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Joseph MontesSTATEMENT OF ECONOMIC COVER PAGE Please type or print in ink. Montes Joseph T 1. Office, Agency, or Court nv Agency Name -- Rosemead Community Development Commission Division, Board, Department, District, r applicable Your Position Assistant General Counsel ► If filing for multiple positions, list below at on an attachment. Agency: Position: _ 2. Jurisdiction Of Office (Check at least one box) ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑Multi -County _ ❑ County of City of Rosemead ❑ Other 3. Type of Statement (check at least one box) ❑ Annual: The period Covered Is January 1. 2011, through Fx] Leaving Office: Dale Left 01 , 31 / 2012 December 31, 2011. (Check one) -or- The period covered is through g The period covered is January 1, 2011, through the date of December 31, 2011. leaving office. Assuming Office: Date assumed O The period covered is I , through the date of leaving once. Candidate: Election Year .___.____ Office sought, if different than Part 1: ________,.. _ ---- 4. Schedule Summary Check applicable schedules or "None." ► Total number of pages including this cove! page: 3 Ex] Schedule A -1 - Investments - schedule attached ❑X Schedule C - Income, Loans, & Business Positions- schedule attached ❑ Schedule A -2 - investments- schedule attached ❑ Schedule D - Income - Gifts - schedule attached ❑ Schedule B - Real Propeny- schedule attached ❑ Schedule E - Income - Gilts - Travel payments- schedule attached -or- None - No repalable infaests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (nusines5 xAgsxy Address AYcwnmmdod - Pub!k Oo,u P.,J - BWS, 444 South Flower, Suite 2400 Los Angeles CA 90071 CA'fTIME TELEPHONL NUMBER 1 E -MAIL. ADDRESS (OPT'IONAL) ( 213 ) 236 -2736 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 allached schedules is true and complete. I acknowledge this is a public document I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. . Date Signed March 1, 2011 Signature_ t.•nw::iA day' fa=r/ rndnaCysi ..'s1a:e .,n ..rlhywr';Dig'. NiuiaL; F t C FPPC Form 700 (2011/2012) FPPC Toll -Free Flelpline: 866/275 -3772 www.fppc.ca.gov SCHEDULE A -1 Investments Stocks, Bands, and Other Interests (Ownership Interest is Less Than 10 %) Do not attach brokerage or financial statements. L ' CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES, COMMISSION ' ► NAME Burke, Williams & Sorensen LLP GENERAL DESCRIPTION OF BUSINESS ACTIVITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY Law Firm FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 []x $100,001 - $1,000,000 ❑ over $1,000,000 FAIR MARKET VALUE. ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1.000,000 NATURE OF INVESTMENT ❑ Stock ❑ Olhel' (Describe) I]X Partnership O Income Received of $0 - S499 ® Income Received of $500 or More (Raper! on Schedule C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE $2,000 - $10,000 [;] $10:001 - $1no.000 ❑ $100,001 - $1,000,000 ❑ Over $1000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Deeoribe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report an Schedule C) IF APPLICABLE, LIST DATE: 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 (Deehil:e) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report oo schedu;e C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED Comments: NATURE OF INVESTMENT ❑ Stock. ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report an SC,eduio C) IF APPLICABLE, LIST DATE: 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 ooaxo ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other - ( Desaibe) - ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More Tenpvf on Schodula c) IF APPLICABLE. UST DATE:' ACQUIRED DISPOSED ► NAME Uh tlU51NtJJ tNIIIY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1000,000 NATURE OF INVESTMENT ❑ Stork ❑ Other (Der,.ribe) ❑ Partnership O Income Received of SO - $499 O Income Received of $500 or More (Report a: Srhed'vre q IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED FPPC Form 700 (2011/2012) Sch. A -1 FPPCToll -Free Helpline :666 /275 -3772 www.fppc.c .gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME Burke, Williams & Sorensen LLP ADDRESS (Business Address Acceptable) 444 South Flower Street, Suite 2400, L.A. CA 90071 BUSINESS ACTIVITY, IF ANY, OF SOURCE Law Firm YOUR BUSINESS POSITION Partner GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑� $1,001 - $10,000 ❑ $10,001 - $100,000 LI OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED Salary ❑ Spouse's or registered domestic partner's income ❑ Loan repayment J Partnership ❑ Sale of (Real propaPi, car, beer, etc) ❑ Commission or ❑ Rental Income, bst each se=e of$10,000 a ❑ Other (Opscribe) NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) 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 EI Salary ❑ Spouses or registered domestic partner's income ❑ Loan repayment U Partnership ❑ Sale of (Real properly, car host, etc.) ❑ Commission or ❑ Rerrlal locome, Irst aad� source oI $18000 prmme ❑ 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. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑. $500 - $1,000 . ❑ S1,001 - $10,000 - ❑ $10,001 - $100,000 E] OVER $100,000 INTEREST RATE TERM (Months/Years) % ❑ None SECURITY FOR LOAN ❑ None . ❑ Personal residence ❑ Real Property City ❑ Guarantor ❑ Other Comments: (DO.mbe) FPPC Form 700 (2 0 1112 0 1 2) Sch. C FPPC Toll -Free Helpline: 8661275.9772 xww.fppc.ca.gov MAYOR: STEVEN LY MAYOR PRO TEM: SANORAARMENTA COUNCIL MEMBERS: BILL ALARCON MARGARET CLARK POLLY LOW March 1, 2012 Secretary of State Political Reform Division 1500 11 Street, Room 495 Sacramento, CA 95814 To Whom It May Concern: f icy osesnead 8838 E. VALLEY BOULEVARD • P.O. BOX 399 ROSEMEAD, CALIFORNIA 91770 TELEPHONE (626) 569 -2100 FAX (626) 307 -9218 Enclosed, is an original 700 Statement of Economic Interest for Rosemead's Assistant City Attorney and Assistant Agency Counsel. If there are any questions, please feel free to contact the office of the City Clerk at (626)569 -2171. Thank You. Sincerely, Ericka Hernandez Assistant to the City Clerk I • 1 1 STATEMENT OF ECONOMIC INT R T 1 I ��� "_� �Lj CITY 01 >_ IvTI -D = • • COVER PAGE Please type or print in ink. MAR � NAME OF FILER (LAST) (FIRST) Montes Joseph CITY C 7 EIWI< 1. Office, Agency, or Court Agency Name City of Rosemead Division, Board, Department, District, if applicable Your Position Assistant City Attorney ► If thing for multiple positions, list below or on an attachment. Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑ Stale ❑ Multi-County City of Rosemead ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other _ 3. Type of Statement (Check at least one box) 0 Annual: The period covered lks January 1, 2011, through Cl Leaving Office: Date Left —0 31 1 2012 December 31, 2011. ( Cheeck one) -or- The period covered is i J through O The period covered is January 1, 2011, through the dale of December 31, 2011. leaving office. ❑ Assuming Office: Date assumed O The period covered is through the date of leaving office. ❑ Candidate: Election Year .-- --- - _...- .....__ --- ---- _.. - -. Office sought, if different than Part 1: .. ...__- _ ------------------- ..... 4. Schedule Summary Check applicable schedules or "None." P. Total number of pages including this cover page. 3 U Schedule A -1 - Investments - schedule attached X Schedule C - Income, Loans, & Business Positions- schedule attached ❑ Schedule A -2 - Inves(rnents- schedule attached ❑ Schedule D - Income - Gifts - schedule attached ❑ Schedule B - Real Property- schedule attached ❑ Schedule E - income - Gifts - Travel Payments- schedule attached -or- L] None - No reportable interests on any schedule 5. Verifica MAILING ADDRESS STREET CITY STATE ZIP CODE (ausinuss vA3m yABlress Recmnnwnred - Public Document) BWS, 44 4 South Flower, Suite 2400 Los Angeles CA 90071 OAYrIME TELEPHONE NUMBER E -MAIL ADDRESS (OPTIONAL) ( 213 ) 236 -2736 _ 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 acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed Ma rch. 1, 2011 Signature —. — (rnonl6 rfcy, ye'�:l efiw uyi:r�;ly sip slalerrienl:vdhymrfirrg: M/kialj FPPC Fond 700 (201112 0 1 2) FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov SCHEDULE A -1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10 %) Do not attach brokerage or financial statements. Burke, Williams & Sorensen LLP GENERAL DESCRIPTION OF