Jean HallRECEIVE(;
CITY OF ROSEIAi ,-
STATEMENT OF ECONOMIC INTERESTS APE 2 3 20'
•• COVER PAGE
Please type or print in ink. CITY CLERK'S OFFICE
ly
NAME OF FILER // MAST, (FIRST) (MIDDLE)
1ffiL L_
1. Office, Agency, or Court
Agency Name (Do not use acronymsfj
• I' filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency.
Position:
2. Jurisdiction of Office ((heck at feast one boa)
State ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi County 7County of kc 5 ,41,2 ci ez Lff
City of h�bG Ein —�4 i C'4 E] Other
3. Type of Statement (check at (east one boa)
Annual: The period covered is January 1, 2013, through
December 31, 2013.
-ol
The period covered is JJ through
December 31, 2013.
Assuming Office: Date assumed _/ J�'aeo
Q Leaving Office: Date Left
(Check one)
O The period covered is January 1, 2013, through the date of
leaving office ,
O The period covered is through
the date of leaving office.
❑ candidate: Election year and office sought if different than Pan 1
4. Schedule Summary
Check applicable schedules or "None." ► Total number of pages including this cover page: —�
N Schedule A-1 - Investments - schedule attached ILII Schedule C - Income, Loans, 8 Business Positions - schedule attached
4 Schedule A -2 - Investments - schedule attached r-1 Schedule D - Income - Gifts - schedule attached
ItF Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
"or-
None - No reachable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(2111 sor A1.1 Addle. Retn..,Odd I PuClk Documene
�83N �, ✓A l�E� %j� 770
/ao
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 laves of the State of California that the foregoing is true and correct.
Date Signed �- 2' 3 `�' U Signature
FPPC Form 700 (201312016)
FPPC Advice Email: advice @fppc.w.gov
FPPC Toll -Free Melpline: 866 /275 -3772 viww.fppc...gov
SCHEDULE A-1 CALIFORNIA FORm 700
Investments FAIR POLITICAL PRACTICES COMMISSION
Stocks, Bonds, and Other Interests N
(Ownership Interest is Less Than 10%)
Do not attach brokerage or financial stato it
IF APPLICABLE, LIST DATE
13
ACQUIRED DISPOSED
IF NAME OF BUSINESS ENTITY
bir)
RS
/07 A
GENERAL DESCRIPTION OF
THIS BUSI
C
tf,",si BI Iski
FAIR MARKET VALUE
2 000 $10 000
El $to 001 - $100 000
W[]
li-s-001 $1,000000
Over $1 000 000
NATURE OF INVACTIVENT
F1 Stock FI Other
Didishice,
E] Partordsh, Q Income Received of $0 - $499
0 Income Received of $500 Or More Scress,
so schbos, On
IF APPLICABLE, LIST DATE
13
ACQUIRED DISPOSED
IF NAME OF BUSINESS ENTITY
bir)
RS
/07 A
GENERAL DESCRIPTION OF THIS
BUSINESS
C
tf,",si BI Iski
FAIR MARKET VALUE
$2,000 $10 000
$To 001 $100000
$100 001 $1 coo 000
El over $1 SEE Ooo
NATURE OF INVESTMENT
Stock Other
Imbei
E] Partneemp 0 Income Received of So - SPR9
(D Income Received of $500 or More nion, or no. C,
IF APPLICABLE LIST DATE
ACQUIRED DISPOSED
IF NAME OF BUSINESS ENTIT'(`
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
F-I $2 000 S10000 $to 001 $100,000
P $100 001 $1 000 000 Over $1 000 000
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership 0 Income Recoesed of $0 $499
0 In... Received of $500 or More,'Ficcort — Schenve C)
IF APPLICABLE LIST DATE
3
-�L-
ACQUIRED DISPOSED
Comments:
<�& 5 /�oq' T. e,4 �
C 0
FAIR MARKET VALUE
[] $2 000 $10 000 $to 001 $100 000
X$ 100 LOT $1 �000 000 Over $1 000,000
NATURE OF INVESTMENT
Stock F-1 Giber
ni
Ej Partnership 0 Income Received Ed $0 - $499
0 Income Received of WO or More (Pookst on rocneonle S)
IF APPLICABLE LIST DATE
--j--j-13- ---J--j-13
ACQUIRED DISPOSED
� NAME OF BUSINESS ENTITF
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
$2 000 $10000 $To 001 $100 FOG
$100 001 51 000 coo F1 over $1 000 000
NATURE or INVESTMENT
Stock Other
Descrod
Partnership 0 Income Received Of SO - $499
0 Income Received of $500 or More Pener, ch Sneor C)
IF APPLICABLE. LIST DATE
3
__L_
ACQUIRED DISPOSED
� NAME
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
$2,000 $To 000 $10001 $100000
$100,001 $1 000 000 F-1 Over $1,000,000
NATURE OF INVESTMENT
stock ED Other
Vi
E] Partnership 0 Income Recaremd of $0 5499
0 Incence Received Of $5dO or More Proton AS receneve, c)
IF APPLICABLE LIST DATE
13
ACQUIRED DISPOSED
FIRE Form 700 (2013/2014)
FISPC Advice Email: advice@fppc.ca.gov
FISPC Tall-Free Helpline; 866/275-3772 Mosassfppicoca.gov
SCHEDULE A -2 CALIFORNIA FORm 700
Investments, Income, and Assets PAIR POLITICAL ARACImPs Conablussium
Business Entities Name
(Ownership � E� E , /44
(Ownership Interest is 10% or r Greater)
-5 1x1
Trust go to 2 ] Business Entity Complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
Address shires, Address Acceptable)
Check one
] Trust, go to 2 11 Business Entity , complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
IF APPLICABLE. LIST DATE.
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
] $0 - $1.999
] $o - 51 999
]$2000- $10000
JJ13 JJ13
]$2000- $1,000
JJ 13
]$10 001 - $100,000
ACQUIRED DISPOSED
]Sto001 -Stan 000
ACQUIRED DISPOSED
$100 not - $1,000.000 El sl oo ool - Sir L000 000
over $1,000 000 ] Over $1.000 000
VATURE OF INVESTMENT NATURE OF INVESTMENT
]
Partnership ❑sole Proprietorship ❑ I I
t r ] Partnership ] Sole Proprietorship
YOUR BUSINESS POSITION
] $0 $499 ❑ 510,001 $too, 000
] $5o0 $1 Lou OVER $100,000
] SO Sol $1n,000
None
] INVESTMENT ] REAL PROPERTY
Name of Business Entitg if Investment p[
Assessors Parcel Number or Street Adcss of Real Property
Description of Business Activity Y
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE.
] $2,000 - $10,000
] $10,001 - $100 000 JJ 13 JJ 13
] $100001 - $1000000 ACQUIRED DISPOSED
] Over 51 000000
NATURE OF INTEREST
]
Property OwnershiylDeetl of Trust ] Stock ] Partnership
] Leaseholtl Vrs. E] Other
rema nmg
] Check box it additional schedules reporting Investments or real property
are attached
YOUR BUSINESS POSITION
]$0 5499 ❑$10001 $100000
]$500 -$1000 OVER $100 000
] s, Let -$l 0000
None
] INVESTMENT ] REAL PROPERTY
Name of Business Entity, if Investment as
Assessors Parcel Number or Street Address of Real Property
Description of Business Activity gL
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE.
] $2 000 - $10.000
❑
$10,001 8100,000 JJ 13 JJ 13
] $100,001 - $1,000,000 ACQUIRED DISPOSED
] Over $1,000000
NATURE OF INTEREST
] Property Ownership/Deed of Trust ] Stock ] Partnership
] Leasehom ] Other
7r; rema mng
] Check box if additional schedules reporting investments or real property
are attached
FPPC Form 700 (2013/2014) Sch. A -2
FPPC Advice Email: a dvice@Ilp,ac.ca.gov
FPPC Toll- Free Helpline :866 /275 -3772 www.(ppc.ca.gov
SCHEDULE B
Interests in Real Property
(Including Rental Income)
ASSESSORS PARCEL NUMBER OR STREET ADDRESS
�6SS )/. MLi4 7ELAVE I'l
CITY
CA
FAIR MARKET VALUE IF APPLICABLE. LIST DATE'.
❑
$2,000 $10000
❑ $100ol . $100.000 _JJ 13 J� t3
100.001 $1000000 ACQUIRED DISPOSED
�J Over $1.00(1
NATURE OFINTEREST
❑ Oxnenhio/Oeed of Trust ❑ Easement
❑ Leasehold ❑
rva ores,
IF RENTAL PROPERTY GROSS INCOME RECEIVED
❑ SO - Sa99 ❑ $500 . $1000 ❑ $1.001 - $10 000
❑ $10001 - $100,000 ❑ OVER $100000
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 $10,000 or more.
❑ None
CALIFORNIA FORM 700
FAIR PO IrICAL TRACTI¢ 5 fCO.MF KIISSIUN
AsstSSOR 5 PARCEL NUMBER OR STREET ADDRESS
0207
CITY�
rrRS.�t��ni
A r.,4
FAIR MARKET VALUE
IF APPLICABLE LIST pgTE.
❑$z.009 $to 000
��,� ff�j
29
❑ $10001 $100,000
�LkaJJ/ 13
,Wsmo001- $1000,000
ACQUIRED DISPOSED
❑ Over $1900,000
NATURE OF INTEREST
❑ Ownership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Ara. ranan", OfMr,
IF RENTAL PROPERTY GROSS INCOME RECEIVED
❑ SO � $099 ❑ $500 - $1 000 ❑ $1001 $10000
❑
$10S01 - $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 $10,000 or mare.
(2 None
` You are not required to report loans from Commercial lending institutions made in the lender's regular course of
business on terms available to members of the public without regard to your official status. Personal loans and
loans received not in a lender's regular course of business must be disclosed as follows:
NAME OF LENDER'
ADDRESS (business Address Acceptebre)
BUSINESS ACTIVITY, IF ANY OF LENDER
INTEREST RATE TERM (MonthsNears)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑$sop-$tow ❑$1001 -$10 not
❑ $10,001 $100,000 ❑ OVER $100.000
❑ Guarantor, if applicable
Comments:
NAME OF LENDER"
ADDRESS rBVSide55 Address Acceatai
BUSINESS ACTIVITY IF ANY OF LENOER
INTEREST RATE TERM (MonthslYears)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑$500 -$1000 ❑$1001.$to 000
❑$10001 - $100000 OVER $100000
❑ Guarantor. If applicable
FPPC Farm 700(2013/2016) Sch, B
FPPC Advice Email: advice@fppcca.gov
FPPC Toll -Free Helpline: 966 /275 -3772 www.fppc.ougov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOM
C� yy v/csEincHt
ADDRESS (auvness Address Acceptaele) Q
0k�' F- \/9t t_�y ,LSO /UM
BUSINESS ACTIVITY, IF ANY OF SOURCE
YOUR BUSINESS POSITION
.T�J7_45, in Gu r. ci 4 "C ml ,e
GROSS INCOME RECEIVED
❑$500 - $1,000 ;4$1 001 - $to.000
p $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑ Salary [] Spouses or registered Domestic partner s income
El Loan repayment ❑ Partnership
Sale or
(Real 11 .! .1 eo)
�C0m.am.o pr Ej racist Income . lseach murca ordfod0pm more
n
CALIFORNIA FORM 700
FNIR I'll IrICAL 1111 T16L5 LON Ln SSI,,I
NAME OF SOURCE OF INCOME
ADDRESS (BusOess
BUSINESS ACTIVITY IF ANY OF SOURCE
BUSINESS POSITION
GROSS INCOME RECEIVED
❑$500 - $1.000 ❑$1,001 - $10,000
❑ $10001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary CD Spouses or registered domestic padmi income
Loan repayment ❑ Partnership
❑ See of
(Real pNpaM cer. Doh! ar,
�COmmisson or Rental Income. /x eacn ri of $1, ors c,
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'
(Business Address Acceptable)
BUSINESS ACTIVITY IF ANY OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOO
$500 $1,000
$1 001 - $10,000
❑ $to,001 - $100.000
❑ OVER $I DO DOD
Comments:
INTEREST RATE TERM (MOnlhs/Years)
% None
SECURITY FOR LOAN
None E] Perbenal reeitlence
Real Property
❑ Guarantor
Other
FPPC Form 700 (2013/2010) Sch. C
FPPC Advice Email: advice @fpKc .gov
FPPC Toll -Free Ha ine: 966 /275 -3772 www.tppc.ca.gov
1 1 CITY EME
e• a �' %aEMEnp
STATEMENT OF ECONOMIC INTERESTS,, 232014
Please We 01 P"tiIlk COVER PAGE
CITY CLERKS OFFICE
NAME OF FlLEa ILasn BY'
141— t— (Fast, (MIDDLE)
I. Office, Agency, or Court
Agency Name f0o not use eaonyms)
-- -' Your POE
* i' filing for multiple positions . list below or on an attachment. (Do net use ecmnyms)
Agency:
Position
2. Jurisdiction of Office ( Check at least one box)
❑ Stale
Mup;.000nty 11 Judge or Court Commissioner (Statevirde Jurisdiction)
❑
7 _ ; county of �� -S �yNCC:Lt3
�CitV at 4bC�/n[f}Q
/ C' 4 71 Diner
3. Type of Statement (check at feast one box)
�i Annual: The period covered is Jancary t, 2013, through Leaving ice: Date Left _/ p(Lf
December 31, 2013.
-or. (Check one)
The period covered is _I_J
December 31, 2013.
. drought O The period covered is January 1, 2013, through the date of
B
leaving office.
❑ Assuming Office: Date assumed ;/
O The period covered is
_L_,_
Pro date of leaving aflice. through
❑ Candidate: Election year and office sought if different than Part 1:
4, Schedule Summary
Check applkable schedules or "None. ^
► Total number of pages including this cover page:
Schedule A.1 • !nvesfinents - schedule attached
Schedule C • Income,
[� Schedule A- 2 - Investments - schedule attached
& Business Pochioos- schedule attached
� Schedule D Income
Schedule e - Real Pro ert
p y - schedule attached
- - Gfts
GIRs - schedule attached
❑ Schedule E - income GiAs
- - Travel Payments - schedule attached
•01•
❑ None - No reportable interests on any schedule
5. Verification
WUNG ADDRESS STREer
(Bwrrmx wAgenoy AOtlress RxwnmerwbO Pu Oavmanry
err
�I 6TATE Z CODE
I
DAY *!ME TELEPHONE NUMBER
% ` � J l ] 'J p
EMAIL ADDREC610PSI ql)
have used all reasonable diligence in preparing this statement.
herein and in any attached schedules is true
have reviewed this statement and Ie the best of my knowledge the information
and complete, t acknowledge
contained
this is a public document.
I certify under Penalty of Pill under the laws of the State of California that the foregoing
is true and comet.
Date Signed / — 2- ? - _7 U / ` /
n
—. rm�rn, de...,,
Signature �
FPPC Form 700 (2013/2011)
FPPC Advice Email: advice@fppccagov
FPPC Tall -Free Relpline: 866 /275 -3772 www.fppc.ca.8av
SCHEDULE A -1 700;1
Investments
Stocks, Bonds, and Other Interests Name
(Ownership Interest is Less Than 10 %)
Do not attach brokerage or financial statements.
��1.'iv4 -AE' c A L SAV I
GENERAL DESCRIPTION OF THIS BUSINESS
cii, SONI nl CNS, CFf�C Kent
FAIR MARKET VALUE
❑E2000- $10.000 ❑$to.001 -$100 too
X$100.001 - $1,000,000
3
❑ Over $1 000,000
NATURE OF INVESTMENT
❑ Stook
❑ Other
❑P- R'Ol -N P
O Income Received of c$499e)
$499
FAIR MARKET VALUE
$5
O Income Received of 6500 or More (Rek,R on ScneiWe q
IF APPLICABLE, LIST DATE.
ACQUIRED DISPOSED
NAME OF BUSINESS ENTITY
,PJArOy cnrA�,;c4 rA 6it�nD,
GENERAL DESCRIPTION OF THIS BUSINESS �G
,FAIR MARKET VALUE
ITL$2000- $10,000 ❑510.00-- sm0000
IfJ� 5100,001 - $1.000,000 ❑ over $1,000, 000
NATURE OF INVESTMENT
❑ Stook ❑ other
❑Pannerehi (- $499el
P O Income Received of $0 - E499
O Income Received of $500 or More Beoert $enercwe e)
IF APPLICABLE.. LIST DATE.
--J--J-13- --j---j-t3
ACQUIRED DISPOSED
. NAME OF
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
❑$2000 - $10,000 $10,001 $100
❑ $100001 - $1,000.000 ❑ over $1 0ag000
NATURE OF INVESTMENT
❑ StoU ❑ Other
1,B —W
❑ PamPFFRP O Income Revived PI $o - $499
O Income Received of $500 or More (Region on So,,eve C)
IF APPLICABLE, LIST DATE.
1 13 _J_J 13
ACQUIRED DISPOSED
Comments:
NAME OF BUSINESS ENT
3
><'.FCc`-5
w4.S "4
UGxERAL DESCRIPTION OF THIS BUSINESS r
�n
FAIR MARKET VALUE
❑ $2000 $10.000 ❑ Sio, 001 - $100,000
1W$100001 - $1 000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
oe nwl
❑ PaFr -Ir MP O Income Received of $0 - $499
O Inrome Recerved of $500 or More rR,00rt on Scnedvle Ci
IF APPLICABLE. LIST DATE:
---j--j--t3
ACQUIRED
. NAME OF BUSINFG!
JI_ 13
DISPOSED
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
❑ $2000 - $10,000 ❑ $10,001 � $100,000
❑ $100 001 - $1.000000 ❑ Over $1000Goo
NATURE OF INVESTMENT
❑ Stock ❑ Other
Part tDeacnEe)
❑ p 0Income Received of So S499
O Income ReceNed Of 5500 or More VvFo r an SrAerture CI
IF APPLICABLE. LIST DATE.
--J--]-13- --J---/-13
ACQUIRED DISPOSED
NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
'IN MARKET VALUE
❑ $2000 $10,000 ❑ $10001 - $100,000
❑ $IDo,001 - S1,Ocum ❑ Over $t 000.000
NATURE OF INVESTMENT
❑ Stock ❑ Other
Des)
❑ P- OrVFmP O Inrome Received of $0 - $499
O Income Received of $500 or More (Rv{n, on Scn Luk C)
IF APPLICABLE. LIST DATE
J -J -13 _lJ 13
ACQUIRED DISPOSED
FPPC Form 700 (2013/2016)
FPPC Advice Email: advice @Fppcsa.gov
FPPC Toll -free Helpline: 866 /275 -3772 v arvcfppcUoa &ov
SCHEDULE A -2 CALIFORNIA FORm
Investments, Income, and Assets
of Business Entities /Trusts rlame
(Ownership Interest is 113 or Greater) -TE'A, E • �
4'r n!,
Y Trust, Bo to 2 ❑ Eke ness Entity, complete the boa then BO to 2
NER4L DESCRIPTION OF THIS BUSINESS
R MARKET VALUE
IF APPLICABLE. LIST DATE.
$0 $1999
$2,000 - $10,000
JJ�3 JJ?3
$10,001 $100,000
ACQUIRED DISPOSED
$100.001 - $1 000,000
Over 51,000 000
FURS OF INVESTMENT
Partnership [] Sole Proprietorship
BUSINESS POSITION
[:1 $0 -$499 ❑$10,Doi $too, coo
❑ 5500 - $I coo OVER $100.000
❑ $1, Doi - $tocoo
0 JNVESTMENT E3 REAL PROPERTY
Address S Suess Address Acreptabk)
Check one
11 Trust, 90 m 2 El Suvnesa Enbm, complete the box, then do to 2
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
IF APPLICABLE. LIST DATE.
7 $C - $1 999
$2 000 - $10 000
--J---J-13 _/J 13
$10,001 -$100 GOO
ACQUIRED DISPOSED
9100,001 - $1, goo ,OOC
Over $1.000 000
NATURE OF INVESTMENT
ID Partnership (] Sole Propriiedr,do --------- —x --
Stfi
YOUR BUSINESS POSITION
❑$0 -$499 El sin Sol -$loo, 000
❑ 5500 - $1 000 i] OVER $100.000
❑ $t or' - $10,000
None
un ene Cox: --
0 INVESTMENT (] REAL PROPERTY
Name of eumndal Entty U Investment, re I I Name of Business Emil, O
. I Investment
Assessors Parcel Number or BVeel Aotl ss of Real Proper, Assessors Paml Number or Street Address o' Real PropeM
Description Of Business Ad iYty or
City or Offer Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE LIST DATE.
C] $2,000 - $10 000
❑ $mool - stoo,000 JJ 13 JJ 13
❑ $100,001 - 51,000 Goo ACQUIRED DISPOSED
Over $1,000000
NATURE OF INTEREST
PropeM Ownershid /Deed of Trust (] Stock (] Partnership
❑ Leasehold (] Other
Vr mmaniog
❑ Chid. IMx if additional sohedules reporting investments or real property
are attended
Descnptpn of BusOees Acvvtty g
City or Order Precise Location of Real PoORa,
FAIR MARKET VALUE IF APPLICABLE, LIST DATE.
