Jean HallSTATEMENT OF ECONOMIC I
COVER PAGE
Please type or print in ink.
1-14- zL
1. Offi Agency, or Court
Agency Name
GT -7�1 /<a CA
Division, Board, Department, District, if applicable Your Position
N. If filing for multiple positions, list below or on an attachment.
Agency: Position:
,,;
''il`'i'� r " l Vf.2,
2. Jurisdiction of Office (check at least one box)
`;Stale �-� i� ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi -County ❑ County of
City of �n .Sm�� -1J ❑ Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2011, through
December 31, 2011.
-or-
The period covered is through
December 31, 2011.
❑ Assuming Office: Dale assumed _�Z� d
❑ Leaving Office: Date Left
(Check one)
O The period covered is January 1, 2011, through the dale of
leaving office.
O The period covered is _
the date of leaving office.
❑ Candidate: Election Year °�' y1 Office sought, if different than Part 1:
through
4. Schedule Summary
Check applicable schedules or "None."
Schedule A -1 - Investments - schedule attached
Schedule A -2 - Investments - schedule attached
Schedule B - Real Property- schedule attached
❑ Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule D - Income - Gifts- schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or-
El None - No reportable interests on any schedule
5. Verification
MAIIJNG ADDRESS STREET CITY STATE ZIP CODE
(Business wAgemyAddfess Recommended - Public Document)
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 %' 1-:2—
(month, day, year)
► Total number of pages including this cover page.
FPPC Form 700 (201112012)
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.oa.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
OF BUSINESS ACTIVITY
ens
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
ep $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schetlule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINES
CAQ `t S ENTITY
/� /C.c�'75 (
N DESCRIPTION OF BUSINESS ACTIVITY
J
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
(Describe)
❑ Partnership O Income Received of $0 - $499
Q Income Received of $500 or More (Report 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 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership Q Income Received of $0 - $499
Q Income Received of $500 or More (Report m Schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
Comments:
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
► NA 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
( Descnbe)
❑ Partnership Q Income Received of $0 - $499
Q Income Received of $500 or More (Report oe Schedule C)
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
(Describe)
❑ Partnership Q Income Received of $0 - $499
Q Income Received of $500 or More (Report 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 ❑ $10,00l - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE.
ACQUIRED DISPOSED
❑ $10,001 - $100.000
❑ Over $1,000,000
FPPC Form 700 (201112012) Sch. A -1
FPPC Toll -Free Helpline: 866 /275 -3772 vvvvvvfppc.ca.gov
SCHEDULE A -2 •-
Investments, Income, and Assets
Name
of Business Entities /Trusts N Name
(Ownership Interest is 10% or Greater)
Name F A- . J'l7 1 t- �/e.✓ls
y S ��/ 7 /�&xY) y
Address (Business Address Acceptable)
go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000
❑$10001- $100000
ACQUIRED DISPOSED
❑ $to0,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Sole Proprietorship ❑ Partnership ❑
YOUR BUSINESS POSITION
Other
❑ $0 - $499 ❑ $10,001 - $100,000
❑ $500 - $1,000 OVER $100,000
❑ $1,001 - $10,000
4. INVESTMENTS AND INTERESTS IN REAL PROPERTY D BY THE
BUSINESS ENTITY OR TRUST
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, 1
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
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 OFINTEREST
❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Vrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
Name
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000 -
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Sole Proprietorship ❑ Partnership ❑
YOUR BUSINESS POSITION
Other
0$0-$499 ❑ $10.001 - $100.000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
BUSINESS ENTITY O TRUST
Check one box.'
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity ffi
City or Other Precise Location of Real Property
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
❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Ym. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
Comments: FPPC Form 700 (20112012) Sch. A -2
FPPC Tall -Free Helpline: 866/275 -3772 w .fppc.ca.gov
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREETADDRESS
CITY
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $10,001 - $100,000
0,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INTEREST
❑ Ownership /Deed of Trust
IF APPLICABLE, LIST DATE:
--- J__J 11 __J__J 71
ACQUIRED DISPOSED
❑ 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.
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $19ye1 - $100,000 J� 11 JJ 11
$100,001- $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OFINTEREST
❑ Ownership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Y.. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
V 001 El ❑ $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.
You are not required to report loans from commercial lending institutions 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
INTEREST RATE
❑ None
TERM (Months/Years)
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, d applicable
Comments:
NAME OF LENDER'
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, 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, it applicable.
FPPC Form 700 (2011/2012) Sch. B
FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov