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2003 (19)Ft E C Eti 4iyed CALIF , . STATEMENT OF ECONOMIC INTEREST IrY OF R?T' 'tnt'AO FAIR POLITICAL PRACTICES COMMISSION COVER PAGE MAR 9 2004 Please type or p 10ITY riot in ink A Public Document CLERK'S OFFICr . NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER Seo7r i P 'A-„ 126 2240 MAILING ADDRESS STREET (May be business address) CITY STATE ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS 435 54e, ClArematt eA- 0 1 17/ 1 (bZ) 561 -zz-g3 1 . Office, Agency or Court Name of Office, Agency or Court: Division, Board, District, if applicable: Your Position: P ,IKk 5WoMjntehde4� If filing for mulliple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Office (Cheek at least one box) ❑ Stale ❑ County of - ZCily of ❑ Multi- County ❑ Other Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: Annual: The period covered is January 1, 2003, through December 31, 2003. -or- 0 The period covered is through December 31, 2003. ❑ Leaving Office Date Left: (Check one) O The period covered is January 1, 2003, through the date of leaving office. -or- 0 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 ❑ Yes - schedule attached Investments (Less man ro%ownershp) Schedule A -2 ❑ Yes - schedule attached Investments (10 % o• greater Dwnsrs p) Schedule B as - schedule attached Real Property Schedule C ❑ Yes - schedule attached Income 8 Business Positions (income Other man leans, Gigs, and Tmv ) 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 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 6/3 Q � (mont � hda � y, y Signature (File the originally signed statement wish your fling officlel.) FPPC Form 700 (200312004) FPPC Toll -Free Helpline: 866/ASK-FPPC SCHEDULE B Interests in Real Property > STREET ADDRESS OR PRECISE LOCATION x'35 a4e. s;r CITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST ❑ Rental Property Ownership /Deed 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 P, or n U41� Nuys c,,k I I4 D BUSINESS ACTIVITY OF LENDER W)o ATI4GltS INTEREST RATE TERM (Mon s CIO % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500.- $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ^OVER $100,000 ❑ Guarantor, If applicable Comments: > STREET ADDRESS OR PRECISE LOCATION CITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $to,00l - $100,000 -/_/ 03 ❑ $100,001 - $1,000,000 _ ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST ❑ Rental Property ❑ Ownership /Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $5oo - $1,000 ❑ $1,001 . $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% of 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 (200312004) Sch. B FPPC Toll -Free Helpline: 866IASK -FPPC