Due By April 28, 2006 a 4 MICHAEL J ALLEN 12 SHADY BROOK CIRCLE MANVILLE RI 02838 Lu oe ALL QUESTIONS REFER TO THE CALENDAR YEAR JANUARY 1, 2005 THROUGH DECEMBER 31, 2005 UNLESS OTHERWISE SPECIFIED. Please answer all questions and where your answer Is “none” of “not applicable" so state. ANSWERS SHOULD BE PRINTED OR TYPED, and additional sheets may be used if more space is needed. For clarification of any question, read instruction sheet. Note: Ifyou are a state or municipal official or employee that is required to file a Yearly Financial Statement, a failure to file the Statement is a violation of the law and may subject you to substantial penalties, including fines. If you received a 2005 Yearly Financial Statement in the mail but believe you did not hold a public position in 2005 or 2006 that requires such filing, you should contact the Ethics Commission (See Instruction Sheet for ‘contact information). 1, Webbe L. ALLcen) MICHhEl T. imeororen oa an Fan 2 1a Savy Choo Croce Mawur.é KIO 020629 | mone ery among acy | Same hd 4. UstPublc Poston) you hold and governmental unt: q ee Lebron Fave Desrecer ele eee |was elected ne200 7 1 was appointed in “/™ Iwas ren AVA, (year) (year) ar) If you no longer hold a public position, state year of termination or resignation Me 4. List elected office(s) for which you were/are a candidate in either calendar year 2005 or 2006 (Read instruction #4) Cane: Cévecreo) Fare Atezo) Fite Ursrecer Ompazssuee 5. Ustthe folowing: NAME OF SPOUSE NAME(S) OF DEPENDENT CHILD OR CHILDREN KALEH) “YA BeNouisod SS3NISNE 40 SS3OQY ANY SYN BEWAN Aun 40 30ON Uuonisod ueweBeuew e Jo ‘eaysny ‘ieujed ‘se0Wyo ‘JoyNeup & se UOHIsod & Piey pilyo jepuadap 40 ‘asnods unos ‘nok yoiy ut woud-uoU Jo woud ‘sseulsng Aue Jo Sselppe pue eWeU ays] “6 | siassv "SOON! 1SMLL ONIAIBORY ‘UBQMSH ATINVS 40 50eN JALSTRLL 40 SYN, me (-sjunowy ¥81730N 0) ‘umoUY 11 sjasse 1577 “eLICOU! ss048 @10U JO QDD'LS PeAleoe AenPIAIpU! UAUPIIYD 40 py uapuadep 40 ‘esnods snoA ‘nof yorum wos "sn Aue Jo sajsny ey} Jo sseuppe pue eweu sn Aue Jo eWEU exp IST] “e apa Noudiosaa wo sssuaay ASSRSNI 4O SUNLYN sawn {3s829]u! eloueuy e pey pilys juepusdep 10 ‘esnods 4nof ‘nok yoy Ul ‘eouepises fediouud snok ueY) Jeyjo ‘e}e}se Jea1 Aue Jo uONduosEp jeBa| 10 SSeIpPe ay IST “L t, ans 2200 O 29 Laarescoo : MOE ay Bet THD SOP (1279) y EY (so 930 —50 10) sa wordy ener a me LUAEZG ait oVeza (277% SD 726 Moz TeOKOS Foes wees 71K LL 7-BUHOEU Suri one Salve ‘saucy anv orn sAns50 aN (-sunoury ys11 30N oq) “e1ey pe}si] 9q ysnwu 31 OO‘OSz J0 Sse0xE Ul atuoou $s046 Jo ]UNOWE UB YAM NOK sepIAOud ‘anoge ‘E# Ul PeIS1| 1UALUKO|duIS J0 UORISod syjgnd eu) J ‘PasePUaL Seoyues Jo aunjeu puE eleP suf ISH ‘00'0SZ$ JO $S80xe UI euNCOU! Jo yUNOWE Ue 10} AoUaGe jedjolUNU 40 B}eIS © 0} paiepue) a1em seolies pue pafo|diieses 4! 10 ‘Aouabe fedioluNU 40 24S Aq peko\dwE j| ‘panigoel sem ‘@uoou! $s016 @10LU JO 9O0'L$ YoU Wo Uo¥ednoo0 Aue ySI| ‘pefo|dwe-sfes 41 “G00 JeeA sepue|eD BuLINp swooUl 8016 a10U 10 990'Lg Penle0a1 pio 1wapuadep Jo ‘asnods sno ‘nok YoIYM Wod) JOKO|dWe Aue Jo SCWEU OlB IST “910. List the name and address of any interested person, or business entity, that made total gifts or total contributions in excess of $100 in cash or property during calendar year 2005 to you, your spouse, or dependent child. Certain aifts from relatives and certain campaign contributions are excluded, (See instruction #10) NAME OF PERSON RECEIVING [NAME AND ADDRESS OF PERSON OR ENTITY GIFT OR CONTRIBUTION MAKING GIFT OR CONTRIBUTION POUS 11. List the name and address of any business in which you, your spouse, or dependent child individually or collectively holds a 10% or greater ownership interest, or a $5,000 or greater ownership or investment interest. NAME OF FAMILY MEMBER NAME AND ADDRESS OF BUSINESS Lowe 12. If any business listed in #11, above, did business in excess of a total of $260 in calendar year 2005 with a state or Municipal agency, AND you are a member or employee of the agency or exercise direct or legislative control over the agency, list the following: NAME AND ADDRESS (OF BUSINESS DATE AND NATURE (OF TRANSACTION / 13. If any business listed in #11, above, was a business entity subje: agency, and you are a member or employee of the agency or exerci list the following {gulation by a state or municipal gislative control over the agency, NAME AND ADDRESS OF BUSINESS Jathe OF REGULATING AGENCY