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Dion Bracco - Assuming Office 2004 CALIFORNIA FORM 700 FAIR POLITICAL PRAC"-ICTS CO~'MISS\ON (MIDDLE) STATEMENT OF ECONOMIC INTERESTS COVER PAGE Please type or print in ink A Public Document (FIRSl) e.'1 qtl,,() 1. Office, Agency or Court , Name of Oflice, Agency or Court: fJ I a,~i ") (otHMlrr: 'it (-" i'l(}."l/ iH11 r~ De'" <::.l~ 'W1 e il''- A-B e..tt:.~ Division, Board, District, if applialble: ,m~/vYf bev- Your Position: _ If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Offi~ (Check at least one box) o State o County of ~City of Q I \ "'-0 " o Multi-County , I o Other 3. Type of Statement (Check at least one box) 81 Assuming Office/Initial Date: .ll-JSLLI~ o Annual: The period covered is January 1, 2003, through December 31, 2003. -or- e The period covered is ~~_, through December 31, 2003. o LeavinguOffice Date Left: ~~- (Check one) C The period covered is January 1, 2003, through the date of leaving office. -or- e The period covered is ~----1_, through the date of leaving office. o Candidate IJIDH.J STAlE ZIP CODE LA- 'J J7j.lLJ ~r7 S-/C 4. Schedule Summary (Check applicable schedules or DNo reportable interests. i _ During the reporting period, did you have any reportable interests to disclose on: Schedule A-1 0 Yes - schedule attached Investments (Less llran 10% Ownership) Schedule A-2 r$ Yes - schedule attached Investments (10% or greater Ownership) Schedule B Real Property 1&1" Yes - schedule attached Schedule C ri Yes - schedule attached Income & Business Positions (Income OIher /han Loans, Gills, and Travel) Schedule D 0 Yes - schedule attached Income - Loans Schedule E 0 Yes - schedule attached Income - Gifts Schedule F 0 Yes - schedule attaChed Income - Travel Payments -or- _ 0 No reportable interests on any schedule Total number of pages completed including this cover page: Li 5. Verification 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 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed /--<4 - C)Y (month. day, year) s:natur;"\" ;i5~-~.~,. =. ~ (File the originally signed statement with FPPC SCHEDULE A-2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) ~ 1 BUSINESS ENTITY OR TRUST /3 rn...c LO\s '~6~)\V\a tTt'b..lnc;tlofT 11'\ Name ;:J' '" 7 '30 r11o'n T c V .ey Address r Check one o TNst, go In 2 ~usiness Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF BUSINESS ACTIVITY ~/n...:t ~ FAIR MARKET VALUE o $2,000 - $10,000 o $10,001 - $100,000 o $100,001 - $1,000,000 Over $1,000,000 r;--,q.", 5" D orT , IF APPLICABLE, LIST DATE: --1--103 DISPOSED --1---1 03 ACQUIRED NATURE OF INVESTMENT o Sole Proprietorship 0 Partnership [3. c: oY'"1J YOUR BUSINESS POSITION 9re :"i i J. c.'I.-1 T"' ' 0Iher CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name tc:>v'\.. t.\ V'4.< CD ~ 1. BUSINESS ENTITY OR TRUST o $0 - $499 0$500 - $1,000 0$1,001 - $10.000 GENERAL DESCRIPTION OF BUSINESS ACTIVITY o Business Entity, complete the box, then go to 2 FAIR MARKET VALUE o $2.000 - $10,000 0$10,001 - $100,000 0$100,001- $1,000,000 DOver $1,000,000 NATURE OF INVESTMENT o Sole Proprietorship 0 Partnership YOUR BUSINESS POSITION IF APPLICABLE, LIST DATE: ---1---103, ACQUIRED --1----1 03 DISPOSED Name Address Check one o TNsl, go to 2 o 0Iher 0$0 -$499 0$500 - $1,000 0$1,001 - $10,000 o $10,001 - $100,000 5r OVER $100,000 o $10,001 - $100,000 o OVER $100,000 ~ 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF S 10000 OR MORE (""Clell <l C"IH.1 '" shf:'" If npc!'<:snry\ ~ 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE BUSINESS ENTITY OR TRUST Check one box; o INVEStMENT o REAL PROPERTY Name of Business Entity gr Street Address or Assesso~s Parcel Number 01 Real Property Description of Business Activity gr City or Other Precise Location of Real Property FAIR MARKET VALUE 0$2,000 - $10,000 o $10,001 - $100,000 0$100,001 - $1,000,000 DOver $1,000,000 NATURE OF INTEREST o Property Ownership/Deed of TNSt IF APPLICABLE, LIST DATE: --1---1 03 --1---1 03 ACQUIRED DISPOSED o Stock o Partnership o leasehold o Other Yrs. remaining o Check box if additional schedules reporting investments or real property are aUached Comments: ~ 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF $10000 OR MORE (;'\"'C1rh CI <:ppr:\'''' <:h"''''' d l'll"cr.o..;<;;:'r)) ). 