carleton s. fiorina pfd final

Form Approved:2*()RUP5HY Executive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORTExecutive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORTExecutive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORTExecutive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORTExecutive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORT OMB No. 3209 - 0001&)53DUW

862IILFHRI*RYHUQPHQW(WKLFV

OGE Use On l y

Agency Use On ly

Use OnlyUse OnlyUse OnlyUse Only E th i c sE th i c sE th i c sE th i c sttttGovernmenGovernmenGovernmenGovernmenffffooooeeeeOf f i cOf f i cOf f i cOf f i c

Fee for Late Fi l ingFee for Late Fi l ingFee for Late Fi l ingFee for Late Fi l ing

t w ot w ot w oDDDDScheduleScheduleScheduleSchedule

Schedule C, Part I ISchedule C, Part I ISchedule C, Part I ISchedule C, Part I I

Schedule C, Part ISchedule C, Part ISchedule C, Part ISchedule C, Part I

ScheduleSchedule BSchedule BSchedule B

ScheduleSchedule ASchedule ASchedule A

Vice Pres ident :Vice Pres ident :Vice Pres ident :Vice Pres ident :Candidates for Pres ident andCandidates for Pres ident andCandidates for Pres ident andCandidates for Pres ident andNominees , New Entrants andNominees , New Entrants andNominees , New Entrants andNominees , New Entrants and

Terminat ion F i lersTerminat ion F i lersTerminat ion F i lersTerminat ion F i lers

IncumbentsIncumbentsIncumbentsIncumbentsReporting PeriodsReporting PeriodsReporting PeriodsReporting Periods

Agency Ethics Official's OpinionAgency Ethics Official's OpinionAgency Ethics Official's OpinionAgency Ethics Official's Opinion

S ta tusS ta tusS ta tusS ta tusReport ingReport ingReport ingReport ing

to Sena te Conf i rmat i onto Sena te Conf i rmat i onto Sena te Conf i rmat i onto Sena te Conf i rmat i onPres ident i a l Nominees Sub j ec tPre s ident i a l Nominees Sub j ec tPre s ident i a l Nominees Sub j ec tPre s ident i a l Nominees Sub j ec t

Present Off icePresent Off icePresent Off icePresent Off iceLocation ofLocation ofLocation ofLocation of

F i l ingFi l ingFi l ingFi l ingPosit ion for WhichPosit ion for WhichPosit ion for WhichPosit ion for Which

Individual 's NameIndividual 's NameIndividual 's NameIndividual 's NameReport ingReport ingReport ingReport ing

agency)agency)agency)agency)(If desired by(If desired by(If desired by(If desired byOther ReviewOther ReviewOther ReviewOther Review

CertificationCertificationCertificationCertification

Agency Use On lyAgency Use On lyAgency Use On lyAgency Use On ly

OGE Use On l yOGE Use On l yOGE Use On l yOGE Use On l y

Date of Appointment, Candidacy, Election, or Nomination(Month, Day, Year)

Report ing S ta tus (Check Appropriate Boxes)

Incumbent Calendar Year Covered by Report

New Entrant, Nominee, or Candidate

Termination Filer

Termination Date( If Appli-cable) (Month, Day, Year)

Report ing Individual 's Name

Last Name First Name and Middle Initial

Posit ion for Which F i l ing

Title of Position Department or Agency (If Applicable)

Locat ion of Present Off ice (or forwarding address)

Address (Number, Street, City, State , and ZIP Code) Telephone No. (Include Area Code)

Position(s) Held with the Federal Government During the Preceding 12 Months (If Not Same as Above)

Title of Position(s) and Date(s) Held

Pre s ident i a l Nominees Sub j ec t t o Sena te Conf i rmat i on

Name of Congressional Committee Considering Nomination Do You Intend to Create a Qualified Diversified Trust?

Yes No

Certification

I CERTIFY that the statements I have made on this form and all attached schedules are true, complete and correct to the best of my knowledge.

Signature of Reporting Individual Date (Month, Day, Year)

Other Review (If desired by

agency)

Signature of Other Reviewer Date (Month, Day, Year)

Agency Ethics Official's Opinion

On the basis of information contained in this report, I conclude that the filer is in compliance with applicable laws and regulations (subject to any comments in the box below).

Signature of Designated Agency Ethics Official/Reviewing Official Date (Month, Day, Year)

O f f i ce of Government E th i c s Use Only

Signature Date (Month, Day, Year)

Fee for Late Fi l ing 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 filed, or, if an extension is granted, more than 30 days after the last day of the filing extension period, shall be subject to a $200 fee.

Reporting Periods Incumbents: The reporting period is the preceding calendar year except Part II of Schedule C and Part I of Schedule D where you must also include the filing year up to the date you file. Part II of Schedule D is not applicable.

Terminat ion F i lers: The reporting period begins at the end of the period covered by your previous filing and ends at the date of termination. Part II of Schedule D is not applicable.

Nominees , New Entrants and Candidates for Pres ident and Vice Pres ident :

Schedule AA--The reporting period for income (BLOCK C) is the preceding calendar year and the current calendar year up to the date of filing. Value assets as of any date you choose that is within 31 days of the date of filing.

Schedule BB--Not applicable.

Schedule C, Part I (Liabilities)--The reporting period is the preceding calendar year and the current calendar year up to any date you choose that is within 31 days of the date of filing.

Schedule C, Part I I (Agreements or Arrangements)--Show any agreements or arrangements as of the date of filing.

Schedule D --The reporting period is the preceding t w ot w o calendar years and the current calendar year up to the date of filing.

Comments of Reviewing Officials (If additional space is required, use the reverse side of this sheet)

(Check box if filing extension granted & indicate number of days )

(Check box if comments are continued on the reverse side)

6XSHUVHGHV3ULRU(GLWLRQV

5-4-2015

Fiorina Carleton S.

Presidential Candidate

1020 N. Fairfax St. Alexandria, VA 22314 (571) 257-7050

Not Applicable

2*()RUP5HY&)53DUW862IILFHRI*RYHUQPHQW(WKLFV

****

*** **** *

AmountAmountAmountAmountTypeTypeTypeType

IncomeIncomeIncomeIncomeandandandandAssetsAssetsAssetsAssets Income:Income:Income:Income:AssetsAssetsAssetsAssetso fo fo fo fValuationValuationValuationValuation

SCHEDULE ASCHEDULE ASCHEDULE ASCHEDULE ASCHEDULE A Page NumberReporting Individual's Name

Assets and Income

BLOCK A

For you, your spouse, and dependent children, report each asset held for investment or the production of income which had a fair market value exceeding $1,000 at the close of the report-ing period, or which generated more than $200 in income during the reporting period, together with such income.

For yourself, also report the source and actual amount of earned income exceeding $200 (other than from the U.S. Government). For your spouse, report the source but not the amount of earned income of more than $1,000 (except report the actual amount of any honoraria over $200 of your spouse).

None

Valuation o f Assets at close of reporting period

BLOCK B

Non

e (o

r le

ss t

han

$1,0

01)

$1,0

01 -

$15,0

00

$15,0

01 -

$50,0

00

$50,0

01 -

$100,0

00

$100,0

01 -

$250,0

00

$250,0

01 -

$500,0

00

$500,0

01 -

$1,0

00,0

00

Ove

r $1,0

00,0

00*

$1,0

00,0

01 -

$5,0

00,0

00

$5,0

00,0

01 -

$25,0

00,0

00

$25,0

00,0

01 -

$50,0

00,0

00

Ove

r $50,0

00,0

00

Exce

pte

d I

nve

stm

ent

Fun

d

Exce

pte

d T

rust

Qu

alif

ied

Tru

st

Income: type and amount. If None (or less than $201) is checked, no other entry is needed in Block C for that item.

BLOCK C

Type

Div

iden

ds

Ren

t an

d R

oyal

ties

Inte

rest

Cap

ital

Gai

ns

Amount

Non

e (o

r le

ss t

han

$201)

$201 -

$1,0

00

$1,0

01 -

$2,5

00

$2,5

01 -

$5,0

00

$5,0

01 -

$15,0

00

$15,0

01 -

$50,0

00

$50,0

01 -

$100,0

00

$100,0

01 -

$1,0

00,0

00

Ove

r $1,0

00,0

00*

$1,0

00,0

01 -

$5,0

00,0

00

Ove

r $5,0

00,0

00

Other Income (Specify Type & Actual

Amount)

Date (Mo., Day,

Yr.)

Only if Honoraria

Examples

Central Airlines Common x x x

Doe Jones & Smith, Hometown, State x Law Partnership Income $130,000

Kempstone Equity Fund x x x

IRA: Heartland 500 Index Fund x x x

1

2

3

4

5

6

* This category applies only if the asset/income is solely that of the filer's 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.

