Jim Gailey - Annual 2013Please type or print in ink.
NAME OF FILER
1. Office, Agency, or Court
(LAST)
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
(FIRST)
Agency Name (Do not use acronyms)
Cry o T / Lr'd x
Dvision , B ard, Department, District, if 9pplicable Your Position
f 34 r Ictrn v 10d a"1 U bl 1304
'rW Af evy, /a fo—
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi- County
C4 City of C2 l Lev y
3. Type of Statement (Check at least one box)
Ea Annual: The period covered is January 1, 2013, through
December 31, 2013.
-or-
The period covered is I I through
December 31, 2013.
❑ Assuming Office: Date assumed 1 1.
❑ Candidate: Election year
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
Position:
Date Receive
c .
a <_
(MIDDLE)
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left I I
(Check one)
0 The period covered is January 1, 2013, through the date of
leaving office.
0 The period covered is �� through
the date of leaving office.
and office sought, if different than Part 1:
► Total number of pages including this cover page:
❑ Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
'Or.
El None - No reportable interests on any schedule
5. Verification 71761?m-,"4Ye?z J{- 5L,Ir -2oa Cal—res. C4- 9'6'd7_ 0
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended . Public Document)
qg6-- 1K0V.!(C/ty s-.A
DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS (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 the foregoing is true erect —�
Date Signed? k& G✓b'A 7-0,1z
(month, day, year)
(Fle the on signed slWement with your
FPPCF6rm 700(2013/2014)
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)
7`1#1" (zo./Pw - -
Name
Address (Business Address eptable
Check one
❑ Trust, go to 2 Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS C
FAIR ,MARKET VALUE IF APPLICABLE, LIST DATE:
$0 $1,999
$2,000 - $10,000 L �� 13
os10,001 - $100,000 ACQUIRED DISPOSED
$100,001 - $1,000,000
Over $1,000,000
NATURE OF INVESTMENT
Partnership MSole Proprietorship
j�, • ' p Other
YOUR BUSINESS POSITION
IDENTIFY -• • e (INCLUDE YOUR --• RATA
SHARE O OSS INCOME TO THE ENTITYiTRUST)
p $0 - $499 K$10,001 - $100,000
Q $500 - $1,000 OVER $100,000
❑ $1;001 - $10,000
• • , r rrr e- •-
J&None
LEASED, •-
Check one box:
[]INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, QC
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity
City or Other Precise Location of Real Property
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
0 $100,001 - $1,000,000
Over $1,000,000
NATURE OFINTEREST
Property Ownership /Deed of Trust
IF APPLICABLE, LIST DATE:
__j_j 13 f___/ 13
ACQUIRED DISPOSED
Leasehold 0 Other
Y. remaining
❑ Stock [] Partnership
Check box if additional schedules reporting investments or real property
are attached
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
Name
►. 1. BUSINESS ENTITY OR. .TRUST .
Name -
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑ Business Entity', complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
$0 $1,999
❑ $2,000 - $10,000 --j-j 13 -1- 13
$10,001 $100,000 ACQUIRED DISPOSED
H $100,001 - $1,000,000
Over $1,000,000
NATURE OF INVESTMENT
Partnership [] Sole Proprietorship
--Other -
YOUR BUSINESS POSITION
GROSS 1� 2. IDENTIFY THE • e (INCLUD - R T
SHARE OF -• SS INCOME IQ THE ENTITY/TRUST)
❑ $0-$499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,060
ON$.l,n'e 001 - $10,000
621111111" .1=01 T 11 s --
AND INTERESTS IN REAL PROPERTY • •
LEASED BY THE EUSINESS,ENTITY •-
Check -
Q INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, QC
Assessor's Parcel. Number or Street Address of Real Property
Description of Business Activity 2C
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
$2,000 - $10,000
$10,001 $100,000 _ -J 13 --J---J-13
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
Over $1,000',000
NATURE OF INTEREST
E] Property Ownership /Deed of Trust Stock Partnership
Leasehold [] Other
Yrs. remaining
Check box if additional schedules reporting investments or real property
are attached
FPPC Form 700 (2013/2014) Sch. A -2
Comments: 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
17216 Q wd.,
Ltt A +.8
CITY
G,
G, c• -.r- ,/-4 4
r15?U
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ 52,000 - $10.000
❑ 310,001 - S100,000
L LJL1 12 _j_/ 12
$100001 - $1,000,000
ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
XOwnership/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
T72f6 A - 4L V ,*/?-CZ-
172/6 8-' Ce rrt *//a
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
17,576 e Hari✓" rt
CITY
G,
FAIR MARKET VALUE
IF APPLICABLE. LIST DATE:
❑ $2,000 - $10.000
❑ $10,001 - $100.000
�G��i�
&FfJ 1_2 -_J--J-12
3100,001 - $1,000.000
ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
OR Ownership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY. GROSS INCOME RECEIVED
$0 - $499 ❑ 3500 - $1,000 ❑ $1,001 - $10,000
❑ S10.001 - $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
Pf#-.r eL Re S r�1 tC-F -
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 - S100,000 ❑ 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)
90 ❑ 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
FPPCAdvice 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
7290 &&/ churn
CITY
(z. L real
o
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ S10,001 . $100,000Y,_,2
___J_—j ,z
$700,001 .51,000,000
ACQUIRED DISPOSED
❑ Over 51;000,000
$100,001 - $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
f72,;b — &P-e7
r7 ?Vv _... j9%wn a z
i
ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
(z. L real
o
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ S2,000 - $10,000
❑ $10.001 - $100.000
��p�,��
IL./ [ 2r 12 ,?
