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Jim Gailey - Assuming Office 2012CAI IFORNIA FORM 700 A PUBt IC DOCUMENT Please .: or OF FILER (LMT) F� STATEMENT OF ECONOMIC INTERESTS k e�EizK�cE COVER PAGE u IZ 1. Office, Agency, or Court Agency Name Division, qB rd, Department. District, if aL rt r I &;.. A.417V s ) `r ► If filing for multiple positions, list below or on an attachment. (FIR51) tt Your Position 6da-ed !, erft%er Position. Agency: 2. Jurisdiction of Office (Check at least one box) ❑Judge or Court Commissioner (Statewide Jurisdiction) ❑ State ❑ ❑ Multi- County County of City of 7r L ✓d r! ❑ Other 3. Type of Statement (Check at least one box) ❑ Annual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left _J_J December 31, 2011 (Check one) .or- , through O The period covered is January 1, 2011, through the date of The period covered is _ _J_ —J g leaving office. December 31, 2011. O The period covered is _J_,_i through (� Assuming Office: Date assumed ? J'"' -�" the date of leaving office. ❑ Candidate: Election Year Office sought, if different than Part 1 4. Schedule Summary P. Total number of pages including this Cover page: Check applicable schedules or "None." ❑ Schedule A•1 •Investments - schedule attached ❑ 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 5. Verification 7576'�- - STATE ZIP CODE MAILING ADDRESS STREET CITY (Business or Agency Address Recommended - Public Doclxnent) 2 G A°" d— E -MAIL ADDRESS (OPTIONAL) DAYTIME TELEPHONE NUMBER 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 ft(F ment. 1 certify under penalty of perjury under the laws of the State of California g is true correct. - c Date Signed 2 ` O / Sign w4inalv st ,,;1 , fiYrq oa5oa 1 (month, day, year) FPPC Form 700 (2011/2012) FPPC Toll -Free Helphne. 8661275 -3772 www -fPPc ca 90v SCHEDULE A -2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) Vr� C7grlCv 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: ❑ $2,000 - $10,000 $10,001 - $100,000 10 $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INVESTMENT Sole Proprietorship ❑ Partnership ❑ Other YOUR BUSINESS POSITION ❑ $0 - $ass ❑ $10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 $1,001 - $10,000 Check one box: ❑ INVESTMENT ❑ REAL PROPERTY Name of Business Entity Qf Street Address or Assessors Parcel Number of Real Property Description of Business Activity Qf City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE. ❑ $2,000 - $10,000 ❑ $10,001 - sloo,000 ❑ $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OFINTEREST ❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership ❑ Leasehold ❑ Other Yrs. remaining ❑ Check box if additional schedules reporting investments or real property are attached Name Address (Business Address Acceptable) Check one ❑ Trust, go to 2 ❑ Busi Entit mplete the box, then go to 2 GENERAL DESCRIPTION E ACTIVITY FAIR MARKET VALU /11F APPLICABLE, LIST DATE. ❑ $2,000 - $10,000 10,001 - $100,000 �� _/_/ 10 - - 10 $100,001 - $1,0 ,000 ACQUIRED DISPOSED Over $1,000, 0 NATURE INVESTMENT Sol ropnetorship ❑ Partnership [] Other UR BUSINESS POSITION ❑ $0 - $ass ❑ $10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,001 - $10,000 INWNIL Of � 10 UU0 OR MORE Check one box ❑ INVESTMENT ❑ REAL PROPERTY Name of Business Entity Qf Street Address or Assessor's Parcel Number of Real Property Description of Business Activity Qf 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 Comments: FPPC Form 700 (2010/2011) Sch. A -2 FPPC Toll -Free Melpline: 866/275 -3772 www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) STREET ADDRESS OR PRECISE LOCATION i1 l OS a •rrr� J�-- CITY C714-0 •t e,-,* . 7 saw FAIR MARKET VAL E IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 2003 ❑ $10,001 - $100,00o $100,001 - $1,000,000 ACQUIRED DISPOSED Over $1,000,000 NATURE OFINTEREST �Ownership/Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000 310,001 - $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 $10,0,000 or more. 726S- -*e' TV lT7 2 `r/ IAo✓1!i a ;j.- 7254-- ► STREET ADDRESS OR PRECISE LOCATION Lid Sf �I l-1!- CITY Grc %, ssorh) FAIR MARKET VALUE IF APPLICABLE, LIST DATE. ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 10 ---J--J 10 $100,001 - $1,000,000 ACQUIRED DISPOSED Over $1,000,000 NATURE OFINTEREST Ownership/Deed of Trust ❑ Easement ❑ Leasehold ❑ Yra. 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 $10,000000 or more.. ��+�.��/ mss• Lev ✓�C ei 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 (MonthslYears) % ❑ 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 (MoMhs/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 (2010/2011) Sch. B FPPC Toll -Free Helpline: 866/278 -3772 www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ► STREET ADDRESS OR PRECISE LOCATION _�' lI Sq15Y kf o v,r4 �-- - - - CITY FAIR MARKET VALUE IF APPLICABLE LIST DATE $2,000 - $10.000 ❑ $10,001 - $100.000 /—W?77--/_10 _j 10 $100.001 - $1.000,000 ACQUIRED DISPOSED Over $1.000.000 NATURE OF INTEREST Ownership /Deed of Trust Easement Leasehold vrs remaining Other IF RENTAL PROPERTY GROSS INCOME RECEIVED 0$0-$499 EII $500 - $1.000 ] $t 007 510000 $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��00-,�0,,or more CALIFORNIA i-oRm 700 l "IN rin,fit "'I 1.i �� I„ �.. ..,. ....�,r ► STREET ADDRESS OR PRECISE LOCATION 2 as so CITY FAIR FAIR MARKET VALUE IF APPLICABLE UST DATE $2 000 $10 000 $10.001 $100 000 203r - - -1 _» D ___J __J 10 . 5100.001 - $1,000000 ACQUIRED DISPOSED LJ Over $ 1.000.000 NATURE OF INTEREST Ownership /Deed of Trust Easement Leasehold rn remaumng Dther IF RENTAL PROPERTY GROSS INCOME RECEIVED $0 $499 ^ -; $500 S1 000 _; $1.001 - $10.000 $10001 $100000 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. * 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 Accep(able) BUSINESS ACTIVITY IF ANY OF LENDER INTEREST RATE TERM (Months/Years) -- . - -- - -% !- Ji None HIGHEST BALANCE DURING REPORTING PERIOD [] $500 - $1.000 LJ $1 001 - $10 000 $10,001 - $100.000 OVER $100000 C 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 i $500 - $1.000 -; $1,001 - 510.000 $10001 $too 000 OVER $100000 Guarantor A applicable FPPC Form 700 (2010/2011) Sch. B FPPC Toll -Free Helpitne. 