Salary




Report the source and amount of your salary in Part 2.

#

Description

EIF

Value

Income Type

Income Amount

1

Xylophone Technologies Corporation

N/A

 

salary

$187,489

2

DSLK Financial Techniques, Inc. (financial services)

N/A

 

salary

$195,375

For You

Part 2

Report the source and amount of your salary if you received more than $200 from that source during the reporting period.  Do not report salary from United States Government employment.

Description:  Provide the name of your employer.  In addition, if your employer is a privately held business, provide your employer’s line of business.

EIFSelect “N/A.”

Income Type:  Describe the type of income as “salary.”

Income Amount:  Provide the exact amount of your salary income during the reporting period.

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