Confidential Working Papers

3 STATEMENT OF ECONOMIC INTERESTS CHECK SCHEDULES ATTACHED: □ A 0B 0C 0D 0E 63F □ G-1 0G-2 HG-3 0H-1 □ H-2 FOR OFFICE USE NAME Lawrence Douglas Wilder OFFICE OR POSITION HELD OR SOUGHT Lieutenant Governor of Virginia CANDIDATE FOR ELECTION TO THIS OFFICE OR POSITION □ YES □ NO HOME ADDRESS STREET 3215 Hawthorne Avenue TELEPHONE OFFICE 786-2078 HOME 329-0001 CITY . , STATE ZH> _ Richmond. VA 23220 NAMES OF MEMBERS OF IMMEDIATE FAMILY 1 . OFFICES AND DIRECTORSHIPS. Are you or a member of your immediate family a paid officer or paid director of a business? If yes is checked, complete Schedule A. 2. PERSONAL LIABILITIES. Do you or a member of your immediate family owe more than $10,000 to any one creditor including contingent liabilities (except loans secured by recorded liens on property at least equal in value to the loan and debts to any government) ? If yes is checked, complete Schedule B. 3. SECURITIES. Do you or a member of your immediate family, directly or indirectly, separately or together, own securities valued in excess of $10,000 invested in one business? Be sure to account for mutual funds, limited partnerships and trusts. If yes is checked, complete Schedule C. 4. PAYMENTS FOR TALKS, MEETINGS, AND PUBLICATIONS. During the past 12 months did you receive lodging, transportation, money, or anything else of value with a combined value exceeding $200 for a single talk, meeting, or published work in your capacity as an officer or employee of your agency. If yes is checked, complete Schedule D. 5. GIFTS, TRAVEL, AND BUSINESS ENTERTAINMENT. During the past 12 months did a business, government, or individual other than a relative or personal friend furnish you with tickets to sporting events or shows, travel expenses, meals or lodging, favors, services, property, loans, money, gifts, or anything else of value, the total value of which exceeded $200 and for which you neither paid nor rendered services in exchange? Account for all business entertainment (except if related to your private profession or occupation) even if unrelated to your official duties. If yes is checked, complete Schedule E. 6. SALARY AND WAGES. List each employer that pays you or a member of your immediate family salary or wages in excess of $10,000 annually. (Exclude state or local governmental or advisory agencies.) □ YES KJ NO И □ YES NO И □ YES NO X YES □ X YES □ WILDER, _ GREGORY & MARTIN , 2509 East Broad St . , Richmond . VA 2 32 2 3 If no salary or wages, check here