866 /276 -3772 www,fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ► STREET ADDRESS OR PRECISE LOCATION CITY of 70 FAIR MARKET VALUE IF APPLICABLE LIST DATE $2,000 - $10.000 ❑ $10,001 - $100000 $100,001 - $1.000.000 ACQUIRED DISPOSED E] Over $1.000.000 ► STREET ADDRESS OR PRECISE LOCATION NATURE OF INTEREST g,Ownershtp /Deea of Trust Easement CITY IJ Leasehold _.. Leasenola _ rrs Other vrs Other remainonq IF RENTAL PROPERTY GROSS INCOME RECEIVED FAIR MARKET VA UE IF APPLICABLE. LIST DATE $2 000 $10 000 $10.001 - $100.000 OVER $100000 �I $10.001 - $100,000 � 10- - -J 10 V' $ 1OO.O01 - 31,000.000 - ACQUIRED DISPOSED Over $1 000 000 Interest list the name of each tenant that Is a single source of NATURE OF INTEREST NATURE OF INTEREST g,Ownershtp /Deea of Trust Easement KOwnershiprDeea or Trust _. Easement IJ Leasehold _.. Leasenola _ rrs Other vrs Other remainonq IF RENTAL PROPERTY GROSS INCOME RECEIVED IF RENTAL PROPERTY GROSS INCOME RECEIVED $O $499 $500 - $1 000 'r $1 001 - 510.000 $0 $499 '-. $500 - $1.000 _�' $1 001 - $10000 $10.001 - $100.000 OVER $100000 $10001 $100000 J OVER $100.000 SOURCES OF RENTAL INCOME If you own a 10% or greater SOURCES OF RENTAL INCOME If you own a 10% or greater interest, list the name of each tenant that Is a single source of Interest list the name of each tenant that Is a single source of income of $10,000 or more 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 TERM (Months/Years) _ —% _� None HIGHEST BALANCE DURING REPORTING PERIOD IN, $500 $1.000 1 $1 001 $10000 $10.001 - $100,000 OVER $100000 r; Guarantor, if applicable Comments: __ NAME OF LENDER' ADDRESS !Business Address Acceptable) BUSINESS ACTIVITY IF ANY OF LENDER INTEREST RATE TERM (MorlthslYears) % None HIGHEST BALANCE DURING REPORTING PERIOD $500 - $1 000 $1 001 - $10 000 $10001 - $100.000 OVER 5100 000 Guarantor . it applcab4e FPPC Form 700 (2010/2011) Sch. B FPPC Toll -Free Helpllne: 866 /275 -3772 www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ► STREET ADDRESS OR PRECISE LOCATION CITY FAIR MARKET VALUE IF APPLICABLE LIST DATE $2,000 - $10 000 s10.0ol - $100 000 10 $100,001 - $1,000.000 ACQUIRED DISPOSED Over $1,000000 NATURE OF INTEREST Ownership /Deed of Trust Easement C Leasehold Yrs remaining - Omer IF RENTAL PROPERTY GROSS INCOME RECEIVED 'J $O - $499 r JJJ $500 - $1 000 $1 001 - 510 000 $10.001 - $100000 L] 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 100 —1-04-c-r / 2zv — vc""074- 266 — .i�✓�✓ /2av — N1 { - - - -- - - ► STREET ADDRESS OR PRECISE LOCATION — S151lb —1 CITY _G_r L FAIR MARKET VALUE IF APPLICABLE LIST DATE $2 000 $10000 / 1: 510001 5100000 �IF! J_10 __J__ -_J __1_0_ $100,001 $ 1.000,000 ACQUIRED DISPOSED Over $1 000 000 NATURE OF INTEREST liE Ownership/Deed of Trust _ _ Easement Leasehold - -- rrn rema 1,nq Omer IF RENTAL PROPERTY GROSS INCOME RECEIVED $0 $499 '_ $500 - $1.000 —1 $1 001 $10.000 g4lo001 3100000 J 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' 6-r o it ADDRESS (Bu� eptable) 7- " - -- BUSINESS ACTIVITY IF ANY OF LENDER d� INTATE TERM (Monlhs/Years) ❑ None HIGHEST BALANCE DURING REPORTING PERIOD $500 - $1o00 $1 001 $10 000 'J 510.001 3100000 u OVER $100000 J Guarantor, If apphcaNe 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 $10001 5100 000 _j OVER $100000 J Guarantor if applicable FPPC Form 700 (2010)'20111 Sch. B FPPC Toll -Free Helpllne: 8661275-3772 www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ► STREET ADDRESS OR PRECISE LOCATION 17-2 `� �- -- - - - - -- - -- CITY FAIR MARKEf VALUE IF APPLICABLE LIST DATE $2.000 - $10.000 / $10 001 - $100 000 k- - -- / -- $100.001 - $1 000 000 ACQUIRED DISPOSED Over $1.000 000 NATURE OF INTEREST Xb"Inership/Deed of Trust Easement Leasehold Yrs remaining Otner IF RENTAL PROPERTY GROSS INCOME RECEIVED L $0 - $499 ' _� $500 $1 000 $1 001 - $10 000 $10.001 $100.000 _j 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 r721(o,A— - .F, .7_�-- _ - You are not required to report loans from commercial of business on terms available to members of the pu and loans received not in a lender's regular course o NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY IF ANY OF LENDER INTEREST RATE TERM IMonths/Yeers) % 1. None HIGHEST BALANCE DURING REPORTING PERIOD $500 - $1,000 $1 001 - $10000 J slo.00l . $100000 _ OVER $100000 Guarantor If appllcade Comments: _ ► STREET ADDRESS OR PRECISE LOCATION CITY - G- Gam• � -- �. � �UZv __ - - - -- FAIR MARKET VALUE IF APPLICABLE. LIST DATE . $2,000 - $10 000 Lr $ to ool - $ loo.o00 `Q_A 0 _J/ 10 $100,001 $1 000000 ACQUIRED DISPOSED Over $1 000 000 NATURE OF INTEREST Ownership /Deed of Trust Easement Leasehold --- -. - -- -.. Yrs rema,ning - — other IF RENTAL PROPERTY GROSS INCOME RECEIVED $0 $499 $500 - $1 000 $1 001 - $10000 $10001 $100000 n 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 Inc o a of $10.000 or more �nding institutions made in the lender's regular course c without regard to your official status. Personal loans DUSIneSS 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 I_] $1 001 - $10000 $10001 $100000 OVER 5100000 Guarantor . rf applicable FPPC Form 700 (2010/2011) Sch. El FPPC Toll -Free Helpline: 8661276 -3772 www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ► STREET ADDRESS OR PRECISE LOCATION —Lle J— CITY kilo �_ -sow - - -- — - FAIR MARKET VALUE IF APPLICABLE LIST DATE ❑ 32.000 - $10 000 j $10.001 - $100 000 ` k / -( ! 10 10 5100.001 - $1 000 000 ACQUIRED DISPOSED Over 51,000.000 NATURE OF INTEREST Ownership/Deed of Trust Easement ❑ Leasehold - -. -- - _ _ - ---- __. -- -- Yrs. remaining Other jI PROPERTY. GROSS INCOME RECEIVED 30 - $499 $500 51.000 J $ i OO t 3 10 000 0$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. 72 o .�- -- - - -- - - -- * You are not required to report loans from commercial of business on terms available to members of the pul and loans received not in a lender's regular course o NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY. IF ANY OF LENDER INTEREST RATE TERM (Months/Ysarsi % None _- -- -.— -- HIGHEST BALANCE DURING REPORTING PERIOD L $500 - 31,000 $1 001 $10 000 j 310.001 - $100.000 OVER $100000 Guarantor if applicable Comments: ► STREET ADDRESS OR PRECISE LOCATION CITY FAIR MARKET VALUE IF APPLICABLE. LIST DATE $2000 $10000 _ $ 10 001 $ 100 000 $100.001 - $1 000 000 ACQUIRED DISPOSED Over $1 000 000 NATURE OF INTEREST X� Easnership7Deed of Trust ement Leasehold Yrs remaining Other IF RENTAL PROPERTY GROSS INCOME RECEIVED $0 - $499 ! J) $500 - $1 000 $1 001 $10 000 J�{ $ 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 1s a single source of income of 310.000 or more -fro a --_- & .- - -- - - -- z Au n -)-�- __ ___ !nding Institutions made in the lender's regular course c without regard to your official status. Personal loans )usiness must be disclosed as follows NAME OF LENDER' ADDRESS (Business Address Axaprabre) BUSINESS ACTIVITY IF ANY OF LENDER INTEREST RATE TERM (Months/Years) None HIGHEST BALANCE DURING REPORTING PERIOD $500 $1 000 $1 001 S 10 000 510001 3100000 OVER $100000 Guarantor if applicable FPPC Form 700 (2010/2011) Sch. 8 FPPC Toll -Free Helpline: 866 /276 -3772 www.fppc.ca.gov