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    • ooEFonn278(Rev.o9/2oJo)5 C.F.R. Part 2634 Executive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORT Form Approved: OMB No. 3209- 0001U.S. Office of Government Ethics Calendar Year Termination Termination Date ( /{Appli- Reporting Incumbent Covered by Report New Entrant, Nominee, or )(I Filer 0 cable) (Month, Day, lear) Fee for Late Filing 05/03/2011 (Check Appropriate Boxes) D I I Candidate I I Any individual who is required to file this report and does so more than 30 days after the date the report is required to be Last Name First Name and Middle Initial filed, or, if an extension is granted, more Reporting than 30 days after the last day of the Individuals N arne Cain Herman filing extension period, shall be subject to a $200 fee. Title of Position Department or Agency (If Applicable) Position for Which Filing Candidate for President Reporting Periods Incumbents: The reporting period is Address (Number Street City )tate and ZIP Code) T 1 h N (I d A C d ) the preceding calendar year except Part Location of · · e ep one 0 · nc1u c rca 0 c II of Schedule C and Part I of ScheduleD Present Office 223 Montrose Drive. McDonough, GA, 30253 (678) 565-5335 where you must also include the filing (or forwarding address) year up to the date you file. Part II of1I Title of Position(s) and Date(s) Held ScheduleD is not applicable. losilion(s) Held with the Federal Government During the !receding Termination Filers: The reporting 12 Months (I[ Not Same as Above) period begins at the end of the period covered by your previous filing and endst---------------------------+-:-:---:----------------------.----------------------1 at the date of termination. Part II of Presidential Nominees Subject Name of Congressional Committee Considering Nomination Do You Intend to Create a Qualified Diversified Trust? I Schedule D is not applicable. to Senate Confirmation Not Applicable DYes I8J No Nominees, New Entrants and Candidates for President and __ o_f_R_e_p_o-rt-in_g ln_d_•_·v-id_u_a_I____________________________________ __ Vice President: I CERTIFY that the statements I have Schedule A--The reporting period made on this form and all attached for income (BLOCK C) is the preceding schedules arc true, complete and correct -;J_.t..(-;)..0(( to the best or my knowledge. calendar year and the current calendar year up to the date of filing. Value assets Signature of Other Reviewer Date (Month, Day, Year) as of any date you choose that is within Other Review 31 days of the date of filing. (If desired by agency) Schedule B--Not applicable. Schedule C, Part I (Liabilities)--The AgencyEthicsOfflcialsOpinion Signature of Designated Agency Ethics O!Iiciai/Reviewing Official Date (Month, Day, Year) reporting period is the preceding calendar . . . . . . year and the current calendar year up to On the ba"s of mformat10n contmncd m thiS any date you choose that is within 31 days report. I conclude thal the filer IS an compliance f 1 with applicable laws and regulations (subjeel to of the date 0 f1 mg. anv comments in the box below). Office of Government Ethics I Signature I Date (MonLh Day Year) ISchedule C, Part II (Agreements or Arrangements)--Show any agreements or Use Only arrangements as of the date of filing. ScheduleD--The reporting period is Comments of Reviewing Officials (If additional space is required, usc the reverse side of U1is sheet) the preceding two calendar years and the current calendar year up to the date of filing. ·::- .1"I u·· ,.·J t _l ..,.. • ·.1 (C/Jeck box if filing exrension granted & indicatc number of days----) D 1.f :1 ... •I I ; ·-· • n ·...J , ...,! l...,l :;J 1:1 10 _j... ..] Agency Use Only :8 Hd 9Z IIGl OGE Use Only (C/Jeck box Jf comments are continued on UJC reverse side) D Supersedes SF u !j J;<{J [) j ..:;.1 ::u
