Ermelindo Puente - Leaving Office 2013CALIFORNIA FORm 700 STATEMENT OF ECONOMIC INTERESTS
FAIR POLITICAL PRACTICES COMMISSION
p�3
DOCUMENT A PUBLIC
COVER PAGE �'�s'`�
Please type or print in ink.
NAME OF FILER \ (LAST) (FIRST) (MIDDLE)
1. Office, Agency, or Court
Agency Name
Div,isiiion,/nlBap Department, District, i plicable Your Position
1 , th ti yN \,C 1 L" (,,. -.N I -" -, \ i ,
D. If tiling for multiple podtions, fst below or on an attachment.
Agency:
2. Jurisdiction of Office (Check at least one box)
Position:
❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi- County _
\
❑ City of
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2012, through
December 31, 2012.
-or-
The period covered is I I through
December 31, 2012.
❑ County of
❑ Other
[�lLeaving Office: Date Left Id /-) LzA� rtl1�l
(Check one)
O The period covered is January 1, 2012, through the date of
leaving office.
❑ Assuming Office: Date assumed 1 O The period covered is I through
the date of leaving office.
❑ Candidate: Election year and office sought, if different than Part 1:
4. Schedule Summary
Check applicable schedules or "None."
❑ Schedule A -1 - Investments —
schedule attached
❑ Schedule A -2 - Investments —
schedule attached
❑ Schedule B - Real Property —
schedule attached
► Total number of pages including this cover page:
�.l
R, Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
'or-
F1 None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(
(OPTIONAL)
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 (2012/2013)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov
SCHEDULE C CALIFORNIA FORM "11111
Income, Loans, & Business COMMISSION
Positions Name
(Other than Gifts and Travel Payments) -Lr
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Accept ble)
N.
BUSINESS ACTIVITY, IF ANY, OF SOUR
YOUR BUSINESS POSITION
(
! -V,4: f�.Z, ' )
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑ $1,001 - $10,000
$10,001 - $100,000 ❑ OVER $100,000
COf SIDERATION FOR WHICH INCOME WAS RECEIVED
Salary ❑ 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
r
Q Other &
(Describe)
NAME OF SOURCE OF INCOME
G r i
ADDRESS (Busi Acceptable)
--yi l u- /l )- /'(-<- (/ - C /. �- / -t.
BUSINESS ACTIVITY, IF ANY, OF SOURCE
L^ ,( l c{ ,1-r v ti
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑ $1,001 - $10,000
$10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary ❑ 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
dOther 03�1 t
(Describe)
0� 2- LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD
* 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 (2012/2013) Sch. C
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov