1. ooEFonn278(Rev.o9/2oJo)
5 C.F.R. Part 2634
Executive Branch Personnel PUBLIC FINANCIAL DISCLOSURE REPORT Form Approved:
OMB No. 3209- 0001
U.S. Office of Government Ethics
Calendar Year Termination Termination Date ( /{Appli-
Reporting Incumbent
Covered by Report
New Entrant,
Nominee, or ')(I Filer 0 cable) (Month, Day, l'ear)
Fee for Late Filing
05/03/2011
(Check Appropriate
Boxes)
D I I Candidate
I I
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
Last Name First Name and Middle Initial filed, or, if an extension is granted, more
Reporting
than 30 days after the last day of the
Individual's N arne Cain Herman filing extension period, shall be subject
to a $200 fee.
Title of Position Department or Agency (If Applicable)
Position for Which
Filing Candidate for President Reporting Periods
Incumbents: The reporting period is
Address (Number Street City )tate and ZIP Code) T 1 h N (I d A C d ) the preceding calendar year except Part
Location of ' ' '· · ' e ep one 0 · nc1u c rca ' 0 c II of Schedule C and Part I of ScheduleD
Present Office 223 Montrose Drive. McDonough, GA, 30253 (678) 565-5335 where you must also include the filing
(or forwarding address) year up to the date you file. Part II of
1
I Title of Position(s) and Date(s) Held ScheduleD is not applicable.
l'osilion(s) Held with the Federal
Government During the !'receding Termination Filers: The reporting
12 Months (I[ Not Same as Above) period begins at the end of the period
covered by your previous filing and ends
t---------------------------+-:-:---:----------------------.----------------------1 at the date of termination. Part II of
Presidential Nominees Subject Name of Congressional Committee Considering Nomination Do You Intend to Create a Qualified Diversified Trust? I Schedule D is not applicable.
to Senate Confirmation Not Applicable DYes I8J No Nominees, New Entrants and
Candidates for President and
__
o_f_R_e_p_o-rt-in_g ln_d_•_·v-id_u_a_I____________________________________
__ Vice President:
I CERTIFY that the statements I have Schedule A--The reporting period
made on this form and all attached for income (BLOCK C) is the preceding
schedules arc true, complete and correct -;J_.t..(-;)..0((
to the best or my knowledge. calendar year and the current calendar
year up to the date of filing. Value assets
Signature of Other Reviewer Date (Month, Day, Year) as of any date you choose that is within
Other Review 31 days of the date of filing.
(If desired by
agency)
Schedule B--Not applicable.
Schedule C, Part I (Liabilities)--The
AgencyEthicsOfflcial'sOpinion Signature of Designated Agency Ethics O!Iiciai/Reviewing Official Date (Month, Day, Year) reporting period is the preceding calendar
. . . . . . year and the current calendar year up to
On the ba"s of mformat10n contmncd m thiS any date you choose that is within 31 days
report. I conclude thal the filer IS an compliance f '1'
with applicable laws and regulations (subjeel to of the date 0 f1 mg.
anv comments in the box below).
Office of Government Ethics
I Signature I Date (MonLh Day Year)
' '
ISchedule C, Part II (Agreements or
Arrangements)--Show any agreements or
Use Only arrangements as of the date of filing.
ScheduleD--The reporting period is
Comments of Reviewing Officials (If additional space is required, usc the reverse side of U1is sheet) the preceding two calendar years and
the current calendar year up to the date
of filing.
·::- '.1"I u·· ,.·J
t _l ..,.. • ·.1 (C/Jeck box if filing exrension granted & indicatc number of days----)
D
1.'f :1 ... '•I
I ; '·-· • '
n
·...J , ...,! 'l...,l
:;J 1:1 10
_j... ..]
Agency Use Only
:8 Hd 9Z IIGl OGE Use Only
(C/Jeck box Jf comments are continued on UJC reverse side) D
Supersedes SF
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2. OGE Fonn 278 (Rev. 09/2010)
5 C.F.R. Part 2634
U.S. Office of Govenunent Ethics
Reporting Individual's Name Page Number
Cain, Herman SCHEDULE A
2 of 13
Assets and Income Valuation of Assets ·Income: type and amount. If "None (or less than $201)" is
at close of reporting period checked, no other entry is needed in Block C for that item.
BLOCK A BLOCKB BLOCKC
For you, your spouse, and dependent children, Type Amount
report each asset held for investment or the
production of income which had a fair market
..... 0
value exceeding $1,000 at the close of the
ing period, or which generated more than 200 0
q
0
0
0
0
0
0 ] .... 0
in income during the reporting period, together .... 0 0
0
Q, q 0 0 0
o. J:l.<· 0
N
0
0
0
q Other Date
with such income. 0 0· 0 0 '-'
.Q 0 0 Income (Mo., Day,
; 0
0
8· 0
0 -1< 0 q ci 0
g" b 0
For yourself, also report the source and actual
0
0
0
0 0 0 0 0
0
0 lJ"l 0 q 0 lJ"l N
£ q 0 0 N· lJ"l ...... 0
0 -0
q lJ"l lJ"l 0
0 § "'
Q)
:0
t::
cO
..c:
0
0 R
0
0
0
0
q
q 0
(Specify
Type&
Yr.)
0 0
q 0 0
0 lJ"l
amount of earned income exceeding $200 (other "I
'-'
...... 0 "' "'
'-' Cil: '-' 0 0 0 0 ....
0
0
0
Actual Only if
.s q 0
"'' ...... lJ"l ...... 'Ef7
than from the U.S. Government). For your spouse, 0 ...... ...... 0 0 2
-"' ......
lJ"l
....
lJ"l I
....
I
.s 0 0
lJ"l lJ"l I
"' "' 0 N' 0 Amount) Honoraria
report the source but not the amount of earned
income of more than $1,000 (except report the I-<
I
...... ....
I .... ,...., ...... q o-: 0 0 0 "d E-<
1." I "1. 0
,....,
0 0
0
"d.
cO
Cl
Q)
... .......
lJ"l
...... ,...., ...... q
I
'
I 0
0 0
o_
6 0 g lJ"l 2l ]
..._,_ .... o. 0 0· 0 0
o· I
0 ·;. ' ,...., 0
actual amount of any honoraria over $200 of 0 0 0
]
0
..._, .... 0'
' .... ...... g. 0
0
0 lJ"l
0 0 0 ... 0: q .n. ... ' 0
.... ... ...
!
your spouse). 'Q) 0 0. 0 0 0 0 0 0
q .n· :a q "!. q vi" 0 0
Q)
§. ...... ...... 0 ....... N o:
o: lJ"l 0
d & t:: 0 0
....
0 Q)
NoneD z lJ"l l/"l. lJ"l N·
Jj § 0 •Q)
..s u
cO
z
0 N- ...... N· lJ"l lJ"l ,_.;- >
0
Central Airlines Common '· .
·- .:_ ·- 1- - - 1 - - r-
X X X
1 - - - - - - - - - - - - - ·- 1- I- f.,- I- 1-- 1- 1-.- ·- ·- I- 1-- 1- 1- ---·-
Examples DoeJones&Smith. Hometown, Stale
1 - - -Equity Fund- - - - - - - ·-- 1-
--- ·- ·.- ·- - _I __ - - -- ·- ··- - - 1- - ··- - - -
·-
law Partnership
Income $130,000
1----
Kempslone -:-1-r: I- 1--. I-
1 - - - -500 Index Fund- - - - - -- - ·---. ..__ i-. -
1--
- ,.
X
_I_L -- -.- - :.:.1_ 1.,- f- --
1----
IRA: llearlland
----
X
1--: :- ·- -
X
'- ·- ·-
X
'- '--- --- 1----
1 '
Cox Radio, Inc, Atlanta, GA Salary $165,183
2
(S) The New Voice, Inc., Stockbridge, GA Salary
·.
3 Hallmark Cards, Inc., Kansas City, MO ., Director's Fees
$120,000
4
Agco Corporation, Duluth, GA Director's Fees
$202.500
5
Whirlpool Corporation, Bento("! Harbor, Ml Dir. Fees/Stk
Option Exercise
$359.008
6 Whirlpool Corporation Common .· ·.
X I
X X
* 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.

3. OGE Form 278 (Rev. 09/20 I 0)
5 C.F.R. Part 2634
U.S. Office of Government Ethics
Reporting Individual's Name Page Number
Cain, Herman SCHEDULE A continued
(Use only if needed) 3 of 13
Assets and Income Valuation of Assets Income: type and amount. If "None (or less than $201)" is
at close of reporting period checked, no other entry is needed in Block C for that item.
BLOCK A BLOCKB BLOCKC
Type Amount
0
;::::;-
0
o_
0
0
0
0
0
0
0
0
§ ...... 0
0
...... 0
0
0
0
0 0
J.!.< 0
N
0
0 0 Other Date
I
0 0
0
0 0 0 0 0
0 0 0 Income (Mo., Day,
0 q 0
0
0
0
0
0
0 0
0 0 q
0
0 i< 0 Lrl
0 0 0 0 i< 8 (Specify Yr.)
.s 0
0
0
0 ......
0
0 Lrl.
N
0
Lrl .-I
0
0
0
v) Lrl
N
I
0
0
0 '"' ;g
(/)
..... ;:1
'Cil .s 0
0
0
0
0
0
0
o_ 0
0
0
0
0
0
0
q
.-I
0
0
q
v) 0
0
0
Type&
Actual Only if
a
v) >, Lrl
.s 0
(/) (/) (/)
(/) Lrl
0 I I .-I
0 (/) 0
v) ...... Lrl
Lrl ...... 0
I
0 Amount) Honoraria
.-I .I I I 0 .-I ...... 0 0 q N I 0 .-I 0
I I ...... ...... o_ 0 0 0
0
(/) ell ...... I I ...... q 0 q
E ] "d
.-I
1-<
...... .c..? 1-<
.S· ......
I
0
.-I
0
0
0
0
0
0
0
0
...... 0 0
0
0 Lrl
0
"d
t::
Q) ] '"' .-;
(/)
.....
0
I
I
...... .-I
I I
......
.-I
0
......
0
0
0
.-I o.
0
Lrl
!
0 0 0 0 o" g" 0 0 0. 0 q
J
0 "d 0 0 0 0 0
q 0 1-<
q Vi 1-<
·:;: q 1-<
q
·!i 0 Ill q
Q)
0
aa
0 Lrl Q)
Vl 0
.-t" 0 ...... ......
.-I Lrl .-1 N Vl Lrl N
JS .5 u z N .-I .N Lrl .-I Lrl
(,1'> 0 .(,I'>
1
The Coca-Cola Company Common X X X
2 (S) The Coca-Cola Company Common
X X X
"C
3
Sale of 2,000 shares SonicWalllnc Common
X I X X
4 I
Federated GA Municipal Cash Trust .. X .
I X X X
5 Supervalu Inc Common
X X X ...
6 ..
Whirlpool Corporation Common '
X X X
·•
7
Agco Corporation Common
X
8
Delaware National Hi-Yield Municipal Bond A X ' X X
Common '
C)
Sale of 2,000 shares Whirlpool Corporation I
X X X
Common "
* 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.
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