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2003 (16)- schedule attached ECE calved STATEMENT ©F ECONOMIC INTEREy • a e - Y OF ROSEMEAD FAIR POLITICAL PAAcTicEs cowissioN COVER PAGE MAR 2 2 2004 Rledse type or pdnt in ink r tt PubZ>c Document CITY CLERKS OFF I NAME '; (LAST) (' (FIRST) (MIODLF) DAYTIME TaEPRW NUMBER i- Benjamin Michael Saul ( 213) 321 -9931 - MAILINGAppRE$S STRT:.�T - CITY = $TATE ZIP CODE OPTIONAL! FAX /'EMAIL ADURE3S {nosy de 4u Inese adtlrassT (626 309 -9168 4224 Ivar Ave. Rosemead CA 91770 michaelnjbb a�mail15.com 1. Office, Agency or Court 4, Schedule Summary Name of Office, Agency or Court: 1Chech appllcabte schedules or "No repbrraale tnterests."9 Traffic Commission ++ ©uring the reporting period, did you have any reportable Division, Board, DYBtrict, if apptrcable: = interests to dlsclose on- Schedule -:A -t j,� Yes — schedule attached Your Positron. Ipvaslmante tGss coon 1e %9w0r ipj Traffic Commissioner schedule A -2 p Yes,- schedule attached - schedule attached Comments: None FPPC Form 7011 (200312004) Sch, A-1 1 1 SCHEDULE A-1 Investments FAIR POLITICU PRACTICES COMMISSION Natne Stocks, ;Bonds, and Other Interests M[chaei s. aenjamin (Ownership Interest Is Less Than 10 0%) Do not attach brokerage or financial statamsnts. -.1.: NAME OF BUSINESS ENTITY } -: NAME OF BUSINESS EN'7RY G NERAL DESCRIPTION OF BUSINESS ACTIVITY '- E _ -- GE ERAL DESCRIPTION OF SU$INESS ACTVITY -- FAIAARKET VALUE ; FAIR ARKET VALl1E f' ,' Q $2 00 - $10,000 ❑t� 52 DII - .510,000 $70;007 Y1g0,i0 - - 51 0Y $110M000 [] Over $1,000,000 -. L $10 ,ODI - 51,000,000 [] Over S7 000,006 -_ - NATUREbF INVESTMENT NATURE FINVESTMENT - Stock \: ❑ 5toc f E) Other olnerl IDesttibe) >�.. lDeschbe): IF APPLICABLE. „1ST DATE. ;, IF APPLICAB�E, LIST. DATE. f _ l03 .1.,_x.03 /J`03 _ —� 43 ACQUIRED DISPO D ACOUtRE1 DISP BED T.. NAME OF BVSINES ENT1Ty } NAME OF BUSIVss ENTITY J GENERAL DESCRIPTIO ' OF SINESS ACTIVITY GENERAL DF50R TION,OF�BUSINCSS ACTIVITY r FAIR MARKET VALUE FAIR MARKET VALTr ((( $2,000 - 510 000 $10,001 - $100000 _:. ED 52,000- $10,0Q 574;001 $100,000 s1,000, ❑ Over $1,000 DOD 0 $100,001 - $ Over $1,000000NATURE 03 - NATURE OP 1NVE OF FNVESTtvt T- Q Stock - ❑ Stock D Other r ❑ Other 1 / {0e Opel :. jilescr be) IF APPLICABLE L T DATE' - IF APPLICABLE IST DATE;\ _.1 003 / ^x.:.03 _,-J 03 03 - SPOS €D ACQUIRED i DISPOSEEA ACQUIRED NAME OF BUST ESS ENTITY Y NAME QF BUSirt 4ESS ENTITY GENERAL DESCRIPTION OF BUS IN SS ACTIVITY -. GENERAL. DII$CRIPMON.OF BUSINESS ACTT ,ITY - t FAIR NA�'jt',`ET VALUE FAIR MA4T VALUE - - - $2000- '$10000 - $'1'0,001 - S100. 00 - [] $20f,r0 - $10000 $1 Q,0 1 - $100,000 r--I Q 5700,.01. 31,000000 LJ Over $",000,000 - - r� Q 51j0,rjt,001 - 31 000,000 4 Over S 000,000 OF INVESTMiENT - - OF INVESTMENT �N'A7TURIe Sthok rNF^-A�TIt -- L^7 Other ❑ SOther - _ _ iDescrfieF {pesnl6ej � - IF APPLICCABLF_, LIST DATE: IF APPLICABLE, LIST DATE - -- ACQUIRED. DISPOSED ACQUIRED DISPOSED_ Comments: None FPPC Form 7011 (200312004) Sch, A-1 (Jame Address Chetm�.