Su TanSTATEMENT OF ECONOMIC INTE
Please type or print in ink
(LAST)
NG ADDRESS STREET
use business address)
(FIRST)
6 � .
COVER PAGE
A Public Document
1 . Office, Agency, or Court
Name of Office, A ency, or Court.
a. 12�Szmear_cLz
Division, Board, District, if applicable:
Your Position:
(sr, of- �ncrlulS �
r If filing for multiple positions, qst additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ County of
X ity of _QDS2eM(!
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one (b��o��x)
� Assuming Office /Initial D ate: .'/ ��--t.
❑Annual: The period covered is January 1, 2006,
through December 31, 2006.
-or-
0 The period covered is through
December 31. 2006.
❑ Leaving Office Date Left: __J ___J
(Check one)
0 The period covered is January 1, 2006, through
the date of leaving office.
-or-
0 The period covered is —�� through
the date of leaving office.
❑ Candidate
(MIDDLE)
ORiciol Use Only
1 1 4 ?i 1 31 3
CITY CLERK'S
NUMBER
(your
OPTIONAL: FAX I E -MAIL ADDRESS
A, Schedule Summary
• Total number of pages
Including this cover page: e
r Check applicable schedules or "No reportable
interests."
I have disclosed interests on one or more of the
attached schedules:
Schedule A -1 ❑ Yes — schedule attached
Investments (Less than 10% Ownership)
Schedule A -2 ❑ Yes — schedule attached
Investments tto% or greater Ownership)
Schedule B tag Yes — schedule attached
Real Property V y
Schedule C ❑ Yes — schedule attached
Income, Loans, 8 Business Positions (Income Other than Gifts
and Travel Payments)
Schedule D ❑ Yes — schedule attached
Income — Girls
Schedule E ❑ Yes — schedule attached
Income — Travel Payments
-or-
L] No reportable interests on any schedule
5. Verification
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 her and in any
attached schedules is true and complete.
I certify under penalty of perjury underthe laws of the State
of California that the foregoing is true and correct.
\ \I� o:1
Date Signed \ /�.�-�t� /�/{�� /�J�
(ntanlh, day, Year)
Signature
)File the originally signed statement with your fling official.)
FPPC Form 700 (200612007)
FPPC Toll -Free Helpline: 6661ASK -FPPC
SCHEDULE B
Interests in Real Property
(Including Rental Income)
> STREET ADDRESS OR PRECISE LOCATION
34 �
CITY
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
�_J OG �_/ O6
�y
ACQUIRED DISPOSED
IR $100,001 - $1,000,000
F1 Over $1p00,000
\�NAATTURE OF INTEREST
: �[I Ownership /Deed of Trust ❑ Easement
`❑- Leasehold ❑
Yrs_ remaining
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $ass ❑ $500 - $1,000 ❑ 1H,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
> STREET ADDRESS OR PRECISE LOCATION
CITY
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $10,001 - $100,000
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OFINTEREST
❑ Ownership /Deed of Trust
❑ Leasehold
Yre. remaining
IF APPLICABLE, LIST DATE:
06
ACQUIRED DISPOSED
❑ Easement
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $ass ❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: If you awn a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
: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 ACTIVITY OF LENDER
INTEREST RATE
% ❑ None
TERM (Months /Years)
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
Comments
NAME OF LENDER'
ADDRESS
BUSINESS ACTIVITY OF LENDER
INTEREST RATE
% ❑ None
TERM (Months /Years)
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700 (2006/2007) Sch. B
FPPC Toll -Free lielpline: 6661ASK -FPPC