Jim Gailey - Annual 2012STATEMENT OF ECONOMIC INTERESTS
Please type or print in ink.
NAME OF FILER (LAST)
ML
l�t�
1. Office, Agency, or Court
Agency Name
If fling for multiple positions, list below or on an attachment.
Agency:
2. Jurisdiction of Office (check at least one box)
❑ State
❑ Multi- County
® City of G1 Lra�,
COVER PAGE
Position:
Date ceived
a P CLERKS C�
n ^. R'y f
r
me',,eaes o+�,d
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other _
3. Type of Statement (check at feast one box)
Annual: The period covered is January 1, 2012, through ❑ Leaving Office: Date Left —� —J
December 31, 2012. (Check one)
-or-
The period covered is through O The period covered is January 1, 2012, through the date of
1— December 31, 2012. leaving office.
AC"Assurning Office: Date assume ' O The period covered is — through
the date of leaving office.
❑ Candidate: Election year and office sought, if different than Part 1:
4. Schedule Summary p
Check applicable schedules or "None." ► Total number of pages including this cover page: O
❑ Schedule A -1 - Investments – schedule attached ❑ Schedule C - Income, Loans, & Business Positions – schedule attached
I< � Schedule A -2 - Investments – schedule attached ❑ Schedule D - Income – Gifts – schedule attached
R
BSI' Schedule B - Real Property – schedule attached ❑ Schedule E - Income – Gifts – Travel Payments – schedule attached
-or.
El None - No reportable interests on any schedule
5. Verification r71`16� m•w (rf F, r k Z-cio 9'S'd 2C?
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended Public Document)
(=d 68)
41? --3 G� P I Mi— fl C� C�&F-/C c.�o�r
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 fore a an correct.
Date Signed 'ZlMal-CA Zd1
(month, day, year)
'FPPC Form 700 (2012/2013)
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 8661275 -3772 www.fppc.ca.gov
SCHEDULE A -2
Investments, Income, and Assets
of Business Entities /Trusts
(Ownership Interest is 10% or Greater)
Name
r7 177 6'4 u if 2-CXJ
Address (Business Address Accepts J
Check one
❑ Trust, go to 2 Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF 1LBUSINESS ACTIVITY
rdn,Sa. lfvr✓r
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,090 - $1 o,BOO 12
$10,001 - $100,000 ACQUIRED DISPOSED
$100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVES7TlMENT
E] �el
Partnership Sole Proprietorship ❑
Other
YOUR BUSINESS POSITION e)W ver^
❑ $0 - $499 610,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
v $1,001 - $10,000
None
n r _
IF r
Name
CALIFORNIA FORM 700
:FAIR POLITICAL: PRACTICES COMMISSION
S--
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
FAIR MARKET VALUE
❑ $2,000 - $10,000
_/_/ 12 _/_/ 12
❑ $1m001 - $100,000
ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
F1 Over $1,000,000
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship ❑
YOUR BUSINESS POSITION
❑ $0 - $499
❑ $50o - $1,000
❑ $1,001 - $10,000
None
❑ $10,001 - $100,000
❑ OVER $100,000
1r r , �. , , ..• . .• 4- IRTESTINE1115AIIID IMIERESTS III REAL PROPERTT , ••
.: .• LEASED : OR TRUST
Check one box: Check one box:
❑ INVESTMENT ❑ REAL PROPERTY ❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, Eo Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity of
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 7_1 Other
77 remaining
❑ Check box if additional schedules reporting investments or real property
are attached
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 OF INTEREST
❑ Property Ownership /Deed of Trust
❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
FPPC Form 700 (2012/2013) Sch. A -2
FPPC Advice Email: advice @fppc.ca.gov,
FPPC Toll -Free Hardline: 866 /275 -3772 wvllvvJppc.ca.gov
SCHEDULE B
Interests in Real Property
(Including Rental Income)
le ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
7216 D,,,J•s
-�
J� i�� ji
CITY
,
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ 610,001 - $100,000
1Z
$100,001 - $1,000,000
ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
Ownership /Deed of Trust ❑ Easement
❑ Leasehold
Yrs remaining onher
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 $490 ❑ $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.
❑ None
"7216A - 4L- V#t?-eZ_
"72-46 - ra
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
17 576 4 f1�9 r✓sYH r�
CITY
4-,4. Fseu
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $10,001 $100,000
$100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INTEREST
R Ownership /Deed of Trust
❑ Leasehold
IF APPLICABLE, LIST DATE:
�{ rJ 12
ACQUIRED DISPOSED
❑ Easement
Vrs- remaining Omer
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $490 ❑ $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.
❑ None
PfeXP"e(I aesr�P2hc -P
II
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' NAME OF LENDER"
ADDRESS (Business Address Acceptable) ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER BUSINESS ACTIVITY. IF ANY, OF LENDER
INTEREST RATE TERM (MonthsNears)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 $1,000 ❑ $1,001 $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
Comments:
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 (2012/2013) Sch. B
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Hairline: 866 /275 -3772 www.fppc.ca.gov
SCHEDULE B '
Interests in Real Property Name
(Including Rental Income) "Ti m Gp
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
7z90IFV e -h-rdr rt
CITY /
6,4rcr
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2.000 $10.000 app
❑
$10,001 $100,000 12 !z
$100,001 - $1.000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
VOwnership /Deed of Trust
❑ Leasehold
Ym remaining
❑ Easement
0
Other
IF RENTAL PROPERTY GROSS INCOME RECEIVED
❑ $0 $ass ❑ $500 - $1,000 ❑ $11001 - $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.
