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NEBRASKA ACCOUNTABILITY AND DISCLOSURE COMMISSION
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STATEMENT OF FINANCIAL INTERESTS
11th Floor, State Capitol P.o. Box 95086 Lincoln, NE 68509
(402) 471-2522
POSTMARK DATE
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MICROFILM NUMBER
7900249
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2009 f1AR -3
BEFORE COMPLETING READ FILING REQUIREMENTS
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NADC FORM C-1
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• Individuals listed under Sections 1-A & B of the General Information - Filing Requirements on page 5 must file this form. • Dollar values need not be reported for any item, except for Item 11. • File with the Nebraska Accountability and Disclosure Commission and with the election commissioner or clerk of the county of your residence. • Persons who fail to file this report or otherwise do not complv with the renorfinn provisions of the law are subiect to penalties. ITEM 1 I YOUR NAME, ADDRESS AND PHONE NUMBER Name Address
Greg
lee
LAST
FIRST
MIDDLE
831 West 4th Street STREET ADDRESS
ITEM 2
I OCCASION
OR RURAL ROUTE
NE STATE
CITY
FOR FILING (Check Appropriate
68467 ZIP CODE
Box)
for elective office ~ Annual officeholder's or state employee's report
I OFFICE
4023622153
York
o A candidate ITEM 3
Telephone No.
Adams
HELD & TERM OF OFFICE (for incumbent
o left office or position o Newly appointed to office or position elected or appointed
officials
and state employees)
List the office or position you currently hold which requires this filing. If you have left office, list the office you held. Office or Position:
State Senator
Term:
Name of City, County, District, or State Agency: ITEM 4
I OFFICE
SOUGHT ( for candidate
1/3/07
1/1/11
BEGINS
ENDS
24 only)
List the office sought which requires this filing. Office: State legislature Name of City, County, District, or State Office: ITEMS
I PERIOD
York County,
24th legislative
District
COVERED BY THIS STATEMENT
This statement must cover all financial interests for the entire "preceding calendar year" and not just as of year-end. If you have left office, this statement must cover all financial interests from the end of the calendar year for which you previously filed up to and including the date you left office.
~
This statement covers the preceding
calendar year January1 through December 31,
0
Left office, this statement covers the period January 1,
2008
to (DATE YOU LEFT OFFICE OR POSITION)
,
ITEM 6
I
I SOURCES
OF INCOME OF OVER $1,000
Income includes monev or anv other form of recompense constituting Name and address of any source" (including an individual, business, body of govemment, political subdivision or body corporate) from whom income of over $1,000 was received. 1.)
income under the Intemal Revenue Code. (See definitions) List the nature of the source's business and the nature of the services you rendered or the circumstances under which income was received. 1a.)
2.)
State Teacher Retirement - (Nebraska)
2a.)
Retired teacher
3.)
State of Nebraska
3a.)
State Senator
4.)
MidAmerica
4a.)
Early retirement separation pay
Investments
"NOTE: IF INCOME RESULTED FROM EMPLOYMENT BY, OPERATION OF OR PARTICIPATION IN A PROPRIETORSHIP, PARTNERSHIP, CORPORATION OR OTHER PERSON, LIST THE SAME AS THE SOURCE OF INCOME, BUT NOT THE PATRONS, CUSTOMERS, PATIENTS, OR CLIENTS THEREOF.
ITEM 7
I BUSINESS
ASSOCIATIONS
(See definitions)
Name and address of all businesses, organizations, or associations (profrt and non-profit) with which you held a position of officer, director, limited liability company member, partner, or stockholder and any entity in which you held a position of trustee. Such reporting is required based on the position held, not on whether income was received. You need not report business associations which are otherwise listed under Item 6. Name and Address of Business or Organization Nature of Association 1.)
Nebraska League of Municipalities
1a.)
1335 L Street Lincoln, NE 2.)
Executive Board Member Ended - 1212006
68508
Nebraska Information and Technology
Commission
2a.)
Commisioner Ended - 4/2006
3.)
Creekside Real Estate Trust
3a.)
4.)
4a.)
5.)
Sa.)
6.)
6a.)
7.)
7a).
Beneficiary
~EM' 8
'I
REAL PROPERTY OF
rJ
personal residence need
FILER IN NEBRASKA (Real property
not be reported.
~:.l.t
at less than $1,000 and your
List all real property in your name or in which you have a direct ownership interest. The description required must be sufficient to identify the location of the property. Exceptions: You need not report real estate owned by a business listed in Item 6 or 7, your personal residence or real property valued at less than $1,000. Personal residence refers to your principal dwelling-house and adjacent land used for house-hold purposes, such as lawns and oerdens. Nature of Property Location of Property (such as: agricultural, commercial, industrial, residential-rental) (Description or Address Creekside Estates, west 4'" street, York,NE 68467 Lot #16, Thunderbird Lake, Silvercreek, NE #25 Arbor Court, York, NE 68467
ITEM 9
I
Residential Residential(cabin) residential
','
OTHER FINANCIAL INTERESTS AND PROPERTY HELD DURING THE PERIOD OF THIS STATEMENT WHICH 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 accounts and certificates of deposit. Address
Financial Institution Cornerstone Bank
6'" and Lincoln Ave., York, NE 68467
Ameriprise Financial Advisors
218 West 6 th, York, NE 68467
Leggett Company
612 Grant Ave., York, NE 68467
(b) List the names of the issuers
of all stocks, bonds, and government securities, not otherwise listed under Items 6 or 7.
403(b) Annuity contract with Ameriprise Financial Advisors - 218 West 6th Street, York, NE 68467. The annuity is invested in several various funds which include stocks and government securities.
(c) Describe other property owned or held for the production of income not otherwise disclosed in Items 6, 7, 8 or 9(a)(b). Include leaseholds and other interests in real estate, promissory notes and other obligations owed to you, beneficial interests in trusts and estates, 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 and other tangible personal property unless such property was held primarily for sale or exchange.
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ONE High Yield Savings - Ameriprise Financial AXP Certificate of Deposit - Ameriprise Financial Cash Management(A) money market account - Ameriprise Financial Cash Management(B) money market account - Ameriprise Financial 403(b) Public School Employee Annuity - Ameriprise Financial IRA Ameriprise Financia Life Insurance Policy-Ameriprise Financial Nebraska State Teacher Retirement
... \
ITEM 10
I
CREDITORS TO WHOM $1,000 OR MORE WAS OWED OR GUARANTEED BY YOU OR A MEMBER OF YOUR IMMEDIATE FAMILY. Loans from a relative and land contracts which have been recorded with the County Clerk: or Register of Deeds need not be
Exception: reported. Accounts payable, debts arising out of retail installment transactions or loans made by a financial institution in the ordinary course of business need not be reported. Address
Name Cornerstone Bank
6t" and Lincoln Ave., York,NE 68467
Tier One Bank
Lincoln, NE
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 Donor
Description of Gift and Circumstances or Occasion for Gift
Value of Gift (See Key Below)
A Choose
Value:
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 filer. For each reported gift insert in the Value column the letter which corresponds to the value category of the gift. The value categories are: A) $100.01 to $200;
ITEM 12
B} $200.01 to $500; C) $500.01 to $1,000;
I SIGNATURE
I hereby state tha~e and comolete.
(s~n~a 'r
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or more.
used all reasonable diligence in the preparation of this Statement and that to the best of my knowledge it is true
L
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m $1,000.01
OF FILER AND DATE.
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(Date)
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