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Edward ClineSTATEMENT OF ECONOMIC INTERESTS Please type or print in ink COVER PAGE A Public Document R t .. II CITY OF ROSEng, MAR 2 2 2005 ITY CLERK'S nuirF NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHO C 54 2 MAILING ADDRESS MEET CITY STATE ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS (May use business address) / 3/ 9 / 6ross road6 � /�J�N 5 40� t�duskq, 64 7e 1 . Office, Agency, or Court Name of O Ice, Agency, or Court: 011q of g o w wffeAd Division, Boar District, if applicable: Your / P ltio : If filing or multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Office (Cheek at least one box) ❑ State ❑ County of [City of �D���� ❑ Multi- County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date:__J__J [✓rAnnual: The period covered is January 1, 2004, through December 31, 2004. -or- 0 The period covered is _�� through December 31. 2004. ❑ Leaving Office Date Left: J ---J (Check one) O The period covered is January 1, 2004, through the date of leaving office. -or- 0 The period covered is 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) I Schedule A -2 ❑ Yes - schedule attached Investments (10% or greater Ownership) Schedule B ❑ Yes — schedule attached Real Property Schedule C [eYes — schedule attached Income, Loans, & Business Positions pncoma Other than Gifts and Travel Payments) Schedule D (Eliminated -. report loans on Schedule C) Schedule E ❑ Yes - schedule attached .Income - Gifts Schedule F ❑ Yes - schedule attached - Income - Travel Payments -or- r ❑ 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 underthe laws of the State of California that the foregoing is true and correct. Date Signed 114 r'^ / ;? la (month, y, year) Signature 0, ( e fh riginally signe statement / your fling oKdal.) FPPC Form 700 (2004/2005) FPPC Toll -Free Helpllne: 866 /ASK -FPPC SCHEDULE C CALIFORNIA FORm 700 Income, Loans* & Business FAIR POLITICAL PRACTICES COMMISSION Positions Name (Other than Gifts and Travel Payments) 6.�btla rcy -cl ADDRESS IF ANY, OF YOUR r M GROSS INCOME RECEIVED /HIGHEST BALANCE DURING REPORTING PERIOD, IF LOAN ❑ $500 - $1,000 ❑ $1,001 - $10,000 - 110,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Property, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) ❑ LOAN RECEIVED (complete box 2) ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED /HIGHEST BALANCE DURING REPORTING PERIOD, IF LOAN ❑ $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, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Dascnbe) ❑ LOAN RECEIVED (complete box 2) BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED /HIGHEST BALANCE DURING REPORTING PERIOD, IF LOAN ❑ $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, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source .1$10,000 or more ❑ Other ( Descnbe). ❑ LOAN RECEIVED (complete box 2) INTEREST RATE ❑ None TERM (Months /Years) SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property Street address ❑ Guarantor ❑ Other * 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. Comments: FPPC Form 700 (2004/2005) Sch. C FPPC Toll -Free Helpline: 866 1ASK -FPPC