❑ $2,000 - $10 000
❑ $to.Doi - $100,000 JJ 13 _JJ 73
❑$too Doi $1,000. Coo ACQUIRED DISPOSED
Over $1,000000
NATURE OF INTEREST
PropeM 0wnersh'113m. of Trust El Stock Partnership
Leasehold [] Other
r �rus"d
Check box If additional eehedules reporting nvestments or real property
are attached
FPPC Form 700 (2013/2014) Som A -2
FPPC Advice Email: advice fti,cuu.gov
FPPCTUII -Free Helpline:866 /275-3772 wvrw.fppcuougov
SCHEDULE B
Interests in Real Property
(Including Rental Income)
le ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
36-,5s N Muses fa-Avc Rs
/� oS�snC -RD CA
FAIR MARKET VALUE IF APPLICABLE. LIST DATE.
❑ $2,000 - $1( oa0
❑ $1 a, 001 - $100000 JJ 13 JJ 13
Floor 001- $1.000,000 ACQUIRED DISPOSED
u Over 51 000,000
NATURE OF INTEREST
OwnershiplDeed of Trust Easement
F7 Leasehold
Yn ramming Olner
IF RENTAL PROPERTY GROSS INCOME RECEIVED
$0 - $499 E] $500 $1.000 El $1 001 - $no Beat
310001 - $100,000 E] OVER $100000
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
❑ None
CALIFORNIA FORM 700
FAIR POLITICAL PRACTIOES COMMISSION
Name
P F'Al(GtL ausi OR STREET ADDRESS
02 o,7 /Y)oN2c- /yyo AvE
CITY
�RS
b,--A A
C A
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE.
❑ $1000 - $10 000
„ Q g
❑ $10 001 - $1 $t 00 000
UI JJ 13
� y 81000a1 - 51,000,000
g
ACQUIRED DISPOSED
❑ Over $1 000,000
NATURE OF INTEREST
Ownership /Deed of Trust Easement
E] Lessened r O
Yrs emaning
other
IF RENTAL PROPERTY. GROSS INCOME RECEIVED
L] $0 - $499 D $500 $1000 P $1 001 - $10,000
Ej $10,001 - 5100,000 [] 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
❑ None
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 TERM (MOnlhs/Years)
. F-1 None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1 000 ❑ $1,001 - s10, 000
Lj $10.001 - 5100 000 OVER $100000
Guarantor, If applicable
Comments
NAME OF LENDER'
(Business Addreaa Aweomble)
BUSINESS ACTIVITY. IF ANY
INTEREST RATE TERM (Months/Years)
F7 None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 $1,000 E] $1 001 $to 000
$10,001 - $100000 OVER $100,000
Guarantor, Ifapplinumle
FPPC Form 700 (2013/2014) Sch. B
FPPC Advice Email: advice @fppc.ca.gov
FPPCTUII -Free Helpline :866 /275 -3772 www.fppc.w.gov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOM�t
ADDRESS (BUSmess Address Acceptable)
LkEi P \/,qtL'�y 43WO RsAv
BUSINESS ACTIVITY IF ANY OF SOURCE
YOUR BUSINESS POSITIO ^/Nl
�nl %Ik IFV� `oUr�C /lMT—Art 6ER
GROSS INCOME RECEIVED
❑ $500 - $1,000 $1 001 $10.000
E:1$10,001 - $100,000 OVER $100, 000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
E] Salary 1:1 Spouse's 0r.11S ered domes", partners income
Loan repayment ❑ Partnership
Sale of
IRealpoany Wr one elc)
]DOmml$$IOO Or Rental Income, Oaf each some .1 SIR 0001 more
Other
CALIFORNIA FORM 700
alk Natl,l�n1 eR.�rl�rs eoraNl$$1n�:
NAME OF SOURCE OF INCOME
ADDRESS (Business Atldress Acceptable)
BUSINESS ACTIVITY IF ANY OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
❑$900- $1,000 ❑$1.001 -sic 001
S1oo01 $100,000 C] OVER $100, 000
CONSIDERATION FOR VMICH INCOME MS RECEIVED
El Salary C3 Spouses or registered domesf painners income
❑ Loan repayment ❑ Partnership
❑ Sale of
(Rea(DmwRY, ca< Ooat BR)
El COmmission or Rental income. W exn mince or n¢ m, w more
❑ OmO,
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
$1001 - s10,000
$10.001 s100000
OVER $100000
Comments:
INTEREST RATE TERM (MonibsNears)
C None
SECURITY FOR LOAN
None Personal residence
❑ Real Property
city
❑ Guarantor
❑ Other
FPPC Form 700 (2013/2014) Sch. C
FPPC Advice Emall: adwee@fppcougov
FPPC Toll -Free Helpline :868 /2753772 www.fppcca.gav