2of,

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2*()RUP5HY &)53DUW Do not complete Schedule B if you are a new entrant, nominee, or Vice Presidential or Presidential Candidate 862IILFHRI*RYHUQPHQW(WKLFV

*

****

Part II: Gifts, Reimbursements, and Travel ExpensesPart II: Gifts, Reimbursements, and Travel ExpensesPart II: Gifts, Reimbursements, and Travel ExpensesPart II: Gifts, Reimbursements, and Travel Expenses

SCHEDULE BSCHEDULE BSCHEDULE BSCHEDULE B

***

Part I: TransactionsPart I: TransactionsPart I: TransactionsPart I: Transactions

SCHEDULE B Page NumberReporting Individual's Name

Part I: Transactions Report any purchase, sale, or exchange by you, your spouse, or dependent children during the reporting period of any real property, stocks, bonds, commodity futures, and other securities when the amount of the transaction exceeded $1,000. Include transactions that resulted in a loss.

Do not report a transaction involving property used solely as your personal residence, or a transaction solely between you, your spouse, or dependent child. Check the Certificate of divestiture block to indicate sales made pursuant to a certificate of divestiture from OGE.

None

Identification of Assets

Transaction Type (x)

Purc

hase

Sale

Exch

ange

Date (Mo., Day, Yr.)

Amount of Transaction (x)

$1,0

01 -

$15,0

00

$15,0

01 -

$50,0

00

$50,0

01 -

$100,0

00

$100,0

01 -

$250,0

00

$250,0

01 -

$500,0

00

$500,0

01 -

$1,0

00,0

00

Ove

r$1,0

00,0

00*

$1,0

00,0

01 -

$5,0

00,0

00

$5,0

00,0

01 -

$25,0

00,0

00

$25,0

00,0

01 -

$50,0

00,0

00

Ove

r$50,0

00,0

00

Cer

tifi

cate

of

div

esti

ture

Example Central Airlines Common x 2/1/99 x

1

2

3

4

5

*This category applies only if the underlying asset is solely that of the filer's 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

None

Source (Name and Address) Brief Description Value

Examples Nat'l Assn. of Rock Collectors, NY, NY Airline ticket, hotel room & meals incident to national conference 6/15/99 (personal activity unrelated to duty) $500

Frank Jones, San Francisco, CA Leather briefcase (personal friend)

1

2

3

4

5

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SCHEDULE CSCHEDULE CSCHEDULE CSCHEDULE C

PartPartPartPart I :I :I :I : LiabilitiesLiabilitiesLiabilitiesLiabilities

Part II: Agreements or ArrangementsPart II: Agreements or ArrangementsPart II: Agreements or ArrangementsPart II: Agreements or Arrangements

****

SCHEDULE C Reporting Individual's Name Page Number

Part I : Liabilities Report liabilities over $10,000 owed to any one creditor at a ny t ime during the reporting period by you, your spouse, or dependent children. Check the highest amount owed during the reporting period. Exclude

a mortgage on your personal residence unless it is rented out; loans secured by automobiles, household furniture or appliances; and liabilities owed to certain relatives listed in instructions. See instructions for revolving charge accounts.

None

Creditors (Name and Address) Type of Liability Date Incurred

Interest Rate

Term if applicable

Category of Amount or Value (x)

$10,0

01 -

$15,0

00

$15,0

01 -

$50,0

00

$50,0

01 -

$100,0

00

$100,0

01-

$250,0

00

$250,0

01 -

$500,0

00

$500,0

01 -

$1,0

00,0

00

Ove

r$1,0

00,0

00

*

$1,0

00,0

01-

$5,0

00,0

00

$5,0

00,0

01 -

$25,0

00,0

00

$25,0

00,0

01 -

$50,0

00,0

00

Ove

r$50,0

00,0

00

Examples First District Bank, Washington, DC Mortgage on rental property, Delaware 1991 8% 25 yrs. x

Promissory note 1999 10% on demand x

1

2

3

4

5

*This category applies only if the liability is solely that of the filer's 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 Arrangements Report your agreements or arrangements for: (1) continuing participation in an employee benefit plan (e.g. pension, 401k, deferred compensation); (2) continua-tion of payment by a former employer (including severance payments); (3) leaves

of absence; and (4) future employment. See instructions regarding the report-ing of negotiations for any of these arrangements or benefits. None

Status and Terms of any Agreement or Arrangement Parties Date

Example Pursuant to partnership agreement, will receive lump sum payment of capital account & partnership share calculated on service performed through 1/00.

Doe Jones & Smith, Hometown, State 7/85

1

2

3

4

5

6

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2*()RUP5HY

Carleton S. Fiorina1of 1

See note 22

Agreement to deliver speech for YPO-Twin Cities (See note 23) Worldwide Speakers Group, Miami Beach, FL10/15

Agreement to deliver speech for AT&T (See note 23) Worldwide Speakers Group, Dallas, TX10/15

(S) AT&T deferred compensation AT&T, Dallas, TX8/98

(S) Pension AT&T, Dallas, TX8/98

SCHEDULE DSCHEDULE DSCHEDULE DSCHEDULE D

ParParParPart t t t I :I :I :I : PositionPositionPositionPositions s s s HelHelHelHeld d d d OutsidOutsidOutsidOutside e e e U.SU.SU.SU.S.... Government Government Government Government Exclude Exclude Exclude Exclude

Do not complete this part i f you are anDo not complete this part i f you are anDo not complete this part i f you are anDo not complete this part i f you are an Incumbent, Termination Fi ler, or ViceIncumbent, Termination Fi ler, or ViceIncumbent, Termination Fi ler, or ViceIncumbent, Termination Fi ler, or Vice Presidential or Presidential Candidate.Presidential or Presidential Candidate.Presidential or Presidential Candidate.Presidential or Presidential Candidate.

PartPartPartPart II :II :II :II : CompensatioCompensatioCompensatioCompensationnnn in in in in ExcessExcessExcessExcess ofofofof $5,000$5,000$5,000$5,000 PaiPaiPaiPaidddd by by by by OneOneOneOne SourceSourceSourceSource

SCHEDULE D Reporting Individual's Name Page Number

Part I : Positions Held Outside U.S. Government Report any positions held during the applicable reporting period, whether compen-sated or not. Positions include but are not limited to those of an officer, director, trustee, general partner, proprietor, representative, employee, or consultant of any corporation, firm, partnership, or other business enterprise or any non-profit

organization or educational institution. Exclude positions with religious, social, fraternal, or political entities and those solely of an honorary nature.

None

Organization (Name and Address) Type of Organization Position Held From (Mo., Yr.) To (Mo.,Yr.)

Examples Nat'l Assn. of Rock Collectors, NY, NY Non-profit education President 6/92 Present

Doe Jones & Smith, Hometown, State Law firm Partner 7/85 1/00

1

2

3

4

5

6

Part II : Compensation in Excess of $5,000 Paid by One Source Do not complete this part i f you are an Incumbent, Termination Fi ler, or Vice Presidential or Presidential Candidate.Report sources of more than $5,000 compensation received by you or your

business affiliation for services provided directly by you during any one year of the reporting period. This includes the names of clients and customers of any corporation, firm, partnership, or other business enterprise, or any other

non-profit organization when you directly provided the services generating a fee or payment of more than $5,000. You need not report the U.S. Government as a source. None

Source (Name and Address) Brief Description of Duties

Examples Doe Jones & Smith, Hometown, State Legal services

Metro University (client of Doe Jones & Smith), Moneytown, State Legal services in connection with university construction

1

2

3

4

5

6

2*()RUP5HY

American Conservative Union Non-profit Board of Directors 2/12 5/15

American Conservative Union Foundation Non-profit Chairman 9/13 5/15

Americans for Economic Freedom Non-profit Advisory Board 3/14 Present

Center for Strategic and International Studies Non-profit Sr Advisor; Leadership Co-Chair 5/12 Present

Good360 Non-profit Chairman 4/12 5/15

Initiative for Global Development Non-profit Board of Directors 2/07 12/14

SCHEDULE DSCHEDULE DSCHEDULE DSCHEDULE D

ParParParPart t t t I :I :I :I : PositionPositionPositionPositions s s s HelHelHelHeld d d d OutsidOutsidOutsidOutside e e e U.SU.SU.SU.S.... Government Government Government Government Exclude Exclude Exclude Exclude

Do not complete this part i f you are anDo not complete this part i f you are anDo not complete this part i f you are anDo not complete this part i f you are an Incumbent, Termination Fi ler, or ViceIncumbent, Termination Fi ler, or ViceIncumbent, Termination Fi ler, or ViceIncumbent, Termination Fi ler, or Vice Presidential or Presidential Candidate.Presidential or Presidential Candidate.Presidential or Presidential Candidate.Presidential or Presidential Candidate.

PartPartPartPart II :II :II :II : CompensatioCompensatioCompensatioCompensationnnn in in in in ExcessExcessExcessExcess ofofofof $5,000$5,000$5,000$5,000 PaiPaiPaiPaidddd by by by by OneOneOneOne SourceSourceSourceSource

SCHEDULE D Reporting Individual's Name Page Number

Part I : Positions Held Outside U.S. Government Report any positions held during the applicable reporting period, whether compen-sated or not. Positions include but are not limited to those of an officer, director, trustee, general partner, proprietor, representative, employee, or consultant of any corporation, firm, partnership, or other business enterprise or any non-profit

organization or educational institution. Exclude positions with religious, social, fraternal, or political entities and those solely of an honorary nature.

None

Organization (Name and Address) Type of Organization Position Held From (Mo., Yr.) To (Mo.,Yr.)

Examples Nat'l Assn. of Rock Collectors, NY, NY Non-profit education President 6/92 Present

Doe Jones & Smith, Hometown, State Law firm Partner 7/85 1/00

1

2

3

4

5

6

Part II : Compensation in Excess of $5,000 Paid by One Source Do not complete this part i f you are an Incumbent, Termination Fi ler, or Vice Presidential or Presidential Candidate.Report sources of more than $5,000 compensation received by you or your

business affiliation for services provided directly by you during any one year of the reporting period. This includes the names of clients and customers of any corporation, firm, partnership, or other business enterprise, or any other

non-profit organization when you directly provided the services generating a fee or payment of more than $5,000. You need not report the U.S. Government as a source. None

Source (Name and Address) Brief Description of Duties

Examples Doe Jones & Smith, Hometown, State Legal services

Metro University (client of Doe Jones & Smith), Moneytown, State Legal services in connection with university construction

1

2

3

4

5

6

2*()RUP5HY

Opportunity International Non-profit Board of Directors 2/13 6/14

Opportunity International Non-profit Global Chair 6/14 5/15

Zurich International Non-profit Global Advisory Council 9/12 5/15

James Madison University Non-profit Vice-Rector of the Board of Visitors 7/12 3/15

George Washington Medical Faculty Associates Non-profit Member of the Board 2/13 5/15

CARLETON S. FIORINA

Notes to OGE Form 278 Note 1: Except as otherwise noted, all the assets listed in Schedule A are jointly held by Carleton S. Fiorina and Frank Fiorina (collectively, the Reporting Parties). Note 2: This item reflects the sale of call options for Hewlett-Packard Company (HPQ) common stock. The expiration dates and strike prices of these options varied throughout the reporting period. They were sold on the open market before their expiration. Note 3: This item reflects the sale of put options based on the S&P 500 Index. The expiration dates and strike prices of these options varied throughout the reporting period. They were sold on the open market before their expiration. Note 4: The interest in the Carleton Fiorina IRA is held by Mrs. Fiorina individually. Note 5: The interest in the Frank Fiorina IRA is held by Frank Fiorina individually. Note 6: The Reporting Parties have requested information about underlying holdings of this investment and the value and income amounts for these underlying holdings. However, the investment advisors have informed the Reporting Parties that this item annuity is on a cash payout schedule that is not currently supported by underlying investment positions. Note 7: Mrs. Fiorina serves on the Board of Trustees of Medical Faculty Associates, Inc. This position is disclosed separately in Schedule D, Part I as the George Washington Medical Faculty Associates. Note 8: For Energy Investment Opportunities Onshore Fund LLC Class A3 Series 1, the total asset value is reported as of May 28, 2015, which is the most recent date for which such information is available to the Reporting Parties. The Reporting Parties have requested information about underlying holdings of this investment and the value and income amounts for these underlying holdings. However, the fund managers have informed the Reporting Parties that this information has not yet been made available to any investor, and have declined to provide such information. Note 9: For Distressed Managers IV LP (c), the total asset value is reported as of May 28, 2015, which is the most recent date for which such information is available to the Reporting Parties. The total

income amount for this investment is as of March 31, 2015, which is the most recent date for which such information is available to the Reporting Parties. The Reporting Parties have requested information about underlying holdings of this investment and the value and income amounts for these underlying holdings. However, the fund managers have informed the Reporting Parties that this information is confidential and proprietary, and have declined to provide such information. Note 10: For Private Equity Managers (Concentrated) LP (c), the total asset value is reported as of May 28, 2015, which is the most recent date for which such information is available to the Reporting Parties. The total income amount for this investment is as of March 31, 2015, which is the most recent date for which such information is available to the Reporting Parties. The Reporting Parties have requested information about underlying holdings of this investment and the value and income amounts for these underlying holdings. However, the fund managers have informed the Reporting Parties that this

carleton s. fiorina pfd final

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