Carson Johnnie State

SF2?8·(Rev. 0312000)

Fonn Appro\'eu:

Executive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORT

S C.F.R. Part 2634 U.S. Offioc ofGOWInIJDcJl1 Ethius

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CARSON

IFirst Name and Middfe Initial JOHNNIE

ITitle of POSItiOn

iDeoartment or A£tmcv llfADDlicablel

Assistant Secretary of State for African .Mfairs

State Department

OMS No. 3109·0001

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Senate Foreign Relations Committee

1CERT.IFY that thO statomauts ha.vo Imlclo GO this form and aU a~hed

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assets as of any date you choose that is within 31 days oftbc dlU;offilinB.

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SUDClsedes Prior Editions. WhiClh Cannot He Used.

278·112

Form Desiencd in Microsoft 1:xce12000

OOEU,.dl.lv

MAR 2 3 2009 NSN 7540-01.070-8444

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

SCHEDULE A Assets and Income

Valuation of Assets at close of

2

e: type and amount. If "None (or less than $201)" is checked, no entry is needed in Block C for that item.

reporting period BLOCK A

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 reportr;",4, or which generated more than $200 during the reporting period, together such income. ; . . IY .....

yourself. also report the source and actual of earned income exceedin-g $200 (other 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

BLOCKB

Other '

Income (SpecifY Type & Actual Amount)

spouse).

spouse or Prior Editions Cannot be Used.

Date (Mo .. Dav. Yr.)

Only if Honoraria

SF278 (Rev. 0312000)

5 C.F.R. Part 2634

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SCHEDULE A continued

CARSON

Assets and Income

Valuation of Assets at .close of reporting period

BLOCK A

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I1ncome: type and amount. If"None (or less than $iOI)" is checked, no other entry is needed in Block C for that item.

BLOCKB

Other

Income (Specify Type & Actual Amount)

spouse or

Date (Mo .. Dall. Yr.)

OnlY if Honoraria

SF 278 (Rev. 03/2000) 5 C.F.R Part 2634 U.S. Office ofGovemmenr Ethics

Do not Complete Schedule B if you are a new entrant, nominee, Vice Presidential or Presidential Candidate Page Number

Repoltlng Individual's Name

'4

SCHEDULEB

JOHNNIE CARSON

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Part I: Transactions Report any purchase, sale, or exchanp;e by you, your spouse, or dependent children during the reporting period of anv real property, stocks, bonds, commodity fumres, and other securities when the amount of the transaction exceeded $1,000. Include transactions that resulted in a loss. Do not

report a transaction involving property \1sed solely as your personal residence. or a transaction solely between vou. your spouse, or dependent child. Check the "Certificate of divestiture" block to indicate sales made pursuant to 8 certificate of divestiture from CGE.

Identification of Assets Example: ICentral Airlines Common

Amount of Transaction (x)

Transaction Type (x) Date (Mo. , ~ c

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... 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 the U.S. Government: given to vour agencv in connection with official travel: For YOU. vour spouse and dependent children. report the source. a brief de scrip. received from relatives~ received bv your spouse aT dependent child totally tion. and the value of: (1) gifts (such as tangible items. transportation. lodging. independent of their relationship to vou~ or provided as oersonal hospitality at food. or entertainment) received from one source totaling more than $260: and the donor's residence. Also. for ourooses of aggregating gifts to determine the (2) travel-related·cash reimbursements received from one SOUTce totaling more 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 for other exclusions. as personal friend. agency apprpval under 5 U.S.C. § 4111 or other statutorY None c::J authoritv. etc. For travel-related gifts and reimbursements. include travel itinerarY. dates. and the nature of exnenses provided. Exclude anvthinl! sziven to vou bv Value Brief Description Source (Nome and Addrt!.u) $500 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. ____________________ ---$300--. Frank Jones, San Francisco, CA Leather briefcase (personal friend) .

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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

SCHEDULEC

JOHNNIE CARSON

5

Part I: Liabilities Report liabilities over $10,000 owed to anyone creditor at any time during the reporting period by you, your spouse. or dependent children. Check the highest amount owed durinR the reporting period. Exclude a mortgage on your

personal residence unless it is rented out; loans secured by automobiles, household furniture or appliances; and liabilities owed to certain relatives listed in instructions. 'See instructions for revolving charge accounts.

NoneD

Category of Amount or Value (x)

, Interest Rate

Date Incurred

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~~ ___________ ~9.2! _ L _8% _ P . [JOhn Jones, 123 J St., Washington. DC lPromissory note 1999 10 % 1 IHSBC·- Oepew. New York IMortgage on rental Condo: Virginia I 1984 I 7%

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Part II: Agreements or Arrangements Report your agreements or arrangements for: continuing participation in an

employee benefit plan (e,g. 401k. deferred compensation; (2) continuation payment by a former employer (including severance payments): (3) leaves

of absence; and (4) future employment. See instru~tions tegarding the reporting of negotiations for any of these arrangements 01' benefits

None Example:

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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.

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Parties Doe Jones & Smith, Hometown. State

m Date 7/85

SF 278 (Rev. 0312000) . 5 C.F.R Part 2634

U.S. Office ofGovemmenl Ethics .

wage Number

Reportilljt Individual's Name

SCHEDULED

JOHNNIE CARSON

6

Part I: Positions Held Outside U.S. Government Report any positions held during the applicable reporting period. whether comoensated or not. Positions include but are not limited to those of an officer. director. trustee. general partner. proprietor. representative. emoloyee. or

consultant of any corporation. finn, partnership. or other business enterprise or any non"orofit organization or educational institution. Exclude oositions with religious. social. fraternal. or political entities and those solely of an honorary nature.

None Position Held From (Mo., Yr.) Type of Organization Organization (Name and Address) ___________ __6/92 ____ Examples' ~tl Assl'~,!t~k_Coll~c~l. NY._NJ::. ________________ ~ y-o!!:p~o!l!. e2~ti0!!- ________ . _ 7/85 Partner . Doe Jones & Smith, Hometown, State Lawfirm . 1 Trustee -- Board Member Board of Trustees Member, Drake UniVersity, Des Moines Non -profit educational iDstitution uncompensated June 2004 ~resid_e!!!...

CI To (Mo.• Yr.) _

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1100

Present

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Part IT: Compensation In Excess Of $~,OOO Paid by One Source Report sources of more than $5,000 compensation received by you or your business affiliation for services provided directly by you during anyone year of the reporting period. This includes the names of clients and customers of any

Source (Name and Address) ~e Jones & Smith Hometown.

State Examples: Metro U~i~r;itY (cli;;;t ~fDoe Jones & s;ilih'), Mon~tow-;' Stme - 1

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Prior Editions Cannot Be Used.

corporation, firm, partnership, or other business enterprise. or any other non"profit organization when you directly provided the services ~eneratinJ1; a fee or payment of more than $5,000. You need not report the U.S. Government as a source.

Do not.complete this part if you are an Incumbent, Termination Filer, or Vice Presidential or Presidential Candidate None []J

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Brief Description of Duties __________________________________________ J Legal services in connection with universitY construction I

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