.I hereby state that I have used all reasonable diligence in the preparation of this Statement and that to the best of my knowledge it is trueand complete.

M.J~ J /2/09(Sigrll!fure of Fi~r) ~ (Date) I I

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OCC Festersen SFI