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Judicial Watch • Susan H. Black – 2012

Susan H. Black – 2012

Susan H. Black – 2012

Page 1: Susan H. Black – 2012

Category:Federal Judges

Number of Pages:7

Date Created:January 3, 2014

Date Uploaded to the Library:May 22, 2014

Tags:Susan H Black, BLACK, SUSAN, university, 2012, trust, filing, spouse, transactions, Codes, reportable, reporting, report, Federal Judge, income, Judge


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Rev. 112013 
FOR CALENDAR YEAR 2012 U.S.C. opp. 101-111) Person Reporting (last name, first, middle initial) Black, Susan Court Organization U.S. Court Appeals Date Report 05/02/2013 Title (Article Ill judges indicate active senior status; magistrate judges indicate full-or part-time) Circuit Judge-Active  Sa. Report Type (check appropriate type) Nomination Date Initial [{] Annual Sb. Amended Report Final Reporting Period 01/01/2012 12/31/2012 Chambers Office Address 
300 Hogan Street 
Suite 14-150 
Jacksonville, 32202-4258 
IMPORTANT NOTES: The instructions accompanying this form must followed. Complete all parts, checking the NONE box for each part where you have reportable information. POSJTJ ONS. (Reporting individual only; see pp. 9-13 filing instructions.) NONE (No reportable positions.) 
POSITION NAME ORGANIZATION/ENTITY 

Life Ins. Trust (Part VIII) Trustee 
II. AGREEMENTS. (Reporting individual only; see pp. 14-16 filing instructions.) 
[{] NONE (No reportable agreements.) 

PARTIES AND TERMS 

Black, Susan 
05/02/2013
III. N-INVESTMENT ME. (Reporting individual and spouse; see pp. 17-24 filing instructions.) Filer's Non-Investment Income NONE (No reportable non-investment income.) 

SOURCE AND TYPE INCOME 
(yours, not spouse's) 2012 Duke University School Law-appellate practice course $4,500.00 Spouse's Non-Investment Income you were married during any portion the reporting year, complete this section.
(Dollar amount not required except for honoraria.) NONE (No reportable non-investment income.) 

SOURCE AND TYPE 2012 Self-employed president travel agency 2012 Self-employed real estate broker 
IV. REIMBURSEMENTS transportation, lodging, food, entertainment.

(Includes those spouse and dependent children; see pp. 25-27 offiling instructions.) NONE (No reportable reimbursements.) SOURCE DATES LOCATION PURPOSE ITEMS PAID PROVIDED Bar Assn Jun 21, 2012 Orlando, Speaker Meal, mileage, parking 
FLABOTA Jul 21-22, 2012 Key Biscayne, Award recipient Hotel, meal 
Federal Bar Assn Oct 25-26, 2012 Orlando, Speaker Hotel, meal, mileage, parking 

Duke University Nov 14-16, 2012 Durham, Teach Airfare, hotel 

Black, Susan 
05/02/2013 GIFTS. (Includes those spouse and dependent children; see pp. 28-31 filing instructions.) 
[{] NONE (No reportable gifts.) 
SOURCE DESCRIPTION VALUE 

VI. LIABILITIES. (Includes those spouse and dependent children; see pp. 32-33 filing instructions.)  NONE (No reportable liabilities.)  
CREDITOR  DESCRIPTION  VALUE CODE  Bank America  Mortgage-Parcel (Part VII, line Bank  Mortgage-Parcel (Part VII, line 11) 

VII. INVESTMENTS and TRUSTS -income, value, transactions r1nc1udes those spouse and dependent children; see PP 34-60 filing instructions.) NONE (No reportable income, assets, transactions.) 
Description Assets Income during Gross value end Transactions during reporting period (including trust assets) reporting period reporting period 
(2) (I) (2) (3) (4) (5) 

Place "(X)" after each asset  Amount  Type (e.g.,  Value  Value  Type (e.g.,  Date  Value  Gain  Identity  
exempt from prior disclosure  Code  div., rent,  Code  Method  buy, sell,  mm/dd/yy  Code  Code  buyer/seller  
(A-H) int.)  (J-P)  Code  redemption)  (J-P)  (A-H)  (if private Income Gain Codes:  A=$1.000or less  B=$1,00I -$2.500  c=$2.501 $5.000  D=$5.001 -$15.000  415.001 -$50,000  
(Sec Columns and 04)  F=$50.00I -$I 00.000 I00.001 -$1.000.000 =$1.000.001 -$5.000.000  ll2 =More than $5.000.000 Value Codes =$15.000 Jess =$15,001 $50.000  L=$50.00I I00.000 =$I 00.00 -$250.000  
(See Columns and 03)  N=$250.00I -$500.000  0=$500.00I -$1.000.000  Pl=$1.000.001 -$5.000.000 =$5.000.001 -$25.000.000  
P3=$25.000.001 -$50.000.000 =More than $50.000.000 Value Method Codes (Sec Column C2) =Appraisal =Book Value =Cost (Real Estate Only) V=Othcr =Assessment =Estimated =Cash Market  

Black, Susan 
05/02/2013
VII. INVESTMENTS and TRUSTS income, vatue, transactions r1nc1udes those spouse and dependent children; see PP 34-60 filing instructions.) NONE (No reportable income, assets, transactions.)  
Description Assets  Income during  Gross value end  Transactions during reporting period  
(including trust assets)  reporting period reporting period  

(I) (2) (I) (2) (I) (2) (3) 
(5) Income Gain Codes: =$1.000 orless =$1,001  $2.500  c=$2.501  $5.000  0=$5.001-$15.000  E=$15.00l -$50.000  
(Sec Columns and 04)  F=$50.00I -$I 00.000 =$100.001 -$1.000.000  Ill =$1.000.001  $5.000.000  ll2 =More than $5.000.000 Value Codes  J=$15.000or lcss  K=$15,001-$50.000  L=$50.001-$100.000 =$100.001 -$250.000  
(See Columns and 03)  N=$250.001 -$500.000 =$500.00I -$1.000.000 =$1.000.001 -$5.000.000  P2=$5.000.001 -$25,000.000 =$25.000.001 -$50.000.000 =More than $50.000.000 Value Method Codes =Appraisal =Cost (Real Estate ly) =Assessment =Cash Market  
(Sec Column C2) =Book Value =Other  W=Estimated  

Date Report 
Name Person Reporting 05/02/2013
Black, Susan
VIII. ADDITIONAL INFORMATION EXPLANATIONS. (lndicate part ofreport.) 

Part I- 
Life Insurance Trust -not listed Part VII, unfunded trust. 

Black, Susan 
05/02/2013
IX. CERTIFICATION. certify that all information given above (including information pertaining spouse and minor dependent children, any) accurate, true, and complete the best knowledge and belief, and that any information not reported was withheld because met applicable statutory provisions permitting non-disclosure. further certify that earned income from outside employment and honoraria and the acceptance gifts which have been reported are compliance with the provisions U.S.C. app.  501 et. seq., U.S.C.  7353, and Judicial Conference regulations. 

Signature: Susan Black 
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILLFULLY FALSIFIES FAILS FILE THIS REPORT MAY SUBJECT CIVIL AND CRIMINAL SANCTIONS U.S.C. app.  104) 

Committee Financial Disclosure Administrative Office the United States Courts Suite 2-301 One Columbus Circle, N.E.