BUSINESS ACTIVITY Law Firm FAIR MARKET VALUE 1 $2,000 - $10,000 ❑ $10,001 - $100000 ❑X $100,001 - $1,000,000 ❑ over $1 000,000 NATURE OF INVESTMENT ❑ Stack ❑ Other (omen.) ❑X Partnership O Income Received of $0 - $499 0 Income Received of $500 or More (P.epoa on Schedme C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE 0 $2.000 - $10,000 [;] $10,001 - 4100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Dewdbe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on schodule c) IF APPLICABLE, LIST DATE: _tt 11 _J� 11 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 (Dewnhe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (P.apon a: sdmdwl C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED Comments: ► NAME OF GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE. ❑ $2,000 - $10,000 $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $i NATURE OF INVESTMENT ❑ Stock. ❑ Other (Doscrihe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on S'chadu'e C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ► NAMI= OF HUJINtbJ LN I I I T GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE F] $2,000 - $10,000 '] $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other newribe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (ROpor, w Sch0op r) IF APPLICABLE, LIST DATE:' J� 11 J� 11 ACQUIRED DISPOSED �QI_ AMGIi -ml�L Mb IIIW GENERAL DESCRIPTION OF BUSINESS ACl'IVITY FAIR MARKET VALUE ❑ $2,000 - $10,090 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 [] Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report o:: sohaduln qi IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED F PPC Form 700 (2 01112 01 2) Sch. A -1 FPPC Toll -Free Helpline: 0061275 -3772 www.fppc.ca,gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME Bu Wi lliam s & Sorens L_L ADDRESS (Business Address Acceptable) 444 South Flower Street, Suite 2400, L.A. CA 90071 BUSINESS ACTIVITY, IF ANY, OF SOURCE Law Firm YOUR BUSINESS POSITION Partner GROSS INCOME RECEIVED ❑ $600 - $1,000 ❑ $1.001 - $1,000 ❑ $10,001 - $100,000 [X] OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary [] Spous" or registered domestic partners income ❑ Loan repayment [X] Partnership ❑ Sale of (Rral proFerly ca.; boar, vta.) ❑ Commission or [ Income, list each source or$1o,000 ormaE ❑ Other NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) 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 ❑ Spousds or registered domestic partner's income ❑ Loan repayment ❑ Partnership ❑ Sale of (Reel Properly, car, boat, e6.) ❑ Commission or ❑ Rental Income, list eacb source o/slo,oea or more ❑ Other r • r r •�• sr 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. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER' ADDRESS (Business Address Acceptable) ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑. $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 [� OVER $100,000 INTEREST RATE TERM (MonlhsrYears) —, I — _� None - - -_ SECURITY FOR LOAN ❑ None . ❑ Personal residence ❑ Real Property _ Street eddrass City ❑ Guarantor [] Other_—___.___ _...__._.._._.._ ---- .........._ (Oos,nbe) Comments: FPPC Farm 700 (201112012) Sch. C FPPC Toll -Free Helpline :866 /2753772 WWW.fppaca.g0V • 1 1 STATEMENT OF ECONOMIC INTERESTS'., ', ' - • • COVER PAGE Please type or print in ink. rr�� 7 }u, ! t' ��IU ! Gli'lu, NAME OF FILER (IAST) (FIRST) f__ (MIDDLE) Monies -,v"_V _ Joseph y M, ' 3 'i � 1. Office, Agency, or Court nw —^ Agency Name City of Rosemead Division, Board, Department, District, lt applicable Your Position Assistant City Atto ► If filing for multiple positions, list below Or on an attachment. Agency: — _ Position: _- 2. Jurisdiction of Office (Check at Least one box) ❑ State - ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi- County ❑ County of i] City of Rosemead ❑ Other 3. Type of Statement (Check at least one box) ❑x Annual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left �! December 31, 2011. (Check one) -or- The period covered is _� I through O The period covered is January 1, 2011, through the date Of December 31, 2011. leaving office. • Assuming Office: Date assumed O The period Covered is through the dale of leaving office. • Candidate: Election Year _._____._____ Office sought, if different than Part 1: ---------- ___.__._______._____. ___.- .- __- _- _- .- ______.- . -____. 4. Schedule Summary Check applicable schedules or "None." ► Total number of pages including this cover page: 3 U Schedule A -1 - investments - schedule attached [x] Schedule C - Income, Loans, & Business Positions- schedule attached ❑ Schedule A -2 - Investr7ents- schedule attached ❑ Schedule D - Income - Gifts - schedule attached Schedule B - Real Properly- schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached -or- El None - No reportable interests on any schedule 5. V e r i fi cat i on MAILING ADDRESS STREET CITY STATE ZIP CODE (au5mes m Agency Addles Rmomm, m,ded - PulNic Dmanm nn BWS, 444 South Flower St, Suite 2400 Los Angeles CA 90071 DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS (OPTIONAL) ( 213 ) 236 -2736 jmontes @bwslaw.com 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 acknowledge this is a public document I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. March 26, 2012 Date Signed -- /� y� Signature _f - - ramm d yw,l _ fs�rv•or..ua:7+. ne ,9 men - 111 Y- i , ' 1170 alQ31,% e FPPC Form 700 (20112012) FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.a.gov SCHEDULE A -1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10 %) Do not attach brokerage or financial statements. ► NAME OF BUSINESS ENTITY Burke, Williams & Sorensen, LLP GENERAL DESCRIPTION OF BUSINESS ACTIVITY Law Firm 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 (Decnbe) ❑X Partnership O Income Received of $0 - S499 & Income Received of $500 or More rP.epoa a, Schedule C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE i] $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Dew - nCe) I _] Partnership O Income Received of $0 - $499 O Income Received of $500 or More ( Report w schedule C) IF APPLICABLE, LIST DATE: 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 (Dt,.nbe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or Moro (Report nn Schedu% e) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED Comments: ► NAME OF CALIFORNIA FORM 700 FAIR POLITICAL: PRACTICES COMMISSION 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 (Desalho) ❑ Partnership O Income Received of $0 - $499 O Income Received Of $500 Or More (Report on Schedule C) IF APPLICABLE, LIST DATE: — J � 11 JJ 11 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 (DessiSe) - ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 Or More (Ropon m Scdedulo C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ► NAME OF BUSINESS ENTTY 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 (DOSCnbo) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Repo, nr Schedule ^,I IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED FPPC Form 700 (2 01112 0 1 2) Sch. A -1 FPPC Toll -Free Helpline: 6661275 -3772 www.fppc.Ga.gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME Burke, Wil liams & Sorensen, LLP ADDRESS (Business Address Acceptable) 444 South Flower, St. Suite 2400, L.A. CA 90071 BUSINESS ACTIVITY, IF ANY, OF SOURCE Law Firm YOUR BUSINESS POSITION Partner GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 OVER $700,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED [_) Salary ❑ Spouses or registered domestic partner's Income ❑ Loan repayment LX] Partnership ❑ Sale of I 1 (Rost uroprvdy, ce, .) arm, etc E Commleslon or ❑ Rental Income, list each source o/ $10,(}00 er mare C Other (Dase nhe) NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) 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 or registered domestic partner's Income Loan repayment Partnership ❑ Sale of (keal pepedy, car, hod, e!eJ ❑ Commission or u Rental Income, fist arch woes of $10,900 or rows ❑ Other L OANS r OR OUTSTANDING DURING THE REPORTING OD 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. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 U $1,001 - $10,000 ❑ $10,001 - $100,000 OVER $100,000 Comments: INTEREST RATE TERM (MonlhslYears) h ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property ❑ Guarantor Street address City [] Other __._ (Descnhtn FPPC Form 700 (2011/2012) Sch. C FPPC Toll -Free Helpline: 8661275 -3772 "m,fppc.ca.gov