° one [D Trust: _go to 2 ❑ Business Entiry, complete the 677x. than go to 2 �GENEFtAL DESCRIPTION OF BUSINESS ACTIVITY _sf FAIR MA�KFT VALUE IF APPLICABLEA ST DATE. El 17 51o.0oy . stc0 oco �L___l 03 _,�J i 03 5100 0P -- 51,000,do0: ACQUIRED DISPOSED Q over St,. 00 "0 - NAlUREOFIN ESTMENT -`- f i� Safe Prop'at ship [] Pannarship {j lrtif O rer YOUR BUSINESS OSITION ID s0 $499 E r 10,001 FS1o0,000 [] s0 5499 , - $100,dp0 Ej $500 - 55,000 EJ ER 000 00.000 [J $500' S1 �01VGFoRt�,1 S10o,000 ❑ st,001 - $1 U,000 ' G si'Dol ' 550 000 1`A I L n nwesecrnncemc nxm ewrtaesrc M ae' ®1 aarulcasv 81FLlf aY' Check one box: _.E) INVESTMENT EREAL PROPERT t```YYY - Name of Business EAhTV or - Street Ad(Irek5 or Asst -istuo Parcel Number of Re I Property Cityo Ott of gala s cation f oP Grt or Other Prepi e Location of Heal Property ' - FAIR MARKET VA LIE - IF APPLICABLE, 1ST DATE': $2.000 510 OC - - + - - ACQUIRED -' DISPOSED [} g700.001 - st,00C,000. _ _ _ E] Over $1..000,000 NATURE OF INTEREST Property Ownership/Dead of Trust E] Stock GI Partnership [] Leasehold C Other Y15,rernainlrti, ' [] Check boa 4 additional schedules reporting Investments or real properly are aeactted Comments: None Name or b9emess tnnly, grr -- Street Addr S € -or AsSas3orS Parcel Numb of Real Promertyr Descnpt on of Business Aclrvity, or City or ther Precise Location of Real Property 4 S_ FAIR MARKET -VALUE IF APPLICABLE- LISTDATE; , 4Ej 52000 $10,000 U $10,001 stns add 03 slo0,001 - S1,000,000 _ 'ACQUIRED DISPOSED - {� over $1,000,00c, _ - NATURE OF INTER EST - -- - IEJ Property OwnershtP/Deed of Forst Stock -: Partnership. E] Leasehold- 0 Other. Yu; remaining ,.Q Creak box it addilarradschedules rapontng investments or real property are attached - - FPPC Form 700. (2003!2004.) Sch, A -2 _ -flame - 'Address - `checkane [ Trust, go ro 2 E] Business Entity, complete'Ino lox, then as to 2 -j GENERAL DESt IP ION OF BUSINESS .ACTIVITY - _. r I [ FAIR MARKET VALUE -.. -:IF APPLICABLE, -LtST -DATE: �5z,aoo'xla0oo 610,001 i107,daa =C. —JR- .DI =J �❑ 5100.00Y. S;,COCA 9 ACQUIREDtttf _- DISPOSED tQ Over $1,naa,0o0 ,NATURE OF'- INVESTMENT - J lo Sole ProRrietorshlp - Padnershlp '' (_ (YOUR BUSINESS POSITIO L� (Jame Address Chetm�.° one [D Trust: _go to 2 ❑ Business Entiry, complete the 677x. than go to 2 �GENEFtAL DESCRIPTION OF BUSINESS ACTIVITY _sf FAIR MA�KFT VALUE IF APPLICABLEA ST DATE. El 17 51o.0oy . stc0 oco �L___l 03 _,�J i 03 5100 0P -- 51,000,do0: ACQUIRED DISPOSED Q over St,. 00 "0 - NAlUREOFIN ESTMENT -`- f i� Safe Prop'at ship [] Pannarship {j lrtif O rer YOUR BUSINESS OSITION ID s0 $499 E r 10,001 FS1o0,000 [] s0 5499 , - $100,dp0 Ej $500 - 55,000 EJ ER 000 00.000 [J $500' S1 �01VGFoRt�,1 S10o,000 ❑ st,001 - $1 U,000 ' G si'Dol ' 550 000 1`A I L n nwesecrnncemc nxm ewrtaesrc M ae' ®1 aarulcasv 81FLlf aY' Check one box: _.E) INVESTMENT EREAL PROPERT t```YYY - Name of Business EAhTV or - Street Ad(Irek5 or Asst -istuo Parcel Number of Re I Property Cityo Ott of gala s cation f oP Grt or Other Prepi e Location of Heal Property ' - FAIR MARKET VA LIE - IF APPLICABLE, 1ST DATE': $2.000 510 OC - - + - - ACQUIRED -' DISPOSED [} g700.001 - st,00C,000. _ _ _ E] Over $1..000,000 NATURE OF INTEREST Property Ownership/Dead of Trust E] Stock GI Partnership [] Leasehold C Other Y15,rernainlrti, ' [] Check boa 4 additional schedules reporting Investments or real properly are aeactted Comments: None Name or b9emess tnnly, grr -- Street Addr S € -or AsSas3orS Parcel Numb of Real Promertyr Descnpt on of Business Aclrvity, or City or ther Precise Location of Real Property 4 S_ FAIR MARKET -VALUE IF APPLICABLE- LISTDATE; , 4Ej 52000 $10,000 U $10,001 stns add 03 slo0,001 - S1,000,000 _ 'ACQUIRED DISPOSED - {� over $1,000,00c, _ - NATURE OF INTER EST - -- - IEJ Property OwnershtP/Deed of Forst Stock -: Partnership. E] Leasehold- 0 Other. Yu; remaining ,.Q Creak box it addilarradschedules rapontng investments or real property are attached - - FPPC Form 700. (2003!2004.) Sch, A -2 SCHEDU Interests in RE >. STREET ADDRESS OR PRECISE LOCATION Y CITY FAIR MARKET V IF APPLICABLE LIST DATE [] $2,000 - 510.0 0 / 03 ACQUIRED DISPOSED D $100,001 , $1,001000 t El 0vef $1,000,000\ : e - NATURE OFINTERE�T e �] Renla4 Properly,QwnershlplDc,ed of Trust", `� Easement Leasehhld ❑- Yra rktsammg - Other r St } IF RENTAL PROPERTY. GOSS INCOME RECPVED $0 - SA99 $500 $1000 D $1.001 - L-t 510,000 . r 1:3 $10,001' - 5100.000 't ❑ OVER 5100000 r - SOURCES OF RENTAL tl I= E If ycu ,bwn a 10% Or greater interest, list the name of ea h tenanifthat is a single source of i income of $10,000 or more- - 1 NAME OF LENDER ADDRESS e, t BUSINESS ACTIVITY OF LEN ER tt, INTEREST HATE TERM (111. '1-sh'ears) I .t HIGHEST .BALANCE DURJG REPORTING PERIOD Ci $500 $1.000 - $1,001.. voxo -,] D $10,00, - $100.000 DOVER $100.000 Guafanlor, it applleaele Comments: None CALIFORNIAFORM ! LE B a[ Property Name Michael S. Benjamin STREET ADDRESS OR PRECISE LOCATIONS - CITY FAIR N KET VALUE IF APPLICABLE, LIST DATE 5200'p - $10000 r 510 Oo�1 - si 0D 000 —J —A 03 ' ACQUIRED DISPOSED S10600Q $1,000,000 _ p Over $100,000 N - NATURE OF INTEREST r r�, rr D Rental Prp�riy D Ownership /Deed of TT051 ❑ Easement � l E) Leasehold A 9 '`Other IF RENTAL PROPER4 GROSS INCq E RECEIVED - SO - $499 ❑ $EQO $1,00d $1,001 - $10,000 ,r $10,004 $100,000 -�� [MOVER Si00000 - * 7 SOURCES OF RENTAL INCOME' If Vou OWna 10% of greater` Interest, list the name of eae�k9enant that is a single source of income of $10.000 or more.,; � Ft NAIVE OF LENDER f ADDRESS SCHEDULE C 'CALIFORNIAFORm 700 Income & Business Positions (Income Other than Loans, Gifts, and Name Michael S. Benjamin Travel Payments) > NAME OF SOURCE ---+- _ T NAME OF SOURCE - -_ - ADDRESS - .C- `t'Zu2.1'�i4 S s -:.. C Q 0 0 3 - ADDRESS': ' BUSINESS ACTIVITY, IF ANY, OF SOURCE �— BUSINESS ACTIVITY, IFIANY, OF SOURCE t�cc a -awe `i s `ysr YOUR POSITION - YOUR BUSINESS POSITION M1BUSINESS fr..- ✓1� ����� 1>— Yl� /y19C CLfL ff GROSS INCOME RECEIVED - GROSS INCOME RECEIVED -' Q $500 -$T OtlQ - CJ $1001. - $10000 $500 '$1,000 - $1,004 $T0,001 - $100,000 OVER 5100,000 _ LJ $1tl oot - $100,00() ❑ OVER Y�{00,04i0 _ y/ va CONSIDERATION FOR WHICH INCOME WAS RECEIVED ' CONSIDERATION FOR WHICH INCOME WAS RECEIVED - - Salary ❑ Spouss incoms 01 4q n repaymenl - Salary.. ❑ Spouse's incom° C Loan repayment El g Q Sate of - fFropettq, csr. boa( erc.) [] sale at ( °rppattl: car, boat. emt El COmmiSMoh or ' Rental income, 451 earn soure. of $10.000 or more LJ Commission or CI,. Rental Income, lai eacb suunu, or slo p0o or more- Other __. _..c (Osciibel - C Other IPescribe; _ f1€t__.. NAME OF SOURCE - � ME OF SOURCE - > NAME , ADDRESS- ADDRESS'. - y. SUSINESS ACTIVITY, IP -,ANY OF SOURCE ��- BUSINESS ACTIVITY; IF ANY OF SOURCE - POUR BUSINESS POSITIO - _ YOUR BUSINESS POSITIOi�, f 1' GROSS INCOME RECEIVED � 0.000 - GROSS INCOME RECEIVED ` $500 - 5T 000 El $ i3O/ Llmoo - $1,000 LJ 001 $10.001 - $100,000 LJ VER :$ 00,000 E] 310,091 - jT00,000 :. D OVER. s�, U0 \tWWkS CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR WHICH INCOME RECEIVED Spouse's myome '�y Ej L repayment ❑ Salary G Spousex. Income ❑ L Srt repayment E] Salary '� oan - sale of T r /- \. - p Sale of /f �11< I(Propehy. Gar. boat, tuir) nY car boas. elC �\ U C ommission or. l� ReR I moon fill each ,ov vO of $10..00 o! more - R u Commission Of L', Rania Incg1nl`e, fits! each source of ^;1n,000 of more -. ` V C Other U Other (Oasorlll+iJ (F}p4�(UEj Comments Corelis my regular full time job. FPPG Form 700.(2003/2004) -_Sch. C -. -: - - -- - - FPPG Totl -Free Helpl•.ine: 866 /ASK -FPPC }i SCHEDULED Income — _Loans,_. name rBenjamin (Received or Outstanding) Michael S. NAME OF LENDER " - -> NAME OF LENDER - - - f ADDFrSS- 1 � -- BUSIN SS ACTIVITY OF LENDER - - -- i BUS (NESS ACTIVITY Or LENDER i INTEREA RATE TERM (MontM[Years INTER H5T RATE TERM (Morabs/YearS) ❑ None ! °A ❑ None r DURING REPORTING PERIO HIGHEST- )SALANCE DURING REPt)FTING PERIOD HIGHEST BR'1¢LqANCE pDr ❑ $500 1 $1, OD ❑ S1,007 $70.00D ' g ❑ 5500.5 000 ❑ $1 091 • 510 000 E] $10.001 . 111voo,000 ❑ OVER S100,000 {R ❑j 510,001 tOp ODD �] OVER $100.000 //j f SECURITY F04 - AN SECURITY FO LOAN 0 Nona ❑ Personal residence _ ft -❑ None i [� Personal resipende 1 _ Real Property Shelf adpq xs - - Real Property Q f r Sbeel edb.ess F r - Cet Gay r " ❑ Guaranlor _. -. ❑ Guararrof ,. � ,� i � 17 Other -- r � - ,Y Other ` ❑ (Desenbe) (Hasa e) t k NAME OF LENDER � .' _ - > NAME OF LEN 'ER ADDRESS ADDRESS 4FN BUSINESS ACTIVIT - BUSINES ACTIVITY OF LENDER - - INTEREST RATE - TERM (Months /Years) INTEP S7 FATE - TERklydonths /Years) sr { - % ❑ -Nonel ❑ None -- " HIGHEST BALANCEiDVFJG REPO \TING PERIOD HI HEST BALANCE DURING: REPORTING PrRIOD ❑ $500 $7 DOG - - 9❑ 51.001 ' ++55$1�E,000 $500 - S1,000 - ❑ $1.00'I - S10 000 j -+ ❑ $10,001 - $100.000 �❑ OVER $ 000 - $10,001 $100,000 Q OVER $100,000 SECURITY FOR LOAN f _F - /SECURITY FOR LOAN NOpe. ❑1 Persona. ra510enCe , E] None ❑ P+,arsonal residence \, .t D ❑ Real Properly -� blnw ❑ Real Property - - srsel eodress.. - _ Guy _ - - Lip• ❑ Guarantor Guaranlor - Other ❑ _. (Describe) Other - + (tiesa'rfrar Comments; None ._ FPPC Form 700 (2003/2004)- Sch. D - FPPC Tali -Free H:elpllne: 8661ASK -FPPC `: SOURCE TYPE OF PAYFIEPI OESCRIPT[OW (Irapplk bWi None a[�oRESS