Margaret Clark - Annual ivpo
STATEMENT OF ECONOMIC INTERESTS REC kmea eived
CALIFORNIA FORM 700 �' nh'
FAIR POLITICAL PRACTICES COMMISSION COVER PAGE FEB 21 2019
Please type or print in ink. A PUBLIC DOCUMENT CITY CLERK'S OFFICE
NAME OF FILER (LAST) (FIRST) BY: (MIDDLE)
Via
Clark 6'larrc&re.± F.
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
CA4I-I1 0-r Ros CYrt C-acQ
Division, Board, Department, District, if applicable Your Position
► 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 ❑Judge or Court Commissioner(Statewide Jurisdiction)
❑Multi-County ❑County of
•
g City of 'R 05-e-01' e11d ❑Other
3. Type of Statement (Check at least one box)
j, Annual: The period covered is January 1, 2018, through ❑ Leaving Office: Date Left —J
December 31, 2018. (Check one circle.)
-or-
The period covered is ,through 0 The period covered is January 1, 2018,through the date of
December 31, 2018. -or-leaving office.
❑ Assuming Office: Date assumed—lam 0 The period covered is , through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
4. Schedule Summary (must complete) ► Total number of pages including this cover page:
Schedules attached
❑ Schedule A-1 -Investments-schedule attached [ Schedule C Income, Loans, &Business Positions-schedule attached
❑ Schedule A-2-.Investments-schedule attached 0 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
•
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended-Public Document)
agg3 Va(leg 81Lfd. . tRose►rte 7a
DAYTIME TELEPHONE NUMhER EMAIL ADDRESS •
( )
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/%V/ i 9 Signature --)47Z4-4-1. -
(month,
a47Z4-4-1Z(month,day,year) (File tlfEodginallysigned paper statement with your filing official.)
FPPC Form 700(2018/201.9)
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
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SCHEDULE C CALIFORNIA FORM 700
Income, Loans,. & Business FAIR POLITICAL PRACTICES COMMISSION
• Positions Name
(Other.-than Gifts and Travel Payments) , : _ eetetr
jam,
► 1.INCOME RECEIVED ► 1.INCOME RECEIVED
NAME OF SOURCE OF INCOME NAME OF.SOURCE OF INCOME
i
ADDRESS(Business Address Acceitaile) ADDRESS(Business Address Acceptable)
BUSINESS
s10sBUSINESS ACTIVITY,kj ANY.OF SOURCE BUSINESS ACTIVITY,IF ANY,OF SOURCE
•
YOUR BUSINESS POSITION YOUR BUSINESS POSITION
GROSS INCOME RECEIVED 0 No Income-Business Position Only GROSS INCOME RECEIVED ❑No income-Business Position Only
❑$500-$1,000 ®$1,001-$10,000 ❑$500-$1,000 ❑$1,00l-$10,000
❑$10,001-$100,000 ❑OVER$100,000 ❑$10,001-$100,000 0 OVER$100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑Salary fa Spouse's or registered domestic partner's income. ❑Salary -❑Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.) (For self-employed use Schedule A-2.)
❑Partnership(less than 10%ownership:For 10%or greater use ❑Partnership(Less than 10%ownership.For 10%or greater use
Schedule A-2.) Schedule A-2.)
-
❑Sale of 0 Sale of
(Real property,car,boat,eta) (Real property,car,boat etc.)
❑ Loan repayment • ❑ Loan repayment
❑ Commission or 0 Rental Income,list each source of$10,000 or more 0 Commission or ❑ Rental Income,list each source of$10,000 or more
• (Describe) (Describe)
❑Other 0 Other
(Describe)- (Describe)
► 2.LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD
You are not required to report loans from a commercial lending institution,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' INTEREST RATE TERM(Months/Years)
% ❑None
ADDRESS(Business Address Acceptable)
SECURITY FOR LOAN
BUSINESS ACTIVITY,IF ANY,OF LENDER ❑None ❑Personal residence
❑Real Property
Street address
HIGHEST BALANCE DURING REPORTING PERIOD
❑$500-$1,000 City
❑$1,001 -$10,000
0 Guarantor
❑$10,001-$100,000
❑OVER$100,000 0 Other
(Describe)
•
Comments:
FPPC Form 700(2018/2019)
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
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'CALIFORNIA-FORM 700-
SCHEDULE D FAIR POLITICAL PRACTICES COMMISSION
Name
Income — Gifts
two ct et Dark
► NAME OF SOURCE(Not an Acronym) ► NAME OF SOURCE(Not an Acronym)
arke
( (IICtwl5 v-Sorensty
ADDRESS(Business Address Acceptable) ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY IF ANY,OF SOURCE BUSINESS ACTIVITY, IF ANY,OF SOURCE
et-t Fri
DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
j I8; 1K $1o6,6g Domev CinDci-Cti-fes j� $
I (3/ iJ $ 41'6,62- i/rnY)er
_1_ $ _1_1 $
► NAME OF SOURCE(Not an Acronym) ► NAME OF SOURCE(Not an Acronym)
ADDRESS(Business Address Acceptable) ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY,OF SOURCE BUSINESS ACTIVITY,IF ANY,OF SOURCE
DATE(mm/ddl•yy) VALUE DESCRIPTION OF GIFT(S) DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
_1—/
_1_1
_1_1 $ _1—J $
► NAME OF SOURCE (Not an Acronym) ► NAME OF SOURCE (Not an Acronym)
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
BUSINESS ACTIVITY,IF ANY,OF SOURCE BUSINESS ACTIVITY, IF ANY,OF SOURCE
DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
Comments:
FPPC Form 700(2018/2019)
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
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