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Moe McHenry - Annual 2012D b STATEMENT OF ECONOMIC INTERESTS �� COVER PAGE Please type or print in ink. l� NAME OF FILER (LAST) (FIRST) 11W r mC- HEfur2h' mapal 1. Office, Agency, or Court Agency Name GiT Lk,0'-Lj Gpw\m[ S log%: ti Division, Board, Department, District, if applicable Your Position PXP-kS Nx;'IN 26C9- 6AI101, C- ov"W%(JS(Qi,_ P. If filing for multiple positions, list below or on an attachment. Agency: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Multi- County p City of & I L 20 Y Position: ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other 3. Type of Statement (Check at least one box) �J Annual: The period covered is January 1, 2012, through ❑ Leaving Office: Date Left —J_ I -or- December 31, 2012. M 41 (Check one) The period covered is through O The period covered is January 1, 2012, through the date of Deeertif5871T, —'et� M ''V\ leaving office. ❑ Assuming Office: Date assumed t 1 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 -3 Check applicable schedules or "None." ► Total number of pages including this cover page: &J'Ichedule 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 [DAchedule B - Real Property – schedule attached ❑ Schedule E - Income – Gifts – Travel Payments – schedule attached -or. El None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business dL v v C of S() Z o DAYTIME TELEPHONE NUMBER E- MAILADDRESS (OPTIONAL) (40Is ) X41'- <drDL Sr 3 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�� Signature –2 – l 3 (month, day. year) (file the originally signed statement with your filing official.) FPPC Form 700 (2012/2013) FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS CITY i G I, L_��� FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INTEREST Ownership /Deed of Trust ❑ Leasehold Yrs. remaining S'oLo IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ❑ Easement El 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 $10,000 or more. ❑ None Name rn©eQ1s rnc4f,��,� ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS CITY sou7N � c� 'T400f CA 90j-(, 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 Ownership /Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. 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 $10,000 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 (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: 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 www.fppc.ca.gov SCHEDULE A -1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10 %) Do not attach brokerage or financial statements. ► NAME OF BUSINESS ENTITY 5o���ttiLJ7 SSG V21 l �� 7 GENERAL DESCRIPTION OF BUSINESS ACTIVITY I NL/ 6STwF FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 $100,001 $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ® Stock ® Other B (Describe) ❑ Partnership Q Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: _/ 1 12 _/t 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership Q Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: � 1 12 1 l 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership Q Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: I / 12 1, / 12 ACQUIRED DISPOSED Comments: CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule Cl IF APPLICABLE, LIST DATE: � , 12 /, 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership Q Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 11 12 1� / 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership Q Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 11 12 _ /_/ 12 ACQUIRED DISPOSED FPPC Form 700 (2012/2013) Sch. A -1 FPPC Advice Email: advice C)fppc. ca. gov FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov