Ermelindo Puente - Annual 2011Please type or print in ink.
NAME OF FILER (LAST)
(A e
1. Office, Agency, or Court
Agency Name
of— L, �\ P r
if appl
l7 t �r
STATEMENT OF ECONOMIC INTERESTS
► If filing for multiple positrons, list below or on an attachment.
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi-County
City of ___ _u� \f C ,
3. Type of Statement (Check at least one box)
/Annual: The period covered is January 1, 2011, through
December 31, 2011.
-or-
COVER PAGE
(FIRST)
LY_V"Ne � \Ad
r-\ 01,e1
w
Your Position
Position:
The period covered is I through
December 31, 2011.
❑ Assuming Office: Date assumed
❑ Candidate: Election Year
/ Date Rived
MAR 2012
CITY CLERKS CF� i
GnLFTLI, CA
cr j
SMIDDLE)
❑ Judge or Court Commissioner (Statewide Jurisdiction)
F-1 County of _
❑ Other
❑ Leaving Office: Date Left I I
(Check one)
0 The period covered is January 1, 2011, through the date of
leaving office.
0 The period covered is I I through
the date of leaving office.
Office sought, if different than Part 1:
4. Schedule Summary ��
Check applicable schedules or "None." Po. Total number of pages including this cover page:
❑ Schedule A -1 - Investments - schedule attached IE/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-
0 None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS
(OPTIONAL)
0
ZIP CODE
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
FPPC Form 700 (2011/2012)
FPPC Toll -Free Helpline: 866/275 -3772 www.fppe.ca.gov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
�_,---e,�I \r\ -"- I L CtiGJ CO-
�t � :: �C �, �) 1 C7
YOUR BUSINESS POSITION'
9,ri)
GROSS INCOME RECEIVED
❑ 500 - $1,000 ❑ $1,001 - $10,000
$10,001 - $100,000 ❑ OVER $100,000
C941DERATION FOR WHICH INCOME WAS RECEIVED
�,alary ❑ Spouse's or registered domestic partner's income
❑ Lo' re ment ❑ Partnership
❑ Sale of
(Real property, car, boat, etc.)
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Describe)
Name
NAME OF SOURCE OF INCOME
\
BUSINESS ACTIVITY, IF ANY, FO SOURCE
1iAf
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
V ❑ 00- $1,000 ❑ $1,001 - $10,000
$10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION IR WHICH INCOME WAS RECEIVED
❑ Salary ,L-,J spouse's or registered domestic partner's income
❑ Loan repayment ❑ Partnership
❑ Sale of
(Real property, car, boat, etc.)
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Describe)
1� 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD 1 1
* 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
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
INTEREST RATE TERM (Months/Years)
❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
Street address
❑ Guarantor
❑ Other
City
(Describe)
FPPC Form 700 (2011/2012) Sch. C
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov