‘STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS RHODE ISLAND ETHICS COMMISSION 40 Fountain Street Providence, RI 02903 (401) 222-3790 (Voice/TT) Fax Number: 222-3382 May 25, 2006 Gerald v. Riker PO Box 1655 Block island, RI 02807 Dear Mr. Riker: Your Yearly Financial Statement covering calendar year 2005 (05 FS-1) is returned to you because of the following deficiencies ‘Statement Not Signed. Statement Not Notarized. All Questions Not Answered. Other. Financial Statements must be signed and notarized before they are accepted for filing by this office. All questions must be answered, and if necessary "None or Not Applicable" may be used. Please return the form within ten (10) days. Please be aware that any Financial Statements not meeting the above criteria will not be returned to you again and will n . Please call the office if you have any questions. Thank you for your cooperation. Si ot A (Xner Kent A. Willever Executive Director KAW:Ip04 FS-1 Se Bade Island Ethie Ge 2004 YEARLY FINANCIAL STATEMENT r | L 4 ALL QUESTIONS REFER TO THE CALENDAR YEAR JANUARY 1, 2004 THROUGH DECEMBER 31, 2004 UNLESS OTHERWISE SPECIFIED. ‘Please answer all questions and’ whare your answer 1s “fone” or “not applicable" go 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: The failure to file a Yearly Financial Statement by a state or municipal elected or appointed official is a violation of the law and may subject the official to penalties, including fines. If you received a 2004 Yearly Financial Statement in the mail but believe you were not a state or municipal elected or appointed official in 2004 or 2005 _ Ey pn ran at gt es By Sng ker ole @2 Block Zslaxo eOZHOT ok Mal S$ 3._ List Public Office(s) you hold and governmental unit: a : (WORTGIPALTY, STATE-OR REGIOWACY Iwas elected in@2BS | was appointed in 2D>S (year) ‘vear) Ifyou no longer hold office, state year of termination or resignation. 4. List elected office(s) for which you were/are a candidate in elther calendar year 2004 or 2005 (Read instruction #4) 5._ List the following: NAME OF SPOUSE NAME(S) OF DEPENDENT CHILD OR CHILDREN6. List the names of any employer from which you, your spouse, or dependent child received $1,000 or more gross income during calendar year 2004. If self-employed, list any occupation from which $1,000 or more gross income was received. if employed by a state or municipal agency, or if self-employed and services were rendered to a state or municipal agency for an amount of income in excess of $250.00, list the date and nature of services rendered. Ifthe public office or employment listed in #3, above, provides you with an amount of gross income in excess of $250.00 it must be listed here. (Do Not List Amounts.) NAME OF FAMILY NAME AND ADDRESS: DATES AND NATURE MEMBER EMPLOYED (OF EMPLOYER OR OCCUPATION OF SERVICES RENDERED — the address or legal description of any real estate, other than your principal residence, in which you, your spouse, or dependent child had a financial interest. NAMES NATURE OF INTEREST ‘ADDRESS OR DESCRIPTION 8. List the name of any trust, name and address of the trustee of any trust, from which you, your spouse, or dependent child or children individually received $1,000 or more gross income. List assets if known. (Do Not List Amounts.) NAME OF TRUST: - NAME OF TRUSTEE AND ADDRESS: NAME OF FAMILY MEMBER RECEIVING TRUST INCOME: ASSETS: 9. List the name and address of any business, profit or non-profit, in which you, your spouse, or dependent child held a position as a director, officer, partner, trustee, or a management position. NAME OF FAMILY MEMBER NAME AND ADDRESS OF BUSINESS POSITION