    • OGE Fonn 278 (Rev. 09/2010)5 C.F.R. Part 2634U.S. Office of Govenunent Ethics Reporting Individuals Name Page NumberCain, Herman SCHEDULE A 2 of 13 Assets and Income Valuation of Assets ·Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item. BLOCK A BLOCKB BLOCKCFor you, your spouse, and dependent children, Type Amountreport each asset held for investment or theproduction of income which had a fair market ..... 0value exceeding $1,000 at the close of theing period, or which generated more than 200 0 q 0 0 0 0 0 0 ] .... 0in income during the reporting period, together .... 0 0 0 Q, q 0 0 0 o. J:l.<· 0 N 0 0 0 q Other Datewith such income. 0 0· 0 0 - .Q 0 0 Income (Mo., Day, ; 0 0 8· 0 0 -1< 0 q ci 0 g" b 0For yourself, also report the source and actual 0 0 0 0 0 0 0 0 0 0 lJ"l 0 q 0 lJ"l N £ q 0 0 N· lJ"l ...... 0 0 -0 q lJ"l lJ"l 0 0 § " Q) :0 t:: cO ..c: 0 0 R 0 0 0 0 q q 0 (Specify Type& Yr.) 0 0 q 0 0 0 lJ"lamount of earned income exceeding $200 (other "I - ...... 0 " " - Cil: - 0 0 0 0 .... 0 0 0 Actual Only if .s q 0 " ...... lJ"l ...... Ef7than from the U.S. Government). For your spouse, 0 ...... ...... 0 0 2 -" ...... lJ"l .... lJ"l I .... I .s 0 0 lJ"l lJ"l I " " 0 N 0 Amount) Honorariareport the source but not the amount of earnedincome of more than $1,000 (except report the I-< I ...... .... I .... ,...., ...... q o-: 0 0 0 "d E-< 1." I "1. 0 ,...., 0 0 0 "d. cO Cl Q) ... ....... lJ"l ...... ,...., ...... q I I 0 0 0 o_ 6 0 g lJ"l 2l ] ..._,_ .... o. 0 0· 0 0 o· I 0 ·;. ,...., 0actual amount of any honoraria over $200 of 0 0 0 ] 0 ..._, .... 0 .... ...... g. 0 0 0 lJ"l 0 0 0 ... 0: q .n. ... 0 .... ... ... !your spouse). Q) 0 0. 0 0 0 0 0 0 q .n· :a q "!. q vi" 0 0 Q) §. ...... ...... 0 ....... N o: o: lJ"l 0 d & t:: 0 0 .... 0 Q)NoneD z lJ"l l/"l. lJ"l N· Jj § 0 •Q) ..s u cO z 0 N- ...... N· lJ"l lJ"l ,_.;- > 0 Central Airlines Common · . ·- .:_ ·- 1- - - 1 - - r- X X X 1 - - - - - - - - - - - - - ·- 1- I- f.,- I- 1-- 1- 1-.- ·- ·- I- 1-- 1- 1- ---·-Examples DoeJones&Smith. Hometown, Stale 1 - - -Equity Fund- - - - - - - ·-- 1- --- ·- ·.- ·- - _I __ - - -- ·- ··- - - 1- - ··- - - - ·- law Partnership Income $130,000 1---- Kempslone -:-1-r: I- 1--. I- 1 - - - -500 Index Fund- - - - - -- - ·---. ..__ i-. - 1-- - ,. X _I_L -- -.- - :.:.1_ 1.,- f- -- 1---- IRA: llearlland ---- X 1--: :- ·- - X - ·- ·- X - --- --- 1---- 1 Cox Radio, Inc, Atlanta, GA Salary $165,1832 (S) The New Voice, Inc., Stockbridge, GA Salary ·.3 Hallmark Cards, Inc., Kansas City, MO ., Directors Fees $120,0004 Agco Corporation, Duluth, GA Directors Fees $202.5005 Whirlpool Corporation, Bento("! Harbor, Ml Dir. Fees/Stk Option Exercise $359.0086 Whirlpool Corporation Common .· ·. X I X X * This category applies only if the asset/income is solely that of the filers spouse or dependent children. If the asset/income is either that of the filer or jointly held by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate.
