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Margaret ClarkD ate_ReceLvvad� B STATEMENT OF ECONOMIC INTERESTS rQ a c, brcral�o COVER PAGE I 6 y Please type or print in ink f1 Public Docume771 NAME (LAST) (FIRST) (MIDDLE) DAYTIME I'E'LHDNENONIBER MCk,V_ C ref- F. (6 )�98 -? q MAILING ADDRES STRE T CITY STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS (May use business address) 31 0 9 N , oro5 r)z c-4- A e . 11 t) S P t'r -e C I Cf-V `f l - 7 Z O (6 3 1 . Office, Agency, or Court Name of Office, Agency, or Court: Cj}- rT Divisio , Board, District, if applicable: Your Position: C6�'ht L'.(J1.C /11QgyL�r �+ If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Office (cheek at /east one box) ❑ State ❑ County of City of fff'r` -dC ❑ Multi- County ❑ Other 3. Type of Statement (check at least one box) ❑ Assuming Office /Initial Date: Annual: The period covered is January 1, 2005, through December 31, 2005. -or- 0 The period covered is ___J ___J_, through 'December 31, 2005. ❑ Leaving Office Date Left: (Check one) 0 The period covered is January 1, 2005, through the date of leaving office. -or- 4. Schedule Summary Total number of pages including this cover page: 3 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 (10% or greater Ownership) Schedule B ❑ Yes - schedule attached Real Property - Schedule C X Yes - schedule attached Income, Loans, & Business Positions (Income Other than Gilts and Travel Payments) Schedule D ❑ Yes - schedule attached Income - Gifts Schedule E Yes - schedule attached Income - Travel Payments -or- E] 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 herein and in any attached schedules is true and complete. - I certify under penalty of perjury under the laws of the State of California that the foregoing is true_ and correct. Date Signed 22JA,, "� aoo6 (marl , day, year) 0 The period covered is through the date of leaving office. - ❑ .Candidate Signature �W/ At - ,- / C r (File the original, igood Statement with your filing official.) FPPC Form 700 (200512006) FPPC Toll -Free Helpline: 866 /ASK -FPPC SCHEDULE C income, Loans & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME 13hI LO -A n Inc. ADDRESS 3 149 Ver-duq© Rcad LOS AT g dt ; 01f 1_,106 BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED F $ 500 - $1,000 Lry$1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary S Spouse's Income ❑ Loan repayment ❑ Sale of (Property, car, boat, etc.) F Commission or F Rental Income, list each source of S10,000 or more ❑ Other (Descnbs) NAME OF SOURCE OF INCOME ADDRESS 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 income ❑ Loan repayment ❑ Sale of (Property, esq boat, elm.) ❑Commissioner ❑Rental Income, fal each soumeof$10,000 ormore ❑ Other 2. L OAN RECEIVED 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, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 Comments: INTEREST RATE TERM (MonthsfYears) q ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property S treet a ddesss ❑ Guarantor ❑ Other FPPC Form 700 (200512006) Sch. C FPPC Toll -Free Helpline: 8661ASK -FPPC SCHEDULE E Income — Guts Travel Payments, Advances, and Reimbursements • Reminder — you must mark the gift or income box. • You are not required to report "income" from government agencies. > NAME OF SOURCE l ec�gtu �� (ull rn(a c4e-r ADORNS /900 k sfr•ee4 CITY AND STATE SIZCr4z!np4e L '?E91 f BUSINESS ACT� FANY, OF SOURCE /i�%Zucain/ KT' 64 PS grel Aei^ /p5 DATE(S): L/ d - _zl�l -3-[J O SAMT: $ 9ff, 6-3 (I/appliwble) > NAME OF SOURCE CITY AND STATE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S): J _/_ -_J --- J_ ANT. $ (flappli Wa ) TYPE OF PAYMENT: (must check one) ❑ Gift S Income DESCRIPTION: / / ye( f Meals r - is FCGi f Yo1w fit S=rVice5 & ,i rzl a�'?7 rzrl-art oln� 'T f AJ -h�v L G s - > NAME OF SOURCE ADDRESS CITY AND STATE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S):___ -��_ AMT $ (1/appliwble) , TYPE OF PAYMENT. (must check one) ❑ Gift ❑ Income DESCRIPTION'. Comments TYPE OF PAYMENT: (must check one) ❑ Gift ❑ Income DESCRIPTION: > NAME OF SOURCE ADDRESS CITY AND STATE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S): __j_ /_-_��_ AMT $ (ITappllwble) TYPE OF PAYMENT: (must check one) ❑ Gift ❑ Income DESCRIPTION: FPPC Form 700 (2005/2006) Sch. E FPPC Toll -Free Helpline: 866 /ASK -FPPC