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE BUSINESS ENTITY OR TRUST Check one box; o INV~TMENT o REAL PROPERTY Name of Business Entity gr Street Address or Assesso~s Parcel Number of Real Property Description of Business Activity gr City or Other Precise location of Real Property FAIR MARKET VALUE o $2,000 - $10,000 0$10,001 - $100,000 0$100,001 - $1,000,000 DOver $1,000,000 NATURE OF INTEREST o Property Ownership/Deed of Trust o leasehold Yrs. remaining o Check box if additional schedules reporting investments or real property are aUached IF APPLICABLE, LIST DATE: ----1---1 03 --1----1 03 ACQUIRED DISPOSED o Stock o Partnership o Other FPPC Form 700 (2003/2004) Sch. A.2 FPPC Toll-Free Helpline: 866/ASK-FPPC :",,,.,,.1111' SCHEDULE B Interests in Real Property CALIFORNIA FORM 700 FAIR POLITICAL PRACT,CES COM',' SSIO~ Name ---'::;:'l ~ ~ V'A-CcP > CITY ~ it ('0 t FAIR MARKET "'LUE 0$2,000 - $10,000 0$10,001 - $100,000 ~$1oo,001 - $1,000,00.0 DOver $1,000,000 C fr 95lJ...l.. C) > STREET ADDRESS OR PRECISE LOCATION IS:~D Sc>,^~ ~t CITY UOlfl';) re.V" <::::.4- IF APPLICABLE, LIST DAlE: FAIR MARKET VALUE o $2,000 - $10,000 o $10,001 - $100,000 o $100,001 - $1,000.000 W Over $1,000,000 IF APPLICABlE, LIST DATE: -.J-1 03 ~---1 03 ACQUIRED DISPOSED -.J-.J 03 ~~ 03 ACQUIRED DISPOSED NATURE OF INTEREST ~ Rental Property 0 Ownership/Deed of Trust 0 Easement Q Leasehold 0 NATURE OF INTEREST m... Rental Property 0 Ownership/Deed of Trust 0 Easemtlnt o Leasehold Yrs. remainl"" o Olher Yrs. remaini"" Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED 0$0 - $499 0 $500 - $1,000 0 $1,001 - $10,000 8 $10,001 - $100,000 0 OVER $100,000 IF RENTAL PROPERTY, GROSS INCOME RECEIVED 0$0 - $499 0 $500 - $1,000 0 $1,001 - $10,000 ~ $10,001 - $100,000 0 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, Cr'">ll 'r1" r O-P.5 Ci vf\Q.. C \~rC\. NAME OF LENDER NAME OF LENDER ADDRESS ADDRESS BUSINESS ACTIVITY OF LENDER BUSINESS ACTIVITY OF LENDER INTEREST RATE TERM (Months/Years) INTEREST RATE TERM (Months/Years) % 0 None % 0 None HIGHEST BALANCE DURING REPORTING PERIOD 0$500 - $1,000' 0 $1,001 - $10,000 0$10,001 - $100,000 0 OVER $100,000 HIGHEST BALANCE DURING REPORTING PERIOD o $500 - $1,000 0 $1,001 - $10,000 0$10,001 - $100,000 0 OVER $100,000 o Guarantor, if applicable o Guarantor, if applicable Comments: FPPC Form 700 (2003/2004) Sch. B FPPC Toll-Free Helpline: 866JASK-FPPC SCHEDULE C Income & Business Positions (Income Other than Loans, Gifts, and Travel Payments) > ~ OF SOURCE O/.4ao. 5 fOWlW/<! VVl:aVlS POV'lt ADDRESS (p '"1 '3 C> m o'")1-r-c::V" -e. 7' ~ ~ 11.91 ",'\~,f BUSINESS ACTIVITY, IF ANY, OF 'soURCE TlJlV 1 . ( V~ {jo vrr . YOUR BUSINESS POSIT~ P\r-€S (~eV\+- GROSS INCOME RECEIVED 0$500 - $1,000 0 $1,001 - $10,000 o $10,001 - $100,000 ~R $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED H Salary 0 Spouse's income 0 Loan repaYll1lint o Sale of (PropetIy. car, 1loaI, eIc.) o Commission or 0 Rental Income, list each soutee of SlO,Ooo or mon> fil. Other Sroc:.K ~\~ elf" (Desctibe) > YOUR BUSINESS POSITION GROSS INCOME RECEIVED 0$500 - $1,000 0 $1,001 - $10,000 o $10,001 - $100,000 0 OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED o Salary 0 Spouse's income 0 Loan repayment o Sale of (PtopetIy, car. 1loaI, etc.) o Commission or ~entallncome, list aach soutee of $10,000 or mon> o Other (Describe) Comments: CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name I::::> lOV\. -6 I'~ > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED 0$500 - $1,000 0 $1,001 - $10,000. 0$10,001 - $100,000 0 OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED o Salary 0 Spouse's income 0 Loan repayment o Sale of (Pmperty, car. boal, etc.) o Commission or 0 Rental IncOme, list each soutee of S10,000 or mon> o Other (Descdbe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED 8 $500 - $1,000 0 $1,001 - $10,000 0$10,001 - $100,0000 OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED o Salary 0 Spouse's income 0 Loan repayment o Sale of o Commission or (Property, car, 1loaI, eIc.) o Rental Income, list each soutee of $10,000 or more o Other (Describe) FPPC Form 700 (2003/2004) Sch. C FPPC Toll-Free Helpline: 866/ASK-FPPC