    • OGE Form 278 (Rev. 09/20 I 0)5 C.F.R. Part 2634U.S. Office of Government Ethics Reporting Individuals Name Page NumberCain, Herman SCHEDULE A continued (Use only if needed) 3 of 13 Assets and Income Valuation of Assets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item. BLOCK A BLOCKB BLOCKC Type Amount 0 ;::::;- 0 o_ 0 0 0 0 0 0 0 0 § ...... 0 0 ...... 0 0 0 0 0 0 J.!.< 0 N 0 0 0 Other Date I 0 0 0 0 0 0 0 0 0 0 0 Income (Mo., Day, 0 q 0 0 0 0 0 0 0 0 0 0 q 0 0 i< 0 Lrl 0 0 0 0 i< 8 (Specify Yr.) .s 0 0 0 0 ...... 0 0 Lrl. N 0 Lrl .-I 0 0 0 v) Lrl N I 0 0 0 " ;g (/) ..... ;:1 Cil .s 0 0 0 0 0 0 0 o_ 0 0 0 0 0 0 0 q .-I 0 0 q v) 0 0 0 Type& Actual Only if a v) >, Lrl .s 0 (/) (/) (/) (/) Lrl 0 I I .-I 0 (/) 0 v) ...... Lrl Lrl ...... 0 I 0 Amount) Honoraria .-I .I I I 0 .-I ...... 0 0 q N I 0 .-I 0 I I ...... ...... o_ 0 0 0 0 (/) ell ...... I I ...... q 0 q E ] "d .-I 1-< ...... .c..? 1-< .S· ...... I 0 .-I 0 0 0 0 0 0 0 0 ...... 0 0 0 0 Lrl 0 "d t:: Q) ] " .-; (/) ..... 0 I I ...... .-I I I ...... .-I 0 ...... 0 0 0 .-I o. 0 Lrl ! 0 0 0 0 o" g" 0 0 0. 0 q J 0 "d 0 0 0 0 0 q 0 1-< q Vi 1-< ·:;: q 1-< q ·!i 0 Ill q Q) 0 aa 0 Lrl Q) Vl 0 .-t" 0 ...... ...... .-I Lrl .-1 N Vl Lrl N JS .5 u z N .-I .N Lrl .-I Lrl (,1> 0 .(,I> 1 The Coca-Cola Company Common X X X2 (S) The Coca-Cola Company Common X X X "C3 Sale of 2,000 shares SonicWalllnc Common X I X X4 I Federated GA Municipal Cash Trust .. X . I X X X 5 Supervalu Inc Common X X X ...6 .. Whirlpool Corporation Common X X X ·• 7 Agco Corporation Common X 8 Delaware National Hi-Yield Municipal Bond A X X X Common C) Sale of 2,000 shares Whirlpool Corporation I X X X Common " * This category applies only if the asset/income is solely that of the filers spouse or dependent children. If the asset/income is either that of the filer or jointly held by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate. ---
    • OGE Fonn 278 (Rev. 09/2010)5 C.F.R. Part 2634U.S. Office of Govenunent Ethics .... - Reporting Individuals Name Page NumberCain, Herman SCHEDULE A continued (Use only if needed) 4 of 13 Assets and Income ValuationofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item. BLOCK A BLOCKB BLOCKC Type Amount ,..... 0 q 0 ....... 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ] 0 N 0 0 0 0 0 Other Date 0 0 0 0 0 0 0 0 d 0 0 0 Income (Mo., Day, 0 0 0 0 q 0 <11 0 0 0 0 0 0 0 0 0 o_ lrl lrl 0 § ...- ...- " ·11 t:: ro 0 0 b 0 (Specify Yr.) -s 0 q 00 lrl 0 0 0 "" 0 0 lrl. N ., 0 0 -s 0 8 0 0 0 0 0 0 0 0 0 vi 0 0 Type& ..... 0 " o. ..... 0 0 N lrl ,....;- 0 0 " 0 0 q .... 0 0 Actual Only if ..... lrl ..... 0 " " lrl 0 I" ....... I ..... 8 ·0 .s " o_ " " 0 lrl .....; 0 lrl ..... lrl 0 I 0 Amount) Honoraria I 0 0 0 E-< ..: lrl- ....... 0 ..... ..... ..... ..... ...... .q. I I q 0 0 ro ..... 1- 0 ..... o_ ·o q 0 _s I I i::5 0 I I 1-<" -9. I ....... 0 0 o. 0 lrl al "0 al "0 t:: ...- -;. L? I I I ....... ..... 0 ..... 0 lrl ...... .0 0 0 0 . 0 0 s ....... ...... ...... ·o 0 I ... " ;;::: 0 0 •.1 0 0 .gj g .Cij 0 0 0 0 0 0 0 0 0. ....... 0 0 q o. lrl 1-< -; <11 o_ 0 0 0 0 0 vi 0 ,....;- o_ vi 0 q 1-< q ·0 ...... ....... lrl ....... t:: <11 § 0 ...... lrl vi 0 0 ....... z N lrl lrl N 0 §: a ..: ·<1) .5 u z N N" lrl ....... lrl ......1 Federated Prime Obligations Trust I X X X X2 The Coca-Cola Company Common X X X3 Federated GA Municipal Cash Trust X X X X4 The Coca-Cola Company Common I X X X5 Federated Prime Obligations Trust x. X X X6 The Coca-Cola Company Common X X X7 Suntrust Bank, Dunwoody, GA - Checking X X X ..8 Suntrust Bank, Dunwoody, GA - Money Market X X Xq Branch Banking & Trust Co., Fayette, GA- Checking X I X X * This category applies only if the asset/income is solely that of the filers spouse or dependent children. If the asset/income is either that of the filer or jointly held by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate.
