Margaret ClarkSTATEMENT OF ECONOMIC
COVER PAGE
Please type or print in ink.
(LAST)
ICE
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1. O ffice, Agency, or Court
Agency Name
Board,
► If filing for multiple positions, list below or on an attachment.
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State ❑ Judge (Statewide Jurisdiction)
❑ Multi -County
.® City of �.OStcvl
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
10 Annual: The period covered is January 1, 2010, through December 31, ❑ Leaving Office: Date Left --J --J -
2010. - or - (Check one)
The period covered is _J �� through December 31, O The period covered is January 1, 2010, through the date of
2010. leaving office.
❑ Assuming Office: Date O The period covered is J _J, through the date
of leaving office.
❑ Candidate: ElectionYear Office sought, if different than Part 1:
4. Schedule Summary
Check applicable schedules or "None." ► Total number of pages including this cover page:
❑ Schedule A -1 - Investments - schedule attached ❑ Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule A -2 - Investments - schedule attached ❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or.
❑ None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business erAgencyAddress Recommended - Public Documerd)
31d9 ff Prospecf A-P-e , [?0 T -ernea't CA R! 7 - 7D
IN
c. tar- ke_ee,5c Ce! ytiho0,cgm
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained
herein and in any attached schedules is true and complete. I acknowledge this is a public document.
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date Signed 3 ` // Signature / 92% : �1�"�'� - k
(month, day year) a the adginnay signed smtement with your fifing aWil..)
C "Uk l(i 1 m rrib'v
MAR 2 2 20011
FPPC Form 700 (2 01 012 011)
FPPC Toll -Free Helpline: 8661275 -3772 www.fppc.ca.gov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Ac ptable)
-iiLtq I /Ark _a,, kd . IBS
BUSINESS ACTIVITY, IFJANY, OF SOURCE l
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
V9 $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑ Salary K Spouse's or registered domestic partner's income
❑ Loan repayment ❑ Partnership
❑ Sale of
(Property; car, boat, elc.)
❑ Commission or ❑ Rental Income, [IV each source of $10,000 or more
❑Other
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑ Salary ❑ Spouse's or registered domestic partner's income
❑ Loan repayment ❑ Partnership
❑ Sale of
(Property, m0 boa( etc.)
❑ Commission or ❑ Rental Income, list each source of $10,000 w more
❑ Other
L OANS 2. r OR OUTSTANDING DURING THE REPORTING •r
" You are not required to report loans from commercial lending institutions, or any indebtedness Created as part
of a retail installment or credit card transaction, made in the lender's regular course of business on terms
available to members of the public without regard to your official status. Personal loans and loans received
not in a lender's regular course of business must be disclosed as follows:
NAME OF LENDER`
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
INTEREST RATE TERM (Months/Years)
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
Street address
❑ Guarantor
❑ Other
Comments:
(Describe)
FPPC Form 700 (2010/2011) Sch. C
FPPC Toll -Free Helpline: 866 1275 -3772 w .fppc.ca.gov
SCHEDULE D
Income — Gifts
► NAME OF SOURCE
/� [/�
?�,, "Q /at CF CctJ: rrr l C =n ES
AD ESS (Business Address Acceptable)
/40U k. Sfi Sacs n�ebrrr, (/F ` %S53 ! l
BUSINESS ACTIVITY, IF ANY, OF SOURCE
A- gvocaCq - i;r0 they 4ujdMair re5,e&rIfs
DATE (mm /d ) /
VALUE D ESCRIPTION OF GIFT(S)
-LJJJ� S �d, U!"� HAY!( 4 .
oo /,� , Y C-"l ei
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY OF SOURCE
DATE (mm /dd/yy) VALUE DESCRIPTION OF GIFT($)
—J _J—
$
—J —J_ $
J am— s
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd/yy) VALUE DESCRIPTION OF GIFT(S)
J J— $
— / —J— 5
Comments:
► NAME OF SOURCE
C'.
1. il'K��( -hj
ADDRESS (Business Address Acceptable)
I iyq S"H, 7 Ef. Suik �yor k54,�aLo fe W
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Ga A(fz
DATE (mm/tldl�I,UE DESCRIPTION OF GIFT(S)
pa
�lC $ 70. J7rn n � -
I
► NAME OF SOURCE
ADDRESS (Business Add ass Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S)
J am— 8
_/ _J_ c
—JJ
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /ddlyy) VALUE DESCRIPTION OF GIFT(S)
_f� c
s
FPPC Forth 700 (201012011) Sch. D
FPPC Toll -Free Helpone: 8661276 -3772 www.fppc.ca.gov