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Report Required by the Ethics in Government Act of 1978 (5 U.S.C. app. ~q~" 101-111)
7. Chambers or Office Address Tuscaloosa Federal Building 1118 Greensboro Ave. Rm. 316 Tuscaloosa, AL 35401
8. On the basis of the information contained in this Report and any modifications pertaining thereto, it is, in my opinion, in compliance with applicable laws and regulations. Reviewing Officer Date
IMPORTANT NOTES: The instructions accompanying this form must be followed. Complete all parts,
checking the NONE box for each part where you have no reportable information. Sign on last page.
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I. 2. 3. 4. 5.
POSITION
Director
NAME OF ORGANIZATION/ENTITY
American Christian Academy
PARTIES AND TERMS State of Alabama, Retirement Systems - Retirement Account - I have no control over this account.
Coo_qler, Lawrence S.
IlL NON-INVESTMENT INCOME. (Reporting individual andspouse; seepp. 17-24 of filing instructions.)
A. Fliers Non-lnvestment Income
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1. 2010 2. 3. 4.
B. Spouses Non-Investment Income - If you were married during any portion of the reporting year, complete this section.
(Dollar amount not required except for honoraria.)
1.2010 2. 3. 4.
DATES
LOCATION
PURPOSE
V. GIFTS. (Includes those to spouse and dependent children; see pp. 28-31 of filing instructions.)
~
1. 2. 3. 4. 5.
DESCRIPTION
VI. LIABILITIES. anetudes those of spouse and dependent children; see pp. 32-33 of filing instructions.)
~-~ NONE (No reportable liabilities.) CREDITOR
1. 2. 3. Bank of Tuscaloosa Citimortgage Bank Of America - Loan sold by Countrywide Mortgage
DESCRIPTION
Real Estate Mortgage (C&C Rental)(33rd) Real Estate Mortgage (Rental) (Hhills) Real Estate Mortgage (C. Creek)
VALUE CODE
J K L
4. 5.
VII. INVESTMENTS and TRUSTS - income, va/ue, transactions (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets (including trust assets) Place "(X)" after each asset exempt from prior disclosure Income during reporting period (1) (2) Amount Type (e.g., Code I div., rent, (A-H) or int.) Gross value at end of reporting period (1) (2) Value Value Code 2 Method (J-P) Code 3 (Q-W) J J M M L J L J J J J J J J J J J
T T T T T
AUSI Common Stock (Personal) SNV Common Stock (Personal) Rental Property No. 2, Tuscaloosa, AL (__) HH Rental Property No. 3, Tuscaloosa, AL (~ Cap Coogler & Copeland, Jnt. Vnt. ~IZ~ ~ Tuscaloosa,AL) 50% lnt Checking Account #1 Bank of Tuscaloosa Checking Account #2 Bank of Tuscaloosa Savings Account - Compass Bank Money Market Account # 1 - Bank of Tuscaloosa TD Waterhouse Bank Money Market Account (__) TD Waterhouse Bank Money Market Account (CHC) TD Waterhouse Bank Money Market Account (HCC) TD Waterhouse Money Market Account (ADC) Checking Account- Life Insurance Trust Bank of Tuscaloosa RF Common Stock (CHC) WFC Common Stock formerly WB (CHC) SNV Common Stock (CHC) A A A A A A A A A A D D D
None Dividend Rent Rent Rent None None Interest Interest Interest Interest Interest Interest None Dividend Dividend Dividend
W W W T
T T
I. Income Gain Codes: (See Columns B I and D4) 2. Value Codes (See Columns CI and D3) 3. Value Method (.odes (See Column C2)
A =$1,000 or less F =$50.001 - $100,000 J =$15,000 or less N =$250,001 - $500,000 P3 ~$25.000,001 - $50,000,000 Q =Appraisal U =Book Value
B =$1,001 - $2,500 G =$100,001 - $1,000,000 K =$15,001 - $50,000 O =$500,001 - $1.000,000 R =Cost (Real Estate Only) V =Other
C =$2,501 - $5,000 HI =$1,000,001 - $5,000,000 L =$50,001 - $ 100,000 PI =$1,000,001 - $5,000,000 P4 =More than $50,000,000 S =Assessment W =Estimated
D =$5,001 - $15,000 H2 =More than $5,000,000 M =$100,001 - $250,000 P2 -$5,000,001 - $25,000,000 T =Cash Market
E =$15,001- $50,000
VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; seepp. 34-60 of filing instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets (including trust assets) Place "(X)" after each asset exempt from prior disclosure Income during reporting period (11 (2) Amount Type (e.g., Code I div., rent, (A-H) or int.) Gross value at end of reporting period (1) (2) Value Value Code 2 Method (J-P) Code 3 (Q-W) J J J J J J J J K J J J M J
J
18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34.
AUS1 Common Stock (CHC) RF Common Stock (HCC) WFC Common Stock formerly WB (HCC) SNV Common Stock(HCC) RF Common Stock (ADC) WFC Common Stock formerly WB (ADC) SNV Common Stock (ADC) Real Estate Rental, Sherwood East, Ltd. 1/12 IRA (LSC) -TmnsAmerica Asset Allocation Fund Prepaid College Tuition Plan, State of Alabama (CHC) Prepaid College Tuition Plan, State of Alabama (HCC) Prepaid College Tuition Plan, State of Alabama (ADC) Real Estate, IHOP, LLC., Tuscaloosa, AL 40% Money Market Account #3, Bank of Tuscaloosa (CHC) Money Market Account #4, Bank of Tuscaloosa (HCC) Money Market Account #5, Bank of Tuscaloosa (ADC) Savings Account - BFE Federal Credit Union D A A A A D A A A A A A E
None Dividend Dividend Dividend Dividend Dividend Dividend Distribution None Distribution None None K-1 Interest Interest Interest Interest
W W W U T T T T
I, Income Gain Codes: (See Columns B 1 and D4) 2. Value Codes (See Columns C I and D3) 3. Value Method Codes (See Column C2)
A =$ 1,000 or less F =$50,001 - $100.000 J =$15,000 or less N =$250,001 . $500,000 P3 =$25,000,001 - $50,000,000 Q =Appraisal U =Book Value
B =$1,001 - $2,500 G =$ 100,001 - $1,000,000 K =$15,001 . $50.000 O =$500,001 - $1,000.000 R =Cost (Real Estale Only) V ~Othcr
C =$2,501 - $5,000 H 1 =$1,000,001 - $5,000,000 L -$50,001 - $100,000 PI -$1.000,001 - $5,000,000 P4 =More than $50,000,000 S =Assessment W =Estimated
D =$5,001 - $15.000 H2 =More than $5,000,000 M =$I00,001 - $250,000 P2 =$5,000,001 - $25,000,000 T Cash Market
E =$15,001- $50,000
VII. INVESTMENTS and TRUSTS - inco,.e, valne, transactions (Includes those of spouse and dependent children; seepp. 34-60 of filing instructions.)
35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47.
Retirement Systems - State of Alabama HCKT (Personal) Rental Property No. 4 -Tuscaloosa, AL (CC) : ,.:~,,~, ........
Interest None
L J M K J
M N J
T T W U T
W T T
D O
Checking Account Compass Bank (CHC) Rental Property No. 5 (C. Creek) Tuscaloosa, AL Merril Lynch Retirement Fund ~~~
Checking Account Compass Bank (HCC)
A A A A
J J J J
T T T T
I. Income Gain Codes: (SceColumnsBlandD4) 2. Value Codes (See Columns C I and D3) 3. Value Method Codes (See Column C2)
A =$1,000 or less F=$50,001-$100,000 J =$15,000 or less N =$250,001 - $500,000 P3 =$25.000,001 - $50,000,000 Q =Appraisal U =Book Value
B =$1,001 - $2,500 G=$100,001 -$1,000.000 K =$15,001 - $50,000 O =$500,001 - $1,000,000 R =Cost (Real Eslate Only) V -Other
C =$2,501 - $5,000 HI $1,000,001-$5,000,000 L =$50,001 - $100,000 PI =$1,000,001 - $5,000,000 P4 -More than $50.000.000 S =Assessment W =Estimated
E =$15,001- $50,000
I certify that all information given above (including information pertaining to 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 ~vithheld because it met applicable statutory provisions permitting non-disclosure. I farther certify that earned income from outside employment and honoraria and the acceptance of gifts which have been reported are in compliance with the provisions of 5 U.S.C. app. 501 et. seq., 5 U.S.C. 7353, and Judicial Conference regulations.
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND W1LFULLY FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. 104)
Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544