❑ None
ri - Pi
1*72W�4r to—wi d y-
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
_ ?f c�/� z
cLiuroS.rf
CITY
( i ,—.Y
�SUZ a
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $4000 - $10,000
❑ $10,001 - $too,000
M_2j 12 _l_J?2
$100,001 $1,000,000
ACQUIRED DISPOSED
Over $1.0001000
NATURE OF INTEREST
ROwnership /Deed of Trust ❑ Easement
❑ Leasehoo
Y s_ remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 $499 ❑ $500 - $1,000 ❑ $1,001 $10,000
p[�$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.
❑ None
79Yo -- Ydeic
_ 7F1-I /lf"0? a Z;-
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 (Marans/Yeam)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 $1,000 ❑ $7,001 - $10,0oo
❑ $10,001 $100,000 ❑ OVER $100,000
❑ Guarantor, if 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 ❑ $t,Do1 $10,000
❑ $10,001 $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700 (2012/2013) Sch. B
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helf ine: 866 /275 -3772 www.fppc.ca.gov
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
7 461- -2Pon
4ie1 loot .2 oo- z io
CITY
OCr.7
gSoao
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2000 - $10000
��%�%'
❑ $10,001 $100'00
12
❑ $100,001 - $1,DO0,000
ACQUIRED DISPOSED
Over $1,000,000
NATURE OF INTEREST
Ownership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Omer
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.
❑ None
5-44C /00 — LoNrc 12Z +" y*c9HT
sw.ir 210 — Do~ /Z6e — flte"S• d 1.-*.
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
/61 �6/
�dr�ier�-
CITY
Gay,,
ls�. 9S'ozo
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
11Y of 12 _ _j_J L2
$100, 001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000.000
NATURE OF INTEREST
AOwnership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaimng Omer
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 $1,000 ❑ $1.001 - $101000
$10,001 $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: It 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'
ME
iC Wry
ADDRESS (EbAiness Address Acceptable)
r7z#fo sa--
BUSINESS ACTIVITY, IF ANY OF LENDER
l0k, V. 'k
INTEREST RATE TERM (Months/Years)
�% ❑ None � ?O
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 $1,000 ❑ $1,001 $10,0oo
❑ $10,001 $100,000 OVER $100,000
❑ Guarantor. if 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
❑ ssao $1,000 ❑ $1,001 - $]a 000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700 (2012/2013) Sch. B
FPPC Advice Email: advice @fppc.ca.gov,
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov
0
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
Z!l /✓U /G UT
CITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 $10,000 .,3 2
❑ $10,001 $100,000 2_&Q 12 _/____J?2
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
kOwnership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining
Ober
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $409 ❑ $500 - $1,000 ❑ $1,001 - $10,000
JR $1Q001 - $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.
❑ None
�2.l� - 13 e �fi-o•+�
fhlS- Gkf�eve�-
Name
IZU GQ< <ev
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
rl fYo !Yy / -/?ti
01 J)t`
CITY
G- r14.
9soz
PAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
J. -L01LJ �2 12
$100,001 $1,000,000
ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
Ownership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining
Omer
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 $499 ❑ $500. $1,000 ❑ $11001 $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.
❑ None ��7
rl /Yo- Ilur-t-
7t� -r�i- W1 ��fC /J�Yr
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 (Manths(Years)
❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if 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, if applicable
FPPC Form 700 (2012/2013) Sch. B
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866 /275 -3772 w vw.fppc.ca.gov
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
71,5_042t
i ?o 1`17,01111 ✓}
CITY
G, II
«. IsdZo
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 $10,000
I� $101001 - $100,000
LC —C�J?2
$100,001 $1,000,000 ACQUIRED DISPOSED
$100,001 - $1,000000
ACQUIRED DISPOSED
Over $1,0001000
NATURE OF INTEREST
Ownership /Deetl of Trust ❑ Easement
❑ Leasehold ❑
Yrs remaining orher
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.
❑ None
r7 ro - Tere fo Are tic s
Name
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
f7 Z Yd
i ?o 1`17,01111 ✓}
CITY
G, II
«. IsdZo
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE.
❑ $2,000 - $10,000
❑ $10,001 - $101
10-3-1 12 J__j 12
$100,001 $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
VOwnership/Deed of Trust
❑ Leasehold
Yrs. remaining
❑ Easement
J
Orher
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001. $10,000
RI $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.
❑ None
!ZZ410 — lea Ndo Cyti
1724141 — M eir da e- t
" 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 (Months /Years)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 310,000
❑ S10.001 $100000 ❑ OVER $100,000
❑ Guarantor, if 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
❑ s5oo . $1,000 ❑ $1,001 $10,000
❑ $10.001 � $100.000 ❑ OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700 (2012/2013) Sch. B
FPPC Advice Email: adVice@fppc.ca.gov
FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov
Y
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
!726_ rI .22T�gzyf
CITY
6.,� L.,.", G4, 4 S'aZo
FAIR MARKET ALOE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000 Zf3Oj
❑ $10,001 - $100,oao
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
xOwnership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Y's, remaining
Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
K $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.
❑ None
r ZO A-114i It�'��2 �/ f - I//KR ,rVT
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
lui SAS{'
CITY
G�
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
7401.
❑�1 $10,001 - $100,000
_/ 12 ��12
X $100,001 - $1,000,000
ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
xOwnership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining
Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
E] $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
IA $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.
❑ None
r=i. 17ee-
II
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' NAME OF LENDER`
ADDRESS (Business Address Acceptable) ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER 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, if applicable
Comments:
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, if applicable
FPPC Form 700 (2012/2013) Sch. B
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866 1275 -3772 www.fppc.ca.gov