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STATEMENT OF\' 2009 I
FINANCIAL INTERESTSFORM 1
Please print or type your name, mailing
address, agency name, and position below:LAST NAME FIRST NAME MIDDLE NAME :DEARMONDPAULFOR OFFICE
USE ONLY:DETAILING
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How to fill out statement of 2009 -i
01
Obtain a copy of the Statement of 2009 -i form.
02
Fill in your personal information accurately, including name, address, and contact information.
03
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04
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Who needs statement of 2009 -i?
01
Individuals who are required to report their financial information for a specific purpose.
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