Margaret ClarkDate Initial Filing
STATEMENT OF ECONOMIC INTERESTS RECEWS&d
CITY OF RMtyrS(E0Y
COVER PAGE MAR 12 2015
Please type or print in ink.
NAME OF FILER (LAST) (FIRST) CITY CL(MN 'tg OFFICE
e" I I AA t BY:
1. Office, Agency, or
Agency Name (Do not use acronyms)
if applicable
Your
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
Position:
2. Jurisdiction of Office (check at least one box)
❑ State
❑ Multi-County
City of ! " GQ
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
® Annual: The period covered is January 1, 2014, through
December 31, 2014.
-or-
The period covered is
December 31, 2014.
❑ Assuming Office: Date assumed
❑ Candidate: Election year
❑ Leaving Office: Date Left
(Check one)
through O The period covered is January 1, 2014, through the date of
leaving office.
O The period covered is —
the date of leaving office.
through
and office sought, if different than Part 1:
Schedule Summary
Check applicable schedules or "None." ► Total number of pages including this cover page:
❑ Schedule A -1 - Investments - schedule attached M Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule A -2 - Investments - schedule attached Schedule D - Income - Gifts - schedule attached
❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or.
❑ None - No reportable interests on any schedule
o. v
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best 6f 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 ._ffl" k 10 t 06 /S Signature �� -
(month, day, year) (File the 461nally signed statement with your filing otflclai.)
FPPC Form 700 (2014/2015)
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
5,bie. "! /nt.�
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
(For self - employed use Schedule A -2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A -2.)
❑ Sale of
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ 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 ❑ Spouse's or registered domestic partner's Income
(For self - employed use Schedule A -2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A -2.)
❑ Sale of
(Real property, cai boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ 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
INTEREST RATE TERM (MonthstYears)
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
❑ Real Property
Street address
city
❑ Guarantor
❑ Other
(Descdba)
FPPC Form 700 (2014/2015) Sch. C
FPPC Advice Email: advice @fppaca.gov
FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc,ca.gov
SCHEDULE D
Income — Gifts
► NAME OF SOURCE (Not an Acronym)
F�urke I.��fllczauts�_tibv�r�sev)�LLI
ADDRESS (Bu ness Address Acceptable)
'PT- F.. /o i, Py- St. 1- o-5 a eV es Cr4
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE m/dd /yy) VALUE DESCRIPTION OF GIFT(S)
Llall_nfr' Ll Sman �LC
F NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S)
__J __J_ $
—/ $
—� —/� $
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S)
Comments:
► NAME OF SOURCE (Not an Acronym)
L JJ
LIG "w a (~ Q J I tY7T'M i eL G 7 �3
ADDRES' (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
�� t
/-�e il :'c:.c2 c.t,r { -e r' c-lb am I4yic
DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S)
_L _3_ y1 /- V,n G
11 q $ 3o,36 L.i-k"
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mmidd /yy) VALUE
— /_ /— $
��— $
DESCRIPTION OF GIFT(S)
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S)
$
��— $
FPPC Form 700(2014/2015) Sch.D
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov