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POSIT! ONS. (Reporting individual only; see pp. 9-13 filing instructions.) 
[{] NONE (No reportable positions.) 
POSITION NAME ORGANIZATION/ENTITY 
 
 
II. AGREEMENTS. (Reporting individual only; see pp. 14-16 filing instructions.) NONE (No reportable agreements.) 
 
PAR TIES AND TERMS 2010 Arizona Elected Officials Retirment Plan, control 
 
Date Report 
04/25/2012 
Jorgenson, Cindy 
III. N-INVESTMENT ME. (Reporting individual and spouse; see pp. 17-14 filing instructions.) Filers Non-Investment Income NONE (No reportable non-investment income.) 
 
 SOURCE AND TYPE INCOME 
(yours, not spouses) 2011 Arizona Elected Officials Retirement Plan $25,194.00 Spouses Non-Investment Income -If 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 2011 Arizona Public Safety Retirement System (Retired) 2011 Arizona State Retirement System 
 
IV. REIMBURSEMENTS -transportation, lodging, food, entertainmenL 
(Includes those spouse and dependent children; see pp. 25-27 filing instructions.) [{] NONE (No reportable reimbursements.) SOURCE DATES LOCATION PURPOSE ITEMS PAID PROVIDED GIFTS. (Includes those spouse and dependent children; see pp. 28-31 filing instructions.) [Z] NONE (No reportable gifts.) SOURCE DESCRIPTION VALUE 
 
 
VI. LIABILITIES. (Includes those spouse and dependent children; see pp. 32-33 filing instructions.) 
[Z] 	NONE (No reportable liabilities.) CREDITOR DESCRIPTION VALUE CODE 
 
 
Date Report 
04/25/2012 
Jorgenson, Cindy 
VII. INVESTMENTS and TRUSTS -income, value, rransacrions r1nc1udes 11rose spouse and dependent children; see PP. 34-60 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) (2) (2) (3) 
(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, Code2 Method buy, sell, mm/dd/yy Code2 Code buyer/seller 
(A-H) int.) (J-P) Code redemption) (J-P) (A-H) (if private 
(Q-W) transaction) Income Gain Codes: =$1,000 less B=$1.00t -$2.500 =$2.501  $5.000 D=$5.00t -$15.000 =$15.001 -$50.000 
(Sec Columns and D4) =$50.001 -$100.000 =$100.001 -$1.000.000 Ill =$1.000,001 -$5.000.000 112 =More than $5.000.000 Value Codes =$15.000 less =$15.001 -$50.000 =$50.00I -$I 00.000 =$100.00 -$250.000 
(Sec Columns and DJ) =$250.00 -$500.000 =$500.00 -$1.000.000 =$1.000.001 -$5.000.000 =$5,000.001 -$25.000,000 =$25.000.001  $50.000.000 =More than $50.000.000 Value Method Codes =Appraisal =Cost (Real Estate Only) =Assessment =Cash Market 
(Sec Column C2) =Book Value V:oOthcr =Estimated 
 
 
Date Report 
0412512012 
Jorgenson, Cindy 
VIII. ADDITIONAL INFORMATION EXPLANATIONS. (lndicalepartofreport.) 
Date Report 
Jorgenson, Cindy 
04/25/2012 
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 ct. seq., U.S.C.  7353, and Judicial Conference regulations. 
Signature: Cindy Jorgenson 
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. Washington, D.C. 20544