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Joan Karns - Assuming Office 2013CALIFORNIA FORm i D Pecei,zed 700 STATEMENT OF ECONOMIC INTERESTS COMMISSION FAIR POLITICAL PRACTICES p 2013 DOCUMENT A PUBLIC COVER PAGE S� Please type or print in ink. NAME OF FILER (LAST) (FIRST) (MIDDLE) t<&RNS 70AN AL1 c,- 1. Office, Agency, or Court Agency Name 0-1 CiLI�U� C,E���A� -r-L Ax> yi so <Y C ©4,Aj -kT t �F_E Division, Board, Department, District, if applicable Your Position ► If filing for multiple positions, list below or on an attachment. Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi- County ❑ County of cg City of ❑ Other 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 _J_ I through December 31, 2012. A / [� Assuming Office: Date assumed �l n/Dl, ') 0 L ❑ Candidate: Election year 4. Schedule Summary Check applicable schedules or "None." ❑ Leaving office: Date Left (Check one) 0 The period covered is January 1, 2012, through the date of leaving office. 0 The period covered is _ the date of leaving office. and office sought, if different than Part 1: through ► Total number of pages including this cover page: A�L [ 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- E] None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended - Public Document) (421 - -- C- Lue-Du C°.A qS020 (406) 53'7- t s 9 0 -TO At0iS (&) PMOTiD St)LvE • CCU 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 tjhe laws of the State of California that the foregoing is true and correct. Date Signed — L 9 —��� . /_ Signature (month, day, year) (File the odginao signed statement with your riling official.) FPPC Form 700 (2012/2013) FPPC Advice Email: adviceC)fppc.ca.gov FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov SCHEDULE A -1 CALIFORNIA O, Investments FAIR POLITICAL PRACTfCES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10 %) Do not attach brokerage or financial Statements. ► NAME OF BUSINESS ENTITY DSA G NER SCR TION OF BUSINESS ACTIVITY e 01k%k1CQ.IG A L, r FAIR MARKET VALUE Q $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) B- <rtnership 0 Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: I_/ 12 1 1, 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY D SA $ E M e.1 to 4XQ_ 44 AQ-V Ala L I F0 CA '117"5Y GENERAL DESCRIPTION OF BUSINESS ACTIVITY 1:GA1. FAIR MARKET VALUE ❑ $2,000 - $10,000 C5110,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) Partnership (0 Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: — / 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 0 Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: I / 12 _J / 12 ACQUIRED DISPOSED Comments: ► 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 0 Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: I_/ 12 1 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 0 Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: / 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 0 Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: _ If / 12 _�_/ 12 ACQUIRED DISPOSED FPPC Form 700 (2012/2013) Sch. A -1 FPPC Advice Email: advice @fppc.ca.gov FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov SCHEDULE A -2 Investments, Income, and Assets of Business Entities /Trusts (Ownership Interest is 10% or Greater) 1. BUSINESS ENTITY •- VMD -ro s o L,V E Name 142 t Su x> pos 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, LISICr Y �t"1 ❑ $0 - $1,999 ❑ $2,000 - $10,000 -/_1. 12 _1 / 12 ❑ $10,001 - $100,000 ACQUIRED DISPOSED $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Partnership © Sole Proprietorship ❑ Other YOUR BUSINESS POSITION • •• • • ❑ $0 - $499 10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,001 - $10,000 3. LIST THE NAME OF '•• TABLE SINGLE SOURCE OF INCOME OF $10,000 OR MORE ❑ None L 16 �-k coo 1� 4, INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST Check one box: ❑ INVESTMENT ER -REAL PROPERTY 43rD) TO S b Name of Business Entity, if Investment, 2 Assessor's Parcel Number or Street Address of Real Property WQ 540 C t..VILIO 4. C� Description of Business Activity 2 City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $ ,000 - $10,000 $1o,001 - $100,000 x_/12 _/� 12 ❑ $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 CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION AV ii 11� 1. BUSINESS ENTITY OR TRUST Name ILIZi Sode151. V9_106. CA Address (Business Address Acceptable) Check one ❑ Trust, go to 2 [Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF BUSINESS ACTIVITY 1/e k c r ®v'g-es FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $o - $1,999 ❑ $2,000 - $10,000 /12 /12 $10,001 - $100,000 ACQUIRED DISPOSED ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Partnership [ Sole Proprietorship ❑ Other YOUR BUSINESS POSITION SQ©1) 16 /0 Lk-) t,) SHARE • •• • • • • • ••• OF •• SS INCOME TO THE ENTITY/TRUST) ❑ $0 - $499 ❑ $10,001 - $100,000 �❑ $$500 - $1,000 ❑ OVER $100,000 tJ $1,001 - $10,000 1� 3. LIST THE NAME OF ••• TABLE SINGLE SOURCE OF None 1� 4. INVESTMENTS AND INTERESTS IN ..• LEASED BY THE BUSINESS ENTITY .• Check one box: ❑ INVESTMENT ❑ REAL PROPERTY Name of Business Entity, if Investment, 2 Assessor's Parcel Number or Street Address of Real Property Description of Business Activity Q City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 _ /_/ 12 __j___j 12 ❑ $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: 4f>,,1r NQy. a�A -X-W-0 `AD" FPPC Form 700 (2012/2013) Sch. A -2 FPPC Advice Email: advice @)fppc.ca.gov FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc,ca.gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE 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 510.000 or more ❑ Other (Describe) NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE 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 ❑ Other (Describe) * 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' P1rz. n V It r g►.) -r GiL C xj , D rJ ADDRESS (Business Address Acceptable) V_r_1x__)0 Dot> 1111 TV 21D R o o ��v��aS , CD. - BUSINESS ACTIVITY, IF ANY, OF LENDER C 2_ v, -1•- 1J #J , o 0 HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 CT1$'1`0,001 - $100,000 ❑ OVER $100,000 INTEREST RATE TERM (Months/Years) 6.5 % r-1 Y None zo eAlLs SECURITY FOR LOAN Q None ❑ Personal residence ❑ Real Property Street address ❑ Guarantor ❑ Other Comments: `5_V E-AR —,y _S OO Q16 ict��b 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