Darrel KeltyRe ceived
Please type or print in ink
STATEMENT OF ECONOMIC INTER r
COVER PAGE
A Public Document
NAME (LAST) (FIRST) (MIDDLE) ! "" - fTAPrIME TEL�PHONP NUMBER
r: C - T`f E)A�'(?nut Doc, i -cis �ZC 443 z�j73
MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS
(May use business address)
4+13 A"F 70
1 . Office, Agency, or Court
Name of Office, Agency, or Court:
CITY 01= I SE rv 64 ,'o
Division, Board, District, if applicable:
PL 14t -ft COt�(IVta /tlXI
Your Position:
C C) M.M I S S fc.Y Pc L
�+ If filing for multiple positions, list . 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
rl' City of ,Z 0�P
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date: — /�.—
[e The period covered is January 1, 2004,
through December 31, 2004.
-or-
0 The period covered is —J_J —, through
December 31, 2004.
❑ Leaving Office Date Left:
(Check one)
• The period covered is January 1, 2004, through the
date of leaving office.
-or-
• The period covered is I — through
the date of leaving office.
❑ Candidate - - -
4. Schedule Summary`
(Check applicable schedules or "No reportable interests. ")
— During the reporting period, did you'have any reportable
interests to disclose on:
Schedule A -1 Yes - schedule attached
Investments (Less than 10% Ownership)
Schedule A -2 ❑ Yes - schedule attached
Investments po% or greater Ownership)
Schedule B Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions (income other than Gina and
Travel Paymehts)
Schedule D (Eliminated report loans on Schedule C)
Schedule E ❑ Yes - schedule attached
Income - Gifts -
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
-or-
. ❑ No reportable interests on any schedule
Total number of pages
completed including this cover page:
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 M t° 2- 5' - 'Z 60 S
(monlh, day, year)
it
Signature
0� J Gees
.(File the originally signed statement with your filing official.)
FPPC Form 700 (2004/2005).
FPPC Toll -Free Helpline: 866/ASK-FPPC
SCHEDULE A -1 1 1
Investments
- -
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10 %)
Name
Do not attach brokerage or financial statements.
> NAME OF BUSINESS ENTITY
A ST_- r-
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE,
❑ $2,000 - $10,000 -
❑ $100,001 - .$1,000,000
NATURE OF INVESTMENT
LR' Stack
❑ Other
IF APPLICABLE, LIST DATE
❑ $10,001 - $100,000
❑ over $1,000,000
t1 yCc��
15 Lsss
Wrr $,Zjo OC7
ACQUIRED DISPOSED
> NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $100,001 - $1,000,000
NATURE OF INVESTMENT
❑ Stock
❑ Other
IF APPLICABLE, LIST DATE:
❑ $10,001 - $100,000
❑ Over $1,00000
ACQUIRED DISPOSED -
> NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $100,001 - $1,000,000
NATURE OF INVESTMENT
❑ Stock
❑ Other
IF APPLICABLE, LIST DATE
❑ $10,001 - $100,000
❑ Over $1,000,000
ACQUIRED DISPOSED
> NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $100,001 - $1,000,000
NATURE OF INVESTMENT
❑ Stock
❑ Other
IF APPLICABLE, LIST DATE
❑ $10,001 - $100,000
❑ Over $1,000,000 '
—/-1 04 —J
ACQUIRED DISPOSED
> NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $100,001 - $1,000,000
NATURE OF INVESTMENT
❑ Stock
❑ Other
IF APPLICABLE, LIST DATE
❑ $10,001 - $100,000
❑ Over $1,000,000
ACQUIRED DISPOSED
> NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $100,001 - $1,000,000
NATURE OF INVESTMENT
❑ Stock
❑ Other
IF APPLICABLE, LIST DATE
❑ $10,001 - $100,000
❑ over $1,000,000
ACQUIRED DISPOSED
Comments: --
FPPC Form 700 (200412005) Sch. AA
FPPC Toll -Free Helpline: B66/ASK-FPPC
SCHEDULE B
Interests in Real Property
(Including Rental Income)
> STREET ADDRESS OR PRECISE LOCATION
4443
CITY
i?_C: G a.
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:-
❑ $2,000- $10,000
❑ $10,001 - $100,000 04 __j 04
ACQUIRED DISPOSED
tn0,001- $1,00a,000
❑ Over $1,000,000
NATURE OF INTEREST -
Ownership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Yes, remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
0$0-$499 ❑ $500 - $1,000 ❑ $1,001 - $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
NAME OF LENDER`
ADDRESS
BUSINESS ACTIVITY OF LENDER
N Or r.7S Nt ura_ - �S Q, e
INTEREST RATE TERM (Months/Years)
5-3/0 % ❑ None ' 30 XF.4 - x
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
$10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
> STREET ADDRESS OR PRECISE LOCATION
CITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
F] $100,001 -$1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OFINTEREST
❑ Ownership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Yes, remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $498 ❑ $500 - $1,000 ❑ $1,001 - $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.
NAME OF LENDER*
ADDRESS
BUSINESS ACTIVITY OF LENDER
INTEREST RATE - TERM (Months /Years)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, If applicable
Comments:
Loans from commercial lending institutions made in the lender's regular course of business on terms available to
members of the public without regard to your official status are not reportable.
FPPC Form 700 (200412005) Sch. B -
_ FPPC Toll -Free Helpline: 866 1ASK -FPPC