Susan Rodriguez - Annual 2015 Date Left //
(Check one)
The period covered is //, through the date
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
FPPC Form 700 (2015/2016)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
(month, day, year)
(Check at least one box)
State
Multi-County County of
City of Other
(Check at least one box)
Election Year and o
//
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
Agency Name
Division, B
()
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Investments – schedule attached
Investments – schedule attached
Real Property – schedule attached
( )
(Business or Agency Address Recommended - Public Document)
Income, Loans, & Business Positions – schedule attached
– schedule attached
– schedule attached
No reportable interests on any schedule
A PUBLIC DOCUMENT
CourtCommissioner
The period covered is January 1, 2015, through
The period covered is //, through
December 31, 2015
-ILDDRESS
Date assumed
FPPC Advice Email: advice fppc.ca.gov@
Dnotuseacronyms
Dnotuseacronyms
December 31, 2015
the date of The period covered is January 1, 2015, through
lntiallng
Received
101500115-NFH-0115
Rodriguez, Susan Elizabeth
City of Gilroy
Planning Commission Commissioner
*SEE ATTACHED FOR ADDITIONAL POSITIONS
X Gilroy
X
4
X
9365 Lariat Drive Gilroy CA 95020
408 846-0451 suezrod@msn.com
01/27/2016 Susan Elizabeth Rodriguez
E-Filed
01/27/2016
07:32:04
Filing ID:
158393133
COVER PAGE
Expanded Statement Attachment Name
FPPC Form 700 (2015/2016) Expanded Statement
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
FPPC Advice Email: advice fppc.ca.gov@
STATEMENT OF ECONOMIC INTERESTS
101500115-NFH-0115
Susan Elizabeth
* This table lists all positions including the primary position listed in the Office, Agency, or Court section of the Cover Page.
Agency Division/Board/Dept/District Position Type of Statement
City of Gilroy Planning Commission Commissioner Annual 1/1/2015 - 12/31/2015
City of Gilroy Physically Challenged Board of
Appeals
Board Member Annual 1/1/2015 - 12/31/2015
SCHEDULE C
Positions
(Other than Gifts and Travel Payments)
GROSS INCOME RECEIVED
Name
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
1. INCOME RECEIVED
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
1. INCOME RECEIVED
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
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 - $100,000
OVER $100,000
GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
Comments:
2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD
* 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:
SECURITY FOR LOAN
None Personal residence
Real Property
Guarantor
Other
Street address
City
(Describe)
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse’s or registered domestic partner’s income
Partnership (Less than 10% ownership. For 10% or greater use
Sale of
Commission or Rental Income, list each source of $10,000 or more
Other (Describe)
FPPC Form 700 (2015/2016) Sch. C
Realp
FPPC Advice Email: advice fppc.ca.gov@
(For self-employed use Schedule A-2.)
Loan repayment
(Describe)
Schedule A-2.)
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse’s or registered domestic partner’s income
Partnership (Less than 10% ownership. For 10% or greater use
Sale of
Commission or Rental Income, list each source of $10,000 or more
Other (Describe)
Realp
(For self-employed use Schedule A-2.)
Loan repayment
(Describe)
Schedule A-2.)
101500115-NFH-0115
Rodriguez, Susan Elizabeth
Watsonville Community Hospital
75 Nielson St
Watsonville , CA 95075
Acute Care Hospital
Respiratory Therapist
X
X
Santa Clara Valley Medical Center
751 S Bascom Ave
San Jose , CA 95128
Acute Care Hospital
Respiratory Therapist
X
X
SCHEDULE C
Positions
(Other than Gifts and Travel Payments)
GROSS INCOME RECEIVED
Name
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
1. INCOME RECEIVED
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
1. INCOME RECEIVED
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
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 - $100,000
OVER $100,000
GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
Comments:
2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD
* 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:
SECURITY FOR LOAN
None Personal residence
Real Property
Guarantor
Other
Street address
City
(Describe)
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse’s or registered domestic partner’s income
Partnership (Less than 10% ownership. For 10% or greater use
Sale of
Commission or Rental Income, list each source of $10,000 or more
Other (Describe)
FPPC Form 700 (2015/2016) Sch. C
Realp
FPPC Advice Email: advice fppc.ca.gov@
(For self-employed use Schedule A-2.)
Loan repayment
(Describe)
Schedule A-2.)
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse’s or registered domestic partner’s income
Partnership (Less than 10% ownership. For 10% or greater use
Sale of
Commission or Rental Income, list each source of $10,000 or more
Other (Describe)
Realp
(For self-employed use Schedule A-2.)
Loan repayment
(Describe)
Schedule A-2.)
101500115-NFH-0115
Rodriguez, Susan Elizabeth
Good Samaritan Hospital
2425 Samaritan Dr
San Jose , CA 95124
Acute Care Hospital
Respiratory