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2003 (5)CALIFORNIAFORM 700 FAIR POLITICAL PRACTICES COMMISSION. -- B ate - Received STATEMENT OF ECONOMIC INTERESTS R rm C P_+% ,,, CITY OF ROSEMEAL COVER PAGE 1,1AR 9 2004 A Public Document NAME (LAST) (FIRST) (MIDDLE) DAYTIME IELEPHONE NUMBER OCEL IDA�,miLeL DAr<<trc_ (; ZG ) ¢q3 - 2473 MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS (May be business address) 444-? r� rt. � l A v t� r c, s ,iZ ryL t"o.q, .C�_ 9 r 710 1 . Office, Agency or Court Name of Office, Agency or Court: - C I T-f 0 r 1Z 05 is r-t ra ms Div ision, Board, District, if applicable: r - - L14N K6'11 5 CO r� fKt S$ 10/4 Your Position: CO tK K t. AY S ION $L If fling for multiple positions, list additional agency(ies)l position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Office (Check at feast one box) ❑State - ❑ County of _ [City of rz OS Et- atEPO- ❑ Multi- County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Officellnitial Date:.) —/ — ❑ Annual: The period covered is January 1, 2003, through December 31, 2003. -o r- The period covered is li�r f 63 , through December 31, 2003. - ❑ Leaving Office Dale Left: --J ----J— (Check one) • The period covered is January 1, 2003, through the date of leaving office. -or- O The period covered is through the dale 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 211es - schedule attached Investments (Less than tow ownership) Schedule A -2 ❑ Yes - .schedule attached _ investments (imerge,ateroerarstep) Schedule B Z ieS schedule attached Real Properly Schedule C ❑ Yes - schedule attached Income & Business Positions (lneome aher0an Loans. Gms, and Travel) Schedule D ❑ Yes - schedule attached Income - Loans Schedule E ❑ Yes - schedule attached - Income - Gilts Schedule F - ❑ Yes - schedule attached Income - Travel Pay/nents -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. 1 have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. 1 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed (month, day, year) Signature (He the originally signed statement with your fling oOi. -I ) FPPC Form 700 (2003/2004) FPPC Toll -Free Helpline: 8661ASK -FPPC SCHEDULE A -1 Investments Name Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10 %) Do not attach brokerage or financial statements. > NAME OF BUSINESS ENTITY A K S z w r--` GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE - ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NAT OF INVESTMENT Sto S -e O ck �o g Sk n.n -.•'fir ❑ Other (Describe) IF APPLICABLE, LIST DATE: 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 ❑ $10,001 - $100,000 ❑ Over $1,000,000 IF APPLICABLE, LIST DATE: 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 j_J 03 _ _j___j 03 ACQUIRED DISPOSED Comments: > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 — $10,000 ❑$10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other IF APPLICABLE, LIST DATE: - J -/ 03 l 03 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 ❑ $10,001 - $100,000 ❑ Over $1,000,000 IF APPLICABLE, LIST DATE: _/__J 03 __j ACQUIRED DISPOSED - > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (D.onb.) IF APPLICABLE, LIST DATE: IJ 03 J� 03 ACQUIRED DISPOSED FPPC Form 700 (200312004) Sch. A -1 FPPC Toll -Free Helle ine: 866/ASK-FPPC SCHEDULE B Interests in Real Property > STREET ADDRESS OR PRECISE LOCATION 40+4 1- 42�e4 >A�� CITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 IE $tAOO1- $1OO,000 J� 03 � / ACQUIRED DISPOSED $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INTERES ❑ Rental Properly Ownership /Deed of Trust ❑ Ease menl ❑ Leasehold ❑ - Yrs. remaining Other '- IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $o - $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 G^KIC a ADDRESS A n+ ts-2 1 C /9. BUSINESS ACTIVITY OF LENDER - W M . 1`40fLT t 4 C E. INTEREST RATE TERM (Months /Years) 5 3 /g % ❑None 3 YIE Il HIGHEST BALANCE DURING REPORTING PERIOD n $Sy0 - $1,000 F1 $1,001 - $10,000 $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Comments: Name OAZP -e- 14eL' > STREET ADDRESS OR PRECISE LOCA11ON CITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 - El $10,001 - $100,000 JU 03 �J 03 ACQUIRED DISPOSED ❑ $100,001 - $1,000,000 ❑ 0Y $1,000,000 - NATURE OF INTEREST _ ❑ Rental Property ❑ Ownership /Dead of Trust ❑ Easement ❑ Leasehold - ❑- Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $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 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 FPPC Form 700 (2003/2004) Sch. B FPPC Toll -Free Helpline: 866 /ASK -FPPC