2003 (14)STATEMENT OF ECONOMIC INTERESTSP — jg C aq - =1y.
CALIFORNIAFORm ... f- � B 2
COVER PAGE CITY OF 0 2004 AD
FAIR POLITICAL � 2004
Please type or print in ink A Public Document l
r r
NAME (LAST) (FIRST) (MIDDLE) '' U_ Y ENDMBEft
T Y .4 vA G01 y WN190 111 Y (6z6, ) %q3 -03 g
MAILING ADDRESS STREET - CITY STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS
(May be business address) -
r
1 . Office, Agency or Court
Name of Office, Agency or Court:
C 1`Y 0/ M1=6D
:Division, Board, District, if applicable:
Your Position:
�+ If fling for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
A i ffl14D- e0141 9*146 -
Position: f> ®/7' m4 k' ac
2. Jurisdiction of Office (Check at feast one box)
❑ State
,
❑County of y�
I1l� K Cityof 1 /V1F_40
7❑ Multi- County
❑ Other
3. Type of Statement (check at feast one box)
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 rLan roan cox owme io)
Schedule A -2 ❑ Yes - schedule attached
investments (cox or greater Ow nop)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C Yes - schedule attached
- Income 8 Business Positions (Imme aver man Loans, Gifts, and r rep
Schedule D ❑ Yes schedule attached
Income - Loans
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 r2
completed including this cover page:
❑ Assuming Office /Initial Dale: —J —J—
171. Annual: The period covered is January 1, 2003,
/// through December 31, 2003.
-or-
0 The period covered is __J__J through
December 31, 2003.
❑ Leaving Office Dale Left: ---J - - -J—
(Check one)
Q The period covered is January 1, 2003, through
the date of leaving office.
-or-
0 The period covered is __J _/_, through
the date of leaving office.
❑ Candidate
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
Form 700 (200312004)
FPPC Toll -Free Helpline: 866 /ASK -FPPC
SCHEDULE C CALIFORNItill 700
Income & Business Positions Name
(Income Other than Loans, Gifts, and � ]� T�f `p Z- 0�
Travel Payments)
> NAME OF SOURCE
A c�33
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
❑ $500 - $1,000 - F1 $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
-. (Propeng coq Goal. Mc.f
❑ Commission or ❑ Rental Income, list each source of S10,000 or more
❑ Other ,�Vsl et be
1
> NAME OF SOURCE
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
(Properly, car, Goal etc.)
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
> NAME OF SOURCE
ADDRESS
/USINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $1a,aB1 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑ Salary ❑ Spouse's income ❑ Loan repayment
❑ Sale of copoet, els.
(Propen(Proper, q )
❑ Commission or ❑ Rental Income, list each source of S10,000 or rrwre
❑ Olher
(D Pro)
> NAME OF SOURCE
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
ppra,alg car, Goal, etc.)
❑ Oommission or ❑ Rental Income, list each source of $10,000 or Marc
❑ Other
Comments,
FPPC Form 700 (2003/2004) Sch. C
FPPC Toll -Free Helpllne: 866(ASK -FPPC