Clint Zollinger - Annual 2016• - - . . J IAI tMtN I Uh tioUNUMK. IM I tKtb I J umcia{ use \
FAIR POLITICAL PRACTICES COMMISSION (1(0
A PUBLIC • • COVER PAGE
Please type or print in ink. (Cl) MAY 2 5 2017 G
NAME OF FILER (LAST) (FIRST) (MIDDLE)
N {
Zollinger Clinton ti 491A rr jC5
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Gilroy
Division, Board, Department, District, if applicable Your Position
General Plan Advisory Committee Committee Member
► 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 _
Gilroy
❑ City of
3. Type of Statement (check at least one box)
❑ Annual: The period covered is January 1, 2016, through
December 31, 2016.
-or-
The period covered is through
December 31, 2016.
❑ Assuming Office: Date assumed —J —�
❑ Candidate: Election year
Position:
❑ Judge or Court Commissioner (Statewide Jurisdiction)
I-1 Crninty of
❑ Other
❑ Leaving Office: Date Left I I
(Check one)
Q The period covered is January 1, 2016, through the date of
-or-
leaving office.
Q The period covered is I I through
the date of leaving office.
and office sought, if different than Part 1:
4. Schedule Summary (must complete) ► Total number of pages including this cover page:
Schedules attached
❑ Schedule A -1 - Investments - schedule attached
❑x Schedule A -2 - Investments - schedule attached
❑ Schedule B - Real Property - schedule attached
-or-
0 None - No reportable interests on any schedule
0 Schedule C - Income, Loans, 8 Business Positions - schedule attached
❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
9460 No Name Uno, #140 Gilroy CA 95020
DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS
( 408 ) 847 -0107 clintzollinger ftmail.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 acknowledge this is a public document.
I certify under penalty of pedury under the laws of the State of California that the foregoing is true and correct.
Date Signed
05/25/17
(month, day, yew)
Signature
(File ft
your Bm9 oftw )
FPPC Form 700(2016/2017)
FDDr Arrvira Finail• arivira(alfnnr rn anv
SCHEDULE A -2 CALIFORNIA FORM-
Investments, Income, and Assets
Name
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
Fritter, Schulz & Zollinger Physical & Occupational Thera
Name
9460 No Name Uno, #140, Gilroy, CA 95020
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
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑X Over $1,000,000
NATURE OF INVESTMENT
X❑ Partnership ❑ Sole Proprietorship ❑
Owner/Partner/PT
YOUR BUSINESS POSITION
SHARE O-F THE G' R'0_ SS,, INCOME TO 'TH, E_ UST).
Q $0 - $499 Q $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
SOURCE
MORE
❑ None or ❑ Names listed below
Physical Therapy Services/Partnership
LEASED BY THE BUSINES§ ENTITY •-
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, 4C
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity gL
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 -i-J 16 _j_j 16
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold El Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
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 16 � .116
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship ❑
YOUR BUSINESS POSITION
INCOME 1.
ii� 2. IDENTIFY THE GROSS ■ YOUR -• RATA
SHARE O -• SS INCOME To THE ENTITY/TRUST)
❑ $o - $499 El $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
•
❑ None or Names listed below
INVESTMENTSAND INTERESTS IN REAL PRO:;ERTY 'HELD OR
RUST
LEASED BY, T�.,E ELJSINESI�� ENTITY b;R -1
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 2[
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, UST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OFINTEREST
❑ 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 (2016/2017) Sch. A -2
Comments:
FPPC Advice Email: advice@fomca.2ov
SCHEDULE C
Income, Loans,. & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
Fritter, Schulz & Zollinger Physical & Occupational Tt
ADDRESS (Business Address Acceptable)
9460 No Name Uno, #140, Gilroy, CA, 95020
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Physical Therapy
YOUR BUSINESS POSITION
Owner/Partner/Physical Therapist
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $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
(For self - employed use Schedule A -2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A -2_)
❑ Sale of
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of 310,OW or more
❑ Other
(De —be)
(De —be)
Name
C G t Pero t1l qu U_ 1__1e7 V —
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $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 partners income
(For self- employed use Schedule A -2.)
❑ Partnership (Less than 10% ownership. For 100/6 or greater use
Schedule A -2.)
❑ Sale of
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
(Describe)
❑ 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`
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
❑ Guarantor
❑ Other
Sheet address
City
(Describe)
FPPC Form 700 (2016/2017) Sch. C
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov