New Entrant Report | U.S. Office of Government Ethics; 5 C.F.R. part 2634 | Form Approved: OMB No.

(3209-0001)(March 2014)

Executive Branch Personnel Public Financial Disclosure Report (OGE Form 278e)
Filer's Information
Peterlin, Margaret J.
Chief of Staff, Department of State, State
Date of Appointment: 01/25/2017

Other Federal Government Positions Held During the Preceding 12 Months: None

Electronic Signature - I certify that the statements I have made in this form are true, complete and correct to the best of my knowledge.
eSigned in FDM by:
Margaret J. Peterlin

05/05/2017

Agency Ethics Official's Opinion - On the basis of information contained in this report. I conclude that the filer is in compliance with applicable laws and
regulations(Subject to any comments below).
eSigned in FDM by:
Sarah E. Taylor

05/11/2017

Other review conducted by

Reviewer:
eSigned in FDM by:
Sarah E. Taylor

05/11/2017

U.S. Office of Government Ethics Certification

1. Filer Positions Held outside United States Government

# NAME CITY, STATE OGE TYPE POSITION FROM TO
1 Freedom Riding Oakton, VA, USA Non-Profit Organiza Director 07/2016 04/2017
tion
2 Peterlin Holdings LLC Arlington, VA, USA Business Enterprise Director 01/2014 Present
3 Profectus Global Arlington, VA, USA Business Enterprise Officer 04/2014 01/2017
2. Filer's Employment Assets and Income
# DESCRIPTION EIF VALUE INCOME TYPE INCOME AMOUNT
1 Profectus Global Corp. N/A $50,001 - $100,000 Payment for Services $80,000
2 Peterlin Holdings, LLC N/A $1,000,001 - $5,000,000 Rent and Royalties $15,001 - $50,000
3 Freedom Riding N/A $1,001 - $15,000 None (or less than
$201)
4 Draper N/A Fees $1500

3. Filer Employment Agreements and Arrangements

This report has no reported Agreements and Arrangements

4. Filer's Sources of Compensation Exceeding $5,000 in a Year

# SOURCE NAME CITY, STATE BRIEF DESCRIPTION OF DUTIES
1 IIA Oak Ridge, TN Strategic consulting services
2 Not Specified McLean, VA Strategic consulting services
3 Not Specified Nassau Strategic consulting services
4 XLP Capital New York, NY Strategic consulting services

5. Spouse's Employment Assets and Income

# DESCRIPTION EIF VALUE INCOME TYPE INCOME AMOUNT
1 Fidelity Investment Account - Spouse No None (or less than None (or less than
$1,001) $201)
1.1 United Health Stock Options N/A Over $1,000,000 Dividends, Capital $5,001 - $15,000
Gains
1.2 United Health Contribution (ESOC) N/A $1,001 - $15,000 Dividends, Capital $2,501 - $5,000
Gains
1.3 United Health (Restricted Stock Units) N/A Over $1,000,000 Dividends, Capital $5,001 - $15,000
Gains
2 United Health Group N/A Salary

6. Other Assets and Income

# DESCRIPTION EIF VALUE INCOME TYPE INCOME AMOUNT
1 Fidelity Bank Acount MJAP N/A $15,001 - $50,000 None (or less than
$201)
2 USAA Checking Account N/A $100,001 - $250,000 None (or less than
$201)
3 TIAA-CREF IRA Yes $500,001 - $1,000,000 None (or less than
$201)
3.1 TIAA-CREF Cash N/A $1,001 - $15,000 None (or less than
$201)
3.2 DFA US Small Cap Yes $15,001 - $50,000 Interest $201 - $1,000
3.3 TIAA-CREF L/C Val Index Yes $100,001 - $250,000 Interest $2,501 - $5,000
3.4 TIAA-CREF Lg Cap Grth Yes $50,001 - $100,000 Interest $201 - $1,000
3.5 Artisan International Fd Yes $15,001 - $50,000 Interest, Rent and $201 - $1,000
Royalties
3.6 DFA Intl Small Cap Yes $15,001 - $50,000 Interest $201 - $1,000
3.7 Harding Loevner Emrg Mkt Yes $15,001 - $50,000 Interest $201 - $1,000
3.8 Harding Lovener intl Equity Yes $15,001 - $50,000 Interest $201 - $1,000
3.9 Ishares Core S&P Yes $50,001 - $100,000 Interest $2,501 - $5,000
3.10 Vanguard REIT ETF Yes $15,001 - $50,000 $201 - $1,000
3.11 Fidelity Adv Emrg Mkts Yes $15,001 - $50,000 Interest $201 - $1,000
3.12 DFA Inflation Protected Sec Yes $15,001 - $50,000 Interest $201 - $1,000
3.13 TIAA-CREF Bond Fd Yes $15,001 - $50,000 Interest $201 - $1,000
3.14 TIAA-CREF High Yield Fd Yes $15,001 - $50,000 None (or less than
$201)
3.15 USAA Short Term Bond Yes $1,001 - $15,000 None (or less than
$201)
3.16 Vanguard Bd Index Fd Yes $15,001 - $50,000 Interest $201 - $1,000
4 TIAA-CREF Joint Account No $500,001 - $1,000,000 Dividends, Capital $5,001 - $15,000
Gains, Interest
4.1 TIAA-CREF Cash - Joint N/A $1,001 - $15,000 None (or less than
$201)
4.2 United Health Group Inc No $100,001 - $250,000 Dividends, Capital $2,501 - $5,000
Gains
4.3 Harding Loevner Inst Emrg Mkt Yes $15,001 - $50,000 None (or less than
$201)
4.4 DJ Wilshire REIT ETF No $15,001 - $50,000 Interest $201 - $1,000
4.5 Ishares MSCI EAFE ETF Yes $15,001 - $50,000 Interest $201 - $1,000
4.6 Ishares MSCI EAFE Small Cap ETF Yes $1,001 - $15,000 $201 - $1,000
4.7 Ishares Russel Midcap ETF Yes $1,001 - $15,000 None (or less than
$201)
4.8 Ishares Russell midcap Value Yes $15,001 - $50,000 Interest $201 - $1,000
4.9 Ishares Russell 1000 Growth ETF Yes $1,001 - $15,000 None (or less than
$201)
4.10 Ishares Russell 1000 Value ETF Yes $15,001 - $50,000 $201 - $1,000
4.11 Ishares Russell 2000 Growth ETF Yes $1,001 - $15,000 None (or less than
$201)
4.12 Ishares Russell 2000 Value ETF Yes $1,001 - $15,000 Interest $201 - $1,000
4.13 Vanguard Growth ETF Yes $50,001 - $100,000 Interest $201 - $1,000
4.14 Vanguard Value ETF Yes $50,001 - $100,000 $1,001 - $2,500
4.15 Fidelity Adv Emg Mkts Yes $1,001 - $15,000 Interest $201 - $1,000
4.16 Nuveen Ltd Trm Muni Yes $15,001 - $50,000 Interest $201 - $1,000
4.17 Nuveen VA Muni Bond Yes $100,001 - $250,000 Interest $2,501 - $5,000
4.18 Vanguard HI Yield T/E Fd Yes $15,001 - $50,000 Interest $1,001 - $2,500
5 TIAA-CREF IRA - Spouse No $250,001 - $500,000 Dividends, Capital $5,001 - $15,000
Gains, Interest
5.1 TIAA-CREF Trust Cash - Spouse N/A $1,001 - $15,000 None (or less than
$201)
5.2 DFA US Small Cap - Spouse Yes $15,001 - $50,000 Interest $201 - $1,000
5.3 TIAA-CREF L/C Val Index - Spouse Yes $50,001 - $100,000 Interest $1,001 - $2,500
5.4 TIAA-CREF Lg Cap Growth Spouse Yes $50,001 - $100,000 Interest $1,001 - $2,500
5.5 Artisan International - Spouse Yes $15,001 - $50,000 Interest $201 - $1,000
5.6 Harding Lovener Emrg Mkts - Spouse Yes $15,001 - $50,000 Interest $201 - $1,000
5.7 DFA Intl - Spouse Yes $15,001 - $50,000 Interest $201 - $1,000
5.8 Ishares Core S&P ETF Yes $50,001 - $100,000 Interest $1,001 - $2,500
5.9 Vanguard REIT ETF - Spouse Yes $15,001 - $50,000 Interest $201 - $1,000
5.10 Fidelity Emerging Markets Yes $1,001 - $15,000 None (or less than
$201)
5.11 DFA Inflation Protected Sec Fund - Spouse Yes $1,001 - $15,000 None (or less than
$201)
5.12 TIAA-CREF Bond Fd Inst Cl - Spouse Yes $15,001 - $50,000 Interest $201 - $1,000
5.13 TIAA CREF High Yield - Spouse Yes $1,001 - $15,000 None (or less than
$201)
5.14 USAA Short Term Bond Fd - Spouse Yes $1,001 - $15,000 $201 - $1,000
5.15 Vanguard Bd Index Fund - Spouse Yes $15,001 - $50,000 $201 - $1,000
5.16 Harding Lovener Intl Equity - Spouse Yes $15,001 - $50,000 Interest $201 - $1,000
6 Bank of America - Joint Accounts N/A $100,001 - $250,000 None (or less than
$201)
7 Rental Property - Arlington, VA N/A $1,000,001 - $5,000,000 Rent and Royalties $15,001 - $50,000
8 Rental Property - Oakton, VA N/A $1,000,001 - $5,000,000 Rent and Royalties $15,001 - $50,000
9 DJK Irrevocable Trust - Life Insurance Policy N/A $250,001 - $500,000 None (or less than
$201)
10 VA 529 Plan - Dependent Child (Age-Based) Yes $15,001 - $50,000 None (or less than
$201)
11 VA 529 Plan - Dependent Child (Age-Based) Yes $1,001 - $15,000 None (or less than
$201)
12 VA 529 Plan - Dependent Child (Age-Based) Yes $1,001 - $15,000 None (or less than
$201)

7. Transactions
This report has no reported Transactions

8. Liabilities
YEAR INTEREST
# CREDITOR NAME TYPE OF LIABILITY AMOUNT INCURRED RATE TERM
1 Bank of America Mortgage, Oakton, VA, USA $500,001 - 2016 2.49% 7 yr Arm
$1,000,000
2 Bank of America Mortgage, Arlington, VA, USA $250,001 - 2015 one month LI 30 year
$500,000 BO
3 Navient Education Loan Loan $10,001 - 2001 6.8% 30 year
$15,000

9. Gifts and Travel Reimbursements

This report has no reported Gifts and Reimbursements

Summary of Contents
1. Filer's Positions Held Outside the United States Government
Part 1 discloses positions that the filer held at any time during the reporting period (excluding positions with the United States Government). Positions are reportable even if the filer did
not receive compensation. This section does not include the following: (1) positions with religious, social, fraternal, or political organizations; (2) positions solely of an honorary nature; (3)
positions held as part of the filer's official duties with the United States Government; (4) mere membership in an organization; and (5) passive investment interests as a limited partner or non-
managing member of a limited liability company.
2. Filer's Employment Assets and Income
Part 2 discloses the following:

• Sources of earned and other non-investment income of the filer totaling more than $200 during the reporting period (e.g., salary, fees, partnership share, honoraria, scholarships, and prizes)
• Assets related to the filer's business, employment, or other income-generating activities that (1) ended the reporting period with a value greater than $1,000 or (2) produced more than $200
in income during the reporting period (e.g., equity in business or partnership, stock options, retirement plans/accounts and their underlying holdings as appropriate, deferred compensation,
and intellectual property, such as book deals and patents)

This section does not include assets or income from United States Government employment or assets that were acquired separately from the filer's business, employment, or other income-
generating activities (e.g., assets purchased through a brokerage account). Note: The type of income is not required if the amount of income is $0 - $200 or if the asset qualifies as an
excepted investment fund (EIF).

3. Filer's Employment Agreements and Arrangements

Part 3 discloses agreements or arrangements that the filer had during the reporting period with an employer or former employer (except the United States Government), such as the following:

• Future employment
• Leave of absence
• Continuing payments from an employer, including severance and payments not yet received for previous work (excluding ordinary salary from a current employer)
• Continuing participation in an employee welfare, retirement, or other benefit plan, such as pensions or a deferred compensation plan
• Retention or disposition of employer-awarded equity, sharing in profits or carried interests (e.g., vested and unvested stock options, restricted stock, future share of a company's profits, etc.)

4. Filer's Sources of Compensation Exceeding $5,000 in a Year

Part 4 discloses sources (except the United States Government) that paid more than $5,000 in a calendar year for the filer's services during any year of the reporting period. The filer discloses
payments both from employers and from any clients to whom the filer personally provided services. The filer discloses a source even if the source made its payment to the filer's employer
and not to the filer. The filer does not disclose a client's payment to the filer's employer if the filer did not provide the services for which the client is paying.

5. Spouse's Employment Assets and Income

Part 5 discloses the following:

• Sources of earned income (excluding honoraria) for the filer's spouse totaling more than $1,000 during the reporting period (e.g., salary, consulting fees, and partnership share)
• Sources of honoraria for the filer's spouse greater than $200 during the reporting period
• Assets related to the filer's spouse's employment, business activities, other income-generating activities that (1) ended the reporting period with a value greater than $1,000 or (2) produced
more than $200 in income during the reporting period (e.g., equity in business or partnership, stock options, retirement plans/accounts and their underlying holdings as appropriate, deferred
compensation, and intellectual property, such as book deals and patents)

This section does not include assets or income from United States Government employment or assets that were acquired separately from the filer's spouse's business, employment, or other
income-generating activities (e.g., assets purchased through a brokerage account). Note: The type of income is not required if the amount of income is $0 - $200 or if the asset qualifies as an
excepted investment fund (EIF). Amounts of income are not required for a spouse's earned income (excluding honoraria).

6. Other Assets and Income

Part 6 discloses each asset, not already reported, that (1) ended the reporting period with a value greater than $1,000 or (2) produced more than $200 in investment income during the
reporting period. For purposes of the value and income thresholds, the filer aggregates the filer's interests with those of the filer's spouse and dependent children. This section does not
include the following types of assets: (1) a personal residence (unless it was rented out during the reporting period); (2) income or retirement benefits associated with United States
Government employment (e.g., Thrift Savings Plan); and (3) cash accounts (e.g., checking, savings, money market accounts) at a single financial institution with a value of $5,000 or less
(unless more than $200 of income was produced). Additional exceptions apply. Note: The type of income is not required if the amount of income is $0 - $200 or if the asset qualifies as an
excepted investment fund (EIF).

7. Transactions
Part 7 discloses purchases, sales, or exchanges of real property or securities in excess of $1,000 made on behalf of the filer, the filer's spouse or dependent child during reporting period. This
section does not include transactions that concern the following: (1) a personal residence, unless rented out; (2) cash accounts (e.g., checking, savings, CDs, money market accounts) and
money market mutual funds; (3) Treasury bills, bonds, and notes; and (4) holdings within a federal Thrift Savings Plan account. Additional exceptions apply.

8. Liabilities
Part 8 discloses liabilities over $10,000 that the filer, the filer's spouse or dependent child owed at any time during the reporting period. This section does not include the following types of
liabilities: (1) mortgages on a personal residence, unless rented out (limitations apply for PAS filers); (2) loans secured by a personal motor vehicle, household furniture, or appliances, unless
the loan exceeds the item's purchase price; and (3) revolving charge accounts, such as credit card balances, if the outstanding liability did not exceed $10,000 at the end of the reporting
period. Additional exceptions apply.

9. Gifts and Travel Reimbursements

This section discloses:

• Gifts totaling more than $375 that the filer, the filer's spouse, and dependent children received from any one source during the reporting period.
• Travel reimbursements totaling more than $375 that the filer, the filer's spouse, and dependent children received from any one source during the reporting period.

For purposes of this section, the filer need not aggregate any gift or travel reimbursement with a value of $150 or less. Regardless of the value, this section does not include the following
items: (1) anything received from relatives; (2) anything received from the United States Government or from the District of Columbia, state, or local governments; (3) bequests and other
forms of inheritance; (4) gifts and travel reimbursements given to the filer's agency in connection with the filer's official travel; (5) gifts of hospitality (food, lodging, entertainment) at the
donor's residence or personal premises; and (6) anything received by the filer's spouse or dependent children totally independent of their relationship to the filer. Additional exceptions apply.

Privacy Act Statement

Title I of the Ethics in Government Act of 1978, as amended (the Act), 5 U.S.C. app. § 101 et seq., as amended by the Stop Trading on Congressional Knowledge Act of 2012 (Pub. L.
112-105) (STOCK Act), and 5 C.F.R. Part 2634 of the U. S. Office of Government Ethics regulations require the reporting of this information. The primary use of the information on this
report is for review by Government officials to determine compliance with applicable Federal laws and regulations. This report may also be disclosed upon request to any requesting person
in accordance with sections 105 and 402(b)(1) of the Act or as otherwise authorized by law. You may inspect applications for public access of your own form upon request. Additional
disclosures of the information on this report may be made: (1) to any requesting person, subject to the limitation contained in section 208(d)(1) of title 18, any determination granting an
exemption pursuant to sections 208(b)(1) and 208(b)(3) of title 18; (2) to a Federal, State, or local law enforcement agency if the disclosing agency becomes aware of violations or potential
violations of law or regulation; (3) to another Federal agency, court or party in a court or Federal administrative proceeding when the Government is a party or in order to comply with
a judge-issued subpoena; (4) to a source when necessary to obtain information relevant to a conflict of interest investigation or determination; (5) to the National Archives and Records
Administration or the General Services Administration in records management inspections; (6) to the Office of Management and Budget during legislative coordination on private relief
legislation; (7) to the Department of Justice or in certain legal proceedings when the disclosing agency, an employee of the disclosing agency, or the United States is a party to litigation
or has an interest in the litigation and the use of such records is deemed relevant and necessary to the litigation; (8) to reviewing officials in a new office, department or agency when an
employee transfers or is detailed from one covered position to another; (9) to a Member of Congress or a congressional office in response to an inquiry made on behalf of an individual who
is the subject of the record; (10) to contractors and other non-Government employees working on a contract, service or assignment for the Federal Government when necessary to accomplish
a function related to an OGE Government-wide system of records; and (11) on the OGE Website and to any person, department or agency, any written ethics agreement filed with OGE by an
individual nominated by the President to a position requiring Senate confirmation. See also the OGE/GOVT-1 executive branch-wide Privacy Act system of records.

Public Burden Information

This collection of information is estimated to take an average of three hours per response, including time for reviewing the instructions, gathering the data needed, and completing the form.
Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Program Counsel, U.S. Office of
Government Ethics (OGE), Suite 500, 1201 New York Avenue, NW., Washington, DC 20005-3917.

Pursuant to the Paperwork Reduction Act, as amended, an agency may not conduct or sponsor, and no person is required to respond to, a collection of information unless it displays a
currently valid OMB control number (that number, 3209-0001, is displayed here and at the top of the first page of this OGE Form 278e).