FINANCIAL DIS CLOSURE REPORT

FOR CALENDARYEAR 2009

I. Person Reporting {last nalnc, first, middle initial) Surrick.. Richard B. 4. Title (Article Ill judges indicate active or sen~or status; magislrate judges indicate full- ur part-tirne.I U.S. District Judge - Active 2. Court or Organization U.S. District Court E.D. PA 5a. Report Type (check appropriate type) [] Nominalion, [] Initial Da~e [] Anoual [] Final

~:~po,.t Re,~,i,edby z/,~,Zt~,ics

m Government ~ct of 1978

3. Date of Rrporl 05/26,r2010 6. Reporting Period 01/01/2009 to 12/31/2009

5b. [] A~.cndcd Report 7. Chambers or Office Address 1.I.S. Courthouse - Rt~m 3614 601 Market Street Philadelphia, PA 19106 8. On the basis of the information contained in this Report and any modification~ pertaining thereto, it is, in my opinion, in compliance with applicable laws and regulations. Reviewing Officer |)ate

L~IPORTANT NOTES: The instructions accompanying this form mu~t be followea~ Complete all parts,
checking the NONE box.lbr each part where you have no reportable information. Sign on l~t page.

!. POSIT10NS. (Reporting indlridual only: .~ee pp. 9-1J of ~l#,g in~ruction~.)

NONE (No reportable positions..)

POSIT1ON

NAM~ OF ORGAN1ZATION/ENTI~

~
I, 2000

N ONE (No reportable agreements.) DATE ~A RTI ES AND TE~MS

Commonwealth of PA State Emp!oyecs Retirement System - No Control

Surrick, Richard B.

FINANCIAL DISCLOSURE REPORT Page 2 of 6

II I. NON-INVESTMENT INCOME. ~Ropo,ti~.~
A. Fliers Non-investment Income

r~ ....f P .....Reporting [ Surrick., Richard B. I

Da,e of Repar~ 05/26i2010

~
1. 2009

NONE

No
DATE

non-investment income.) SOURCE AND TYPE

Commonwealth oFPA State Employee P.etircment System

INCOME
(yours, not spouses) $65,670.25

3.
4.

B. Spouses Non-Investment Income - t~yo,, were mantled during an), portion o]~the repor~ing ycar. com, alete this se~io~
(Do!lar amot,nt not req~,ired except for honoraria )

~
I.

NONE (No reportable non-investment income.) ~ SOURCE AND TYPE

3 4.

IV. ~IMBURSEMENTS .....

(lnc(mles those to

NONE ~Wo reportable reimbursemcnzv.) SOURCE

1.

DATES

LOCATION

PURPOSE

ITEMS PAID OR PROVIDED

3. 4. 5

Name of Person Reportin~

Date of Report

PageFINANCIAL3 of 6 DISCLOSURE REPORT [

Surrick., Richard B.

05/26/2010

NONE (No reportable gifts.) ~ DESCR!pTION VALUE

1. 2, 3.

5.

VI. LIABILITIES. a.c~.u,.~tl, o~oo/,-p ...... d a~p~.~e.,,~,~td~.: ~t,~ 32-3~ off!ling lnstr.ctions.k

NONE (No reportable liabilities.) CRED1TOR DESCRIPTION .VALUE CODE

2. 3.
4

5.

FINANCIAL DISCLOSURE REPORT Page 4 of 6 VII. INVESTMENTS and TRUSTS - i ...........

~_1
~........... ~ A. Descriplion of AsseLs B. Income during

Surrick., Richard B. [

05/26/2010

t.~, , .......,i,,~ (It t-ludes those of sp ....... d dependent children ,eepp. 34.60 ~filing i .......
C. G~ss value at en~ D. .................... Transactions during reporting period

tions.)

NONE (No reportable income, assets, or transactions.)

]

exempt from prior dis~losu~e i

(:ode div., rent, IA-II) or int.) [

Code 2 Method buy, sell. ~ mn~d~Y~ I Code 2 Code I buycrlseller r~emption) ~ (if prival (J-P) C~e 3 (J-P) (A-H) (Q-W) l~n~ction)

~
1. ~2. 3.

Commonwealth of PA State Employees Retlremenl System Equi-Vest Retiremrnl Prt, gram Pershing Government Accout~l Rollover Retirement Account

None None

PI J

W W

None

~4.

16.

I0.

12. 13.
14.

15.

17.

Name of Person Reporting

Dale of Report

PageFINANCIAL5 of 6 DISCLOSURE REPORT

Su,-rick., Richard B.

05/26,2010

VIII. ADDITIONAL INFORMATION OR EXPL~NATIONS.

FINANCIAL DISCLOSURE REPORT Page 6 of 6

IX. CERTIFICATION.

~" ..... fp ..... Reporting Surrick., Richard B.

] I

Da,eofRep~rt 05/26/2_010

I certify that all information given above (including information pertaining 1o my spouse and minor or dependent children, if any) is accurate, true, and complete to the best of my knowledge and belief, and that any information not reported was withheld because it met applicable statutory provisions permitting non-disclosure. I further certify that earned income from outside employment and honoraria aud the acceptance of gifts which have been reported are in compliance with the provisitms of 5 U.S.C. app. 501 el. seq., 5 ILS.C. 7353, and Jndicial Conference regulations.

NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFUI,LY FALSIFIES OR FALLS TO FILE Tills REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. 104)

FILING INSTRUCTIONS Mail signed original and 3 additional copies to: Committee on Financial l)isclosurc Administrative Office of the United States Courts Snite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544