Loading...
Susan Rodriguez - Assuming Office 2014.Dale Rpct r &d STATEMENT OF ECONOMIC INTERESTS / ' U� COVER PAGE 0 �4- r • 2� Please type or print in ink. NAME OF FILER (LAST) (FIRST) (MIDDLE). Rodriguez Susan Elizabeth 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of Gilroy Division, Board, Department, District, if applicable Your Position Planning Commission Member o- 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) Position: ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi- County _ © City of Gilroy ❑ County of ❑ Other 3. Type of Statement (Check at least one box) ❑ Annual: The period covered is January 1, 2013, through ❑ Leaving office: Date Left I December 31, 2013. (Check one) -or- The period covered is through O The period covered is January 1, 2013, through the date of December 31, 2013. leaving office. Assuming Office: Date assumed U 1 O The period covered is J— 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." ► Total number of pages including this cover page: ❑ Schedule A -1 - Investments – schedule attached 7 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- None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE ( Gilroy CA 95020 UAY IlMt ItLtrHVNt NUIVRStN t- MAILAUUKtSS (UF[IONAL) ( 408 ) 710 -8530 suezrod @rnsn.com 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 acknovyledge this is a public ) FPPC Form 700 (2013/2014) FPPC Advice Email: advice @fppc.ca.gov FPPC Toll -Free Helpline: 855/275 -3772 www.,fppc.ca.gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME Good Samaritan Hospital ADDRESS (Business Address Acceptable) San Jose, CA BUSINESS ACTIVITY, IF ANY, OF SOURCE Hospital YOUR BUSINESS POSITION Respiratory Care Practitioner GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 W] $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) 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 p $10,001 - $100,000 p 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) o + o• o + o -o• - so ' 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 terns 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 (2013/2414) Sch. C FPPC Advice Email: advice @fppc.ca.gcv FPPC Toll -Free Helpline: 866 /275 -3772 vA w.fppc.ca.gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME Santa Clara Valley Medical Center ADDRESS (Business Address Acceptable) San Jose, CA BUSINESS ACTIVITY, IF ANY, OF SOURCE Hospital YOUR BUSINESS POSITION Respiratory Care Practitioner GROSS INCOME RECEIVED ❑ S500- 51,000 ❑ $1.001 - S10,000 [Z] $10.001 - $100,000 p OVER $100.000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED Z Salary [] Spouse's or registered domestic partner's income r7 Loan repayment ❑ Partnership Q Sale of (Real property, car. boat, etc.) Commission or ❑ Rental Income, list each source of S10.00 or more M Other (Describe) NAME OF SOURCE OF INCOME Watsonville Community Hospital ADDRESS (Business Address Acceptable) Watsonville, CA BUSINESS ACTIVITY. IF ANY, OF SOURCE Hospital YOUR BUSINESS POSITION Respiratory Care Practitioner GROSS INCOME RECEIVED 5500 - S1,000 $1.001 - S10,000 m 570.001.5100.000 p OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED m Salary [] Spouse's or registered domestic partner's income Q Loan repayment ❑ Partnership Sale of (Real property. car. boat. etc.) Commission or E] Rental Income, list esch source of S10.000 or more Other (Describe) ►,_2:cLOANS- RECEIVED QR?OUTSTANDINGDURINGSNE •.REP,5RTINGeTPERIQD ,^�c'c - -.: .. _..1.x.. ..._ - .:v� r�`..,:d ;z' r '•::, .l£- ;.'._�r -� t,:iC „' * 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 5500 - S1,000 $1,001 - S70,000 S70,001 - $100,000 r7 OVER S100.000 Comments: INTEREST RATE TERM (Months/Years) None SECURITY FOR LOAN None 0 Personal residence Real Property Street address Guarantor [3' Other City (Describe) FPPC Form 700 (2013/2014) Sch. C FPPC Advice Email: advice @fppc.ca.gov FPPC Toll -Free Helpline: 866 /275 -3772 www.fOpc.ca.gov