-
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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-
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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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&)53DUW862IILFHRI*RYHUQPHQW(WKLFV
a nya nya nya ny t imet imet imet ime
ExcludeExcludeExcludeExclude
****
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
-RKQ-RQHV:DVKLQJWRQ'&
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
&)53DUW862IILFHRI*RYHUQPHQW(WKLFV
-RKQ-RQHV:DVKLQJWRQ'&
2*()RUP5HY
Carleton S. Fiorina1of 2
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
&)53DUW862IILFHRI*RYHUQPHQW(WKLFV
-RKQ-RQHV:DVKLQJWRQ'&
2*()RUP5HY
Carleton S. Fiorina2of 2
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