    • OGE Form 278 (Rev. 09/2010)5 C.F .R. Part 2634U.S. Office of Government Ethics Reporting Individuals Name Page NumberCain, Herman SCHEDULE A continued (Use only if needed) 5 of 13 Assets and Income Valuation of Assets Income: type and amount. If"None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item. BLOCK A BLOCKB BLOCKC Type Amount 0 0 q ...... ...... 0 0 .o 0 0 0 0 0 0 0 ] ;:;- 0 0 0 0 Other Date c5 c5 8 0 0 N 0 0 0 "" q c5 Income (Mo., Day, 0 0 c5 0 0 0 0 q c5 "" 0 2 b 8 0 0 0 0 0 0 c5 c5 q 0 0 b .n 0 tr) tr) 0 0 £l " (1) ·p 2 0 0 0 0 0 0 0 .n 0 (Specify Yr.) £ q c5 c5 0 0 tr) 0 0 N "" c5 " ..., t:: 0 til £ 0 0 0 q 0 0 0 q c5 ...... 0 0 Type& c5 "" "" 0 ;g " ..... " 0 ..... "" "" "" "" tr) tr) N I tr) I ....... "" I 0 0 I ..... ..... I 0 I ...... 0 0 .... E-< " s " q N q ..... 0 " ...... 0 tr) tr) tr) tr) 0 ..... "" "" c5 "" c5 0I 0 ...... 0 I 0 Actual Amount) Only if Honoraria _£ "" .0 ..... ..0 ..... ...... a! "0 d• ..., !;.!). 8 "" "" :..-. "" ...... q 0 0 "" 0 q 0 o. ..... ...... I I ...... ..... 0 0 c5 c5 l ·I ...... ..... 0 0 0 0 0 c:: s:: ..... ..... ..... 0 ,.; 0 0 0 0 0 q 0 tr) §, "0 ...,· " til (1) «$ ...,. 0 0 0 0 q 0 8 ,.; tr) q .n c5 0 0 0 ...... q .... 8. q 0 i 0 0 .n 0 c5 0 .... ..... ...... 0 ...... tr) 0 ...... § «$ s:: (1) 0 ..... "l q ....... tr) 0 0 0 ..... .5 ...... tr) N N ,.; N ctrl tr) (1) N tr) tr) "" 0 Ci u "" VfI Branch Banking & Trust Co., Fayette, GA - X X X Certificate of Deposit2 (S) Branch Banking & Trust Co., Fayette, GA- Checking X X X3 (S) Branch Banking & Trust Co., Fayette, GA - Certificate of Deposit X X X4 Distributive Less than 1% ownership in a computer wholesale company in West Palm Beach, FL. X X Share5 Vanguard lnterm-Term Investment-Grade lnv X X X6 Vanguard Total Stock Mkt ldx lnv ..· X X X7 Sale of 1 ,999 shares Whirlpool Corporation Common X X X8 Sale of 1 ,999 shares Whirlpool Corporation X X X Commonq Residential property in Atlanta, GA X .· X X * This category applies only if the asset/income is solely that of the filers spouse or dependent children. If the asset/income is either that of the filer or jointly held by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate.
    • OGE Form 278 (Rev. 09/2010)5 C.F.R. Part 2634U.S. Office of Government Ethics Reporting Individuals Name Page NumberCain, Herman SCHEDULE A continued (Use only if needed) 6 of 13 Assets and Income ValuationofAssets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item. BLOCK A BLOCKB BLOCK C Type Amount 0 ...... 0 o_ 0 0 .0 cS 0 0 0 0 0· § ..... 0 0 0 Other Date ..... ·0 0 0 cS cS o_ "" 0 0 0 N 0 0 cS (Mo., Day, ""7 0 0 "" 0 Income J " 0 0 a -s 0 0 0 0 0 0 cS c:5 0 q c:5 l/) 0 o_ 0 0 0 cS o_ 0 b ..., l/) q l/) 0 l/) !17 0 0 0 :0 !:1 " -s 0 0 0 0 0 0 0 cS 0 q b 8 vi 0 (Specify Type& Yr.) N 8 0 0 cS ...... 0 I g q 0 0 N l/) ..... 0 0 "" •I - 0 0 o_ "" c:5 0 Actual Only if ...... cS 0 0 ..... sg " o_ 0 " ..... ""7 ..., "" "" "" 0 " l/) l/) c:5 I I :::1 0 l/) ..., ..... ""7 cS ..... 0 I Amount) Honoraria " ..... l/) ...... 0 ..... 0 0 N "" ..... ..... ...... ..... ·0 q I I I 0 l/) "" ..... q I 0 q .s "" "" "" "" 0 .0 I I ...... 0 cS .... T-1": I 0 I I _£ ..... 0 0 0 0 0 ..... I 0 0 cS c:5 o l/) 0 0 0 "0 Q) "0 Q) ] - (.!) :""; I ., ..... ..... ..... I ..... ..... o. ..... 0 0 cS l/) q vi c:5 cS cS cS "" o_ o_ l/) .... 0 0 0 o· 0 .o_ "" 0. Q) " ...... 0 0 0 q 0 0 "" 0 "" 0 g .... o_ .... J"" ..., "" .... "0 o_ ..... lll.. q ...... 0 ..... :> ..... Q) a 0 0 ..... ....... l/) ...... N 0 l/) ..... l/) .N §< l/) Q) l/) "" "" Cl - ..s u :£ "" "" ·"" N N l/) l/) .0 "" ·"" 0 "" ·""· "" "" 0 ""7. .""7 ""I Residential property in Atlanta, GA X X X2 Investment in Bell Research Companies, Tilton, X GA3 Sale of 1,000 shares Mentor Graphics Common X X X Stock4 Sale of 450 shares Plains Exploration Common t Stock X. X X5 Sale of 332 shares Centurylink Common Stock X X X6 Blackrock Global Allocation A IRA Investment .· X X X7 LM CBA Appr A IRA Investment X X X8 (S) The Hartford Growth Opportunities Fund - L X X X Mutual Fund Investment IRA InvestmentC) The Hartford Growth Opportunities Fund - L X X X Mutual Fund Investment IRA Investment * This category applies only if the asset/income is solely that of the filers spouse or dependent children. If the asset/income is either that of the filer or jointly held by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate. ------ --------
    • OGE Fonn 278 (Rev. 09/2010)5 C.F .R. Part 2634U.S. Office of Government Ethics Reporting Individuals Name Page NumberCain, Herman SCHEDULE A continued (Use only if needed) 7 of 13 Assets and Income Valuation of Assets Income: type and amount. If "None (or less than $201 )"is at close of reporting period checked, no other entry is needed in Block C for that item. BLOCK A BLOCKB BLOCKC Type Amount 0 ...... 0 0 . "Cl 0 C?. ..... 0 0 0 0· 0 0 0 0 c5 c5 0 0 c5 0 & ..... 0 N 0 0 0 0 0 Other Date i 0 0 0 0 c5 Income (Mo., Day, 0 0 a -s 0 0 0 0 0 c5. 0 0 c5 c5 c5 C?. 0 0 0 0 -1< 0 0 o_ C?. c5 tr) tr) N tr) 0 0 0 ...... ·.c «$ ..c: ..... 0 0 0 0 0 0 0 0 0 0 0 c5 0 C?. -1< 0 0 o_ tr) 0 0 (Specify Type& Yr.) o_ c5 0 N 0 tr) 0 0 " " tr) ..... ..... tr)· ...... I tr) 0 c5 " 0 ...... ..... ...... 0 ...... 0 ·a 0 0 0 I I. I Q) } " "" ... 0 0· C?. 0 tr) N 0 C?. tr) c5 0 tr) C?. ...... 0 ..... tr) ...... I 0 ...... 0 0 I 0 0 Actual Amount) Only if Honoraria ..... ...... ..... " ...... ..... ..... ..... ..... 0 C?. 0 «$ 0 C?. 0. tr) I I C?. 0 0 c5 0 "Cl I 2- ..... ...... 0 0 0 0 ..... g c5 Q. 0 0 0 0 0 .o_ ... 2;l tr) "Cl Q) 13 "Cl "Cl ..... " ca (.!) 2 I ..... . I ...... ..... 0. 0 0 0 ... fr I 0 0 c5 c5 ... o_ C?. Q) (lj § ...... 0 0 0 c5 fr "Cl ..... -1-· ...... 0 0 0 0 0 0 ... 0 C?. ,tr)- "> d C?. tn.. vi ..... N C?. ...... 0 ..... 0 a Q .s 0 tr) Q) 0. 0 0 Jj Jj tr) ...... ...... ...... ......- z tr) N .tr) tr) N 0 u «S· N tr) tr)I Sun Trust Advantage Money Market Account X X X2 Note Receivable Bell Research Companies X X X3 Land held for investment, Walton County, GA X X X4 Berkshire Hathaway Inc Common Stock, Cl B X X X5 Alliance Bernstein Global Thematic Growh Fd Cl A X X X6 Fidelity Advisor Growth Opportunities Fund Cl T X X X7 Goldman Sachs Technology Toll keeper Fd Cl A X X X8 Oppenheimer Champion Income Fund - Cl A X X Xq 50% ownership in VHC Investments, LLC a X X X rental real estate holdings company I * This category applies only if the asset/income is solely that of the filers spouse or dependent children. If the asset/income is either that of the filer or jointly held by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate. - -------
    • OGE Foml278 (Rev. 09/2010)5 C.F.R. Part 2634U.S. Office of Government Ethics Rcporling Individuals Name Page NumberCain, Herman SCHEDULE A continued (Use only if needed) 8 of 13 Assets and Income Valuation of Assets Income: type and amount. If "None (or less than $201)" is at close of reporting period checked, no other entry is needed in Block C for that item. BLOCK A BLOCK B BLOCKC Type Amount 0 ...... 0 0 "Cl 0 o. 0 0 § ;:::;- 0 q 0 0 0 0 Date ...... 0 0 0 0 0 0 0 0 N 0 0 0 Other 0 0 0 Income (Mo., Day, 0 0 0 0 0 0 0 0 0 0 q 0 q 0 0 m " C1 0 0 0 0 0 0 (Specify Yr.) 0 0 0 0 0 q b Lr) N 0 Lr) § Q) ro i< 0 .s 0 0 0 0 Lr) q 0 0 N Lr) ...... 0 0 0 Lr) 0 8 " " - :.::1 til 0 0 0 0 0 q 0 0 0 0 q 0 0 vi 0 0 Type& 0 0 0 0 q Lr) Lr) ..... ...... 0 0 Actual Only if ·I ;:..., 0 " Lr) Lr) ...... 0 ..... ..... ...... 0 2 ;:1 Lr) " ..... ., I I 0 " " 0 .s " ......- 0 N" ..... 0 ...... 0 I Amount) Honoraria .... I I I 0 ...... ...... ...... q 0 0 0 0 0 f:-o " &l ro c.::J .... Lr) I 0 ..... ...... q 0 q .s 0..... ...... ..... 0 0 .0 ..... 00 0 00 Lr) C1 -g "Cl "Cl ] "Cl 0 0 0 0 0 0 Q) Q) ·ro - ·..., " til ..... .s I ..... I ...... ..... ..... o. 0 8 ..... 0 Lr) 0 ! 0 0 q .vi 0 0. 0 0 .... 0 q 0 .... 0 0 "Cl ...... o. 0 0 0 0 0 0 0 .... ·a: Q) "l q .vi 0 0 0 ..... ...... Lr) ....... N . 0 Lr) Lr) Lr)" ........ Lr) N a Cl .s Q) «l u C1 0 N· ..... N· Lr) .... Lr) .... 0 ...... -1 100% ownership of s-carp THE New Voice. Inc., X X a public speaking and publishing entity2 Wells Fargo Advantage Core Equity Fd Cl A X I I X X3 Godfathers Pizza Restaurant Operating X Income $53,965.504 Prime Money Market Fund RBC Investor Class X X X5 Sale of 2,163 shares The Coca-Cola Company Common Stock X· X X6 Sale of 5,738 shares The Coca-Cola Company Common Stock X X X78q * This category applies only if the asset/income is solely that of the filers spouse or dependent children. If the asset/income is either that of the filer or jointly held by the filer with the spouse or dependent children, mark the other higher categories of value, as appropriate. --------------
    • OGE Fonn 278 (Rev. 09/2010)5 C.F.R. Part 2634 Do not complete Schedule B if you are a new entrant, nominee, or Vice Presidential or Presidential CandidateU.S. Office of Government Ethics Reporting Individuals NameCain, Herman Part I: Transactions 1 SCHEDULE B Page Number 9 of 13 Report any purchase, sale, or exchange Do not report a transaction involving NoneO by you, your spouse, or dependent property used solely as your personal children during the reporting period of any residence, or a transaction solely between Transaction Amount of Transaction (x) you, your spouse, or dependent child. · Type (x) real property, stocks, bonds, commodity 8 "-< futures, and other securities when the Check the "Certificate of divestiture" block Dale • •o 88 8 0 amount of the transaction exceeded $1,000. to indicate sales made pursuant to a Q) :g Q) Cl c: (Mo., Day, Yr.) O .--10 .-<O 88 go. qq qq o& g qg l;jo 88 gg 88 8 "" Include transactions that resulted in a loss. certificate of divestiture from OGE. .<:: Q) " .<:: 00 o· ........ ·" . . ,.o oo oo g-s s:o o0 . . . . O&:t . 0 0 >.--. .--itri 0 u;:G • qo. liJ • ·-" >:;:; 8:a Identification of Assets :;) a. <ii (/) .ll Examptc1 Ccnlral Airlines Common X 2/1/99 """" YH;I} X f:flY.t VtY.t {;1;)(;.1) Y,t{;l) Y.tb") {;l)bl} 2 3 4 5 *This category applies only if the underlying asset is solely that of the filers spouse or dependent children. If the underlying asset is either held by the filer or jointly held by the filer with the spouse or dependent children, use the other higher categories of value, as appropriate. Part II: Gifts, Reimbursements, and Travel Expenses For you, your spouse and dependent children, report the source, a brief descrip- the U.S. Government; given to your agency in connection with official travel; tion, and the value of: (l) gifts (such as tangible items, transportation, lodging, received from relatives; received by your spouse or dependent child totally food, or entertainment) received from one source totaling more than $335 and independent of their relationship to you; or provided as personal hospitality at (2) travel-related cash reimbursements received from one source totaling more the donors residence. Also, for purposes of aggregating gifts to determine the than $335. For conflicts analysis, it is helpful to indicate a basis for receipt, such total value fi·om one source, exclude items worth $134 or less. See instructions as personal friend, agency approval under 5 U.S.C. § 4111 or other statutory for other exclusions. authority, etc. For travel-related gifts and reimbursements, include travel itinerary, dates, and the nature of expenses provided. Exclude anything given to you by None 0 Source (Name and Address) llrief Description Value NY, NY___ I ____ _ 5500 oi"Frank.)ones. San Francisco, CA I Leather briefcase (personal friend) $350 3 4 5
    • OGE Fonn 278 (Rev. 09/2010)5 C.F.R. Part 2634 Do not complete Schedule B if you are a new entrant, nominee, or Vice Presidential or Presidential CandidateU.S. Office of Govemment Ethics Reporting Individuals Name Page Number SCHEDULE B continued Cain, Herman I (Use only if needed) 10 of 13 Part 1: Transactions Transaction Amount or TransaCtion (x) Type (x) -o 50 0 0 0 0 1 o o Date " gj " " (Mo., Day, Yr.) I •o 0 ,......!Q 1"""iQ QQ 0 0 ....-10 0 0 0 0 0 0 0 0 ;.8 00 g 0 00 q qq 00 00 00 0 cd::l 1ij e::l a. " (ij oq,qqlqo" o"o" o"o" qVl tnO 0 0 Oll"l lnO ....-1....-1 ....-11.1") 1.1)1"""1 ....-IN Ni.r) Q"O 1.1")....-1 ,..o 0 0 oo oo Lfo !l.lq 0 0 0 ... u1 u10 CJO -> >....-1 ....;v) VlN NV) >U") Identification or Assets (/) (;,IHfl f;fl-E.R "" U"O 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 *This category applies only if the underlying asset is solely that of the filers spouse or dependent children. If the underlying asset is either held by the filer or jointly held by the filer with the spouse or dependent children, use the other higher categories of value, as appropriate.
    • OGE Fonn 278 (Rev. 09/2010)5 C.F.R. Part 2634U.S. Office of Government EthicsReporting Individuals Name Page NumberCain, Herman SCHEDULE c 11 of 13Part I: Liabilities a mortgage on your personal residence NoneOReport liabilities over $10,000 owed unless it is rented out; loans secured by Category of Amount or Value (x)to any one creditor at any time automobiles, household furnitureduring the reporting period by you, or appliances; and liabilities owed toyour spouse, or dependent children. certain relatives listed in instructions. •o .-<0 0 .o 0 .-<0 .-<O 00 00 00 0 qCheck the highest amount owed .-<0 .-<0 .-<0 0 00 See instructions for revolving charge .-<0 .-<0 O .-<O 00 ·00 oo. q 00 0.6 66 0during the reporting period. Exclude accounts. 00 00 00 00 qo. 00 0 deS 00 00 0 00 00 q6 66 00 ...,o 00 00 0 • 00 ...,q v)c) .. q 00 vlO Date Incurred Interest Rate Term if applicable ........ .... " " .... .-<N c)v) 00 OV> V>O ·" NV> ..,.., ..,.., ..,.., ..,.., ..,.., ..,.., o ... ..,.., .,.., ..,.., NV> " .... >.-. tnN QJO Creditors (Name and Address) Type of LiabilityExamples hn Jones, Washington, DC __ Promissory note ___ 1991 r-i999 - 10% __ r -8% - on demand .-. 1 - - _!_ - -- -- - X I-- .- - 1--I SunTrust Investment Services, Inc. Dunwoody, GA Line of Credit · paid off during reporting period 2009 prime+1 on demand X2345 *This category applies only if the liability is solely that of the filers spouse or dependent children. If the liability is that of the filer or a joint liability of the filer with the spouse or dependent children, mark the other higher categories, as appropriate.Part II: Agreements or ArrangementsReport your agreements or arrangements for: ( 1) continuing participation in an of absence; and (4) future employment. See instructions regarding the report-employee benefit plan (e.g. pension, 40lk, deferred compensation); (2) continua- ing of negotiations for any of these arrangements or benefits.tion of payment by a former employer (including severance payments); (3) leaves NoneD Status and Terms of any Agreement or Arrangement Parties DateExample I Pursuant to partnership agreement, will receive lump sum payment of capital account & partnership share calculated on service performed through 1100.1 Pursuant to directors agreement with Hallmark Cards, will receive quarterly retirement payments beginning 03 2011 for 5 years Doc jones & Smith, Hometown, Stale Hallmark Cards 7/85 03/0123456
    • OGE Fonn 278 (Rev. 09/2010)5 C.F.R. Part 2634U.S. Office of Government EthicsReporting Individuals Name Page NumberCain, Herman SCHEDULED 12 of 13Part I: Positions Held Outside U.S. GovernmentReport any positions held during the applicable reporting period, whether compen- organization or educational institution. Exclude positions with religious,sated or not. Positions include but are not limited to those of an officer, director, social, fraternal, or political entities and those solely of an honorarytrustee, general partner, proprietor, representative, employee, or consultant of nature.any corporation, firm, partnership, or other business enterprise or any non-profit None D Organization (Name and Address) Type of Organization Position Held From (Mo., Yr.) To (Mo., Yr.)Examples Rock N2::._N2._ _ _ _ _ _ _ _ _ _ _ _ Doc .)ones & Smith, llomctown, State Non-profit education 1-:-------------- Law firm ---------- - - - - ---- President Partner 6/92 7/85 Present 1/001 Acgo Corporation, Duluth, GA Agricultural equipment manufacture Director 12/2004 4/20112 Hallmark Cards, Inc., Kansas City, MO Greeting card retail Director 03/2001 4/2011 3 Whirlpool Corporation, Benton Harbor, Ml Appliance manufacture Director 12/1992 11/20034 Whirlpool Corporation, Benton Harbor, Ml Appliance manufacture Director 04/2005 4/2011 5 Morehouse College, Atlanta, GA Non-profit education Trustee 04/2002 6/20116 Bell Research Companies, Tilton, GA Agricultural research Director 01/2009 6/2011 Part II: Compensation in Excess of $5,000 Paid by One Source Do not complete this part if you are an Incumbent, Termination Filer, or Vice Report sources of more than $5,000 compensation received by you or your non-profit organization when Presidential or Presidential Candidate. business affiliation for services provided directly by you during any one year of you directly provided the the reporting period. This includes the names of clients and customers of any services generating a fee or payment of more than $5,000. You corporation, firm, partnership, or other business enterprise, or any other need not report the U.S. Government as a source. None D Source (Name and Address) Brief Description of Duties , .Jones & Smith, llomclown, State Legal services Examples -------------------- tro University (client of Doc jones & Smith), Moneytown, Stale ------------------------------- Legal services in connection with university construction 1 2 3 4 5 6
    • OGE Form 278 (Rev. 09/2010)5 C.F.R. Part 2634U.S. Office of Government EthicsReporting Individuals Name Page NumberCain, Herman SCHEDULED 13 of 13Part I: Positions Held Outside U.S. GovernmentReport any positions held during the applicable reporting period, whether compen- organization or educational institution. Exclude positions with religious,sated or not. Positions include but are not limited to those of an officer, director, social, fraternal, or political entities and those solely of an honorary nature.trustee, general partner, proprietor, representative, employee, or consultant ofany corporation, firm, partnership, or other business enterprise or any non-profit None D Organization (Name and Address) Type of Organization Position Held From (Mo., Yr.) To (Mo., Yr.) _ _ _ _ _ _ _ _ _ President PresentExamples Assn. of Rock Collectors, NY, NY - - - - - - - - - - - - - - - - - - - - Law firm oc Jones & Smith, Hometown. State ---------- - - - - ---- Partner 6/92 7185 1/00 1 The New Voice, Inc. Firm involved in public speaking appearances and Shareholder 09/2004 Present book publishing2 Member VHC Investments, LLC Rental real estate holding company 12/2006 Present 3 Cox Radio Group Atlanta, Atlanta, GA Radio broadcast company Employee 01/2008 2/2011 4 5 6 Part II: Compensation in Excess of $5,000 Paid by One Source Do not complete this part if you are an Incumbent, Termination Filer, or Vice Report sources of more than $5,000 compensation received by you or your non-profit organization when Presidential or Presidential Candidate. business affiliation for services provided directly by you during any one year of you directly provided the the reporting period. This includes the names of clients and customers of any services generating a fee or payment of more than $5,000. You corporation, firm, partnership, or other business enterprise, or any other need not report the U.S. Government as a source. None D Source (Name and Address) Brief Description of Duties Jones & Smith. Hometown, State Legal services Examples -------------------- tro University (client of Doc Jones & Smith), Moncytown, State ------------------------------- Legal services in connection with university construction 1 2 3 4 5 6 Prior Editions Cannot Be Used.