Personal Financial Disclosure Statement
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7LOUISIANA SUPREME COURT
PERSONAL FINANCIAL DISCLOSURE STATEMENT
FOR JUDGES
Report
Required
by
Order of the Louisiana
Supreme Court, Part N,
SECTION I:
GENERAL INFORMATION
Rule XXXIX.
1. Person Reporting
2. Date of Report
3. Reporting Period
(Last name, first, middle initial)
4. Title of Person Reporting
5. Name of Court
6. Office Address
7. Spouse’s Name (Last name, first, middle initial)
8. Spouse’s Current Occupation (if applicable)
NOT APPLICABLE
NOT APPLICABLE
9. Spouse’s Current Office Address (if applicable)
NOT APPLICABLE
IMPORTANT: The instructions accompanying this form must be followed. Complete all parts,
checking the “NOT APPLICABLE” box for each part where you have no reportable information.
SECTION II.
INTERESTS IN BUSINESS ENTITIES
Complete this Section for each business in which you or your spouse is a director, officer, owner, partner,
member, or trustee, and in which you or your spouse, either individually or collectively, owns an interest
which exceeds ten percent of that business.
See Rules of the La. Supreme Ct., Part N, Rule XXXIX, Section 2(C)(4)(a).
If none, check the “NOT APPLICABLE” box and skip to the next Section.
NOT APPLICABLE
1. Information Relates to:
Filer
Spouse
Both
2. Name of Business
3. Address of Business:
4. Brief Description of, and
Amount of Interest in, Business
5. Nature of Association with
Director
Officer
Owner
Business
Partner
Member
Trustee
1. Information Relates to:
Filer
Spouse
Both
2. Name of Business
3. Address of Business:
4. Brief Description of, and
Amount of Interest in, Business
5. Nature of Association with
Director
Officer
Owner
Business
Partner
Member
Trustee
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Form PFDS for Judges (Adopted February 2011)
Page ____ of ____
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