$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
❑ 50 - S499 ❑ $500 - S1,000 ❑ $1,001 - $10;000
54$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 510,000 or more.
❑ None
79-Yo - y0oll�
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' I I NAME OF LENDER"
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Years)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ 8500 - $1.000 ❑ $1.001 - $10,000
❑ $10.001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
Comments:
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
❑ 510;001 s100,000 ❑ OVER $100.000
❑ Guarantor, if applicable
FPPC Form 700 (2012/2013) Sch. S
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
trf- /00, 1 oo- 2-1
CITY
2� To
Gt tfnr G
FAIR MARKET VALUE
IF APPLICABLE. LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
2
❑ $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 - 8100,000 ❑ 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
,S'g d c too - Low -er /ax. - (/ *cy.✓f
S� 210 — Dd,& ✓ / 2C& - PCisarra /• 40C:
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
-/Fy A, weI°�
CITY
G,G�ay : Cam. 96fio zo
FAIR MARKET VALUE IF APPLICABLE. LIST DATE:
❑ $2,000 - 510,000 tl ' 2
12
❑ .$1 o,oO1 - 8100.000 --�� 1
O
rtat $100 001 .$1.000.000 ACQUIRED DISPOSED
I ❑ Over $1,D00,000
NATURE OF INTEREST
Ownership/Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ SO - $499 ❑ $500 - $1,000 ❑ s1,001 . $10,000
IKS10,001 - $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
�rlsl �wvN04®ds
Ff 6! — JuewA¢,-Ag
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' NAME OF LENDER-
rtdMP irl'OACMon/
ADJ5RESS (B mess Address Acceptable)
{
! �-0 hPA /Y &4--
BUSINESS ACTIVITY, IF ANY, OF LENDER
P219 Vs h
INTEREST RATE TERM (Months/Years)
�% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10.001 - $100,D00 KOVER $100,000
❑ Guarantor, if applicable
Comments:
ADDRESS (business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months /Years)
�o ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,Ooo ❑ $1,001 - $10.000
❑ s10i001 . $1.00,000 ❑ 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
N
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
�Z ! /�/v�c J4- sl
CITY
- -T
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - S100,00o
$100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
kOwnershiplDeed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY. GROSS INCOME RECEIVED
❑ $0 - S499 ❑ S500 - $1.000 ❑ S1,001 - 510,000
NJ $10,001 -- S100,000 ❑ 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
1PL11— 13eltan r/
W5*— 6c h er ez-
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
rl fYO /17 �
f�-
CITY
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE`.
❑ $2,000 - $10,000
❑ $10,001 • $1.00.000
%�` �j�
j(?& 2 _--J__j 12
5100.001 - $1.000.000
ACQUIRED DISPOSED
Over 51,000.000
NATURE OF INTEREST
51 Ownership /Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ SO • $499 ❑ $500 - S1,000 ❑ $1,001 - S10.000
510.001 - $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' I I 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 p $1,001 - $10.000
❑ $10,001 - $100.000 ❑ OVER $100,000
❑ Guarantor, if applicable
Comments:
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE, TERM (Months/Years)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ S500 - S1.000 ❑ $1,001 - $10.000
❑ $10:001 - $100.000 ❑ OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700 (201212013) Sch. B
FPPC Advice Email: advice @fppc.ca -gov
FPPC Toll -Free Helpline: 866 1275 -3772 www.fppc.ca.gov
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR's PARCEL NUMBER OR STREET ADDRESS
715-0/ STY H.4rdrVO
J-1-
CITY
«•
gsnln
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - $10.000
$10,001 - $100,000
� J. 12 �� 12
$100,001 - $1.000,000
ACQUIRED DISPOSED
Over $1,000,000
NATURE OF INTEREST
xOwnership/Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ 5500 - $1,000 ❑ $1,001 - $10,000
91 $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
1715-0 - Ter�.fo 64rev� s'
R !SY - � •.rte -i owc
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
�7 Z Ya f ply
%�o fo,�/.✓•
CITY
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - 510,000
❑ $10,001 - sim.ow
12
RS100,001 - $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
IZ 510,001 - $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: 'If you own a 10% or greater
interest, fist the name of each tenant that is a single source of
income of $10,000 or more.
❑ None
r12Y4 - Ra NtLy IvA
7ZY4;r — Af ee? da e:p
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' I I 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 0 51.001 - $10.000
$10,001 - $100.000 ❑ OVER $100,000
❑ Guarantor, if applicable
Comments:
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY, OF LENDER
INTEREST RATE TERM (Months/Years)
3, ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑' $500 -$1,000 ❑ $1,001 - $10.000
❑'s1o.001 - s100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700 (2012/2013) Sch. B
FPPC Advice Email- adviceCfppc.ca.gov
FPPC Toll-Free Helpline: 8661275 -3772 www.fppc.ca.gov
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
X 2 65 13 or wri✓y ✓ tj'", 72
CITY
CITY
'L
Tsozo
FAIR MARKET ALUE
IF APPLICABLE, LIST DATE:
. ❑.$2,000 - $10,000
za03
❑ $10,001 - $100,000
_ 1 1,12 _J_ /12
$100,001 - $1,000,000
ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
xOwnership/Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining
Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
K $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
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
P-1 t
CITY
G r -era y . l�:
g SoZz)
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
AOwnership/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
r'isfiee-
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 (MonthslYears)
% ❑ 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
p $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700 (201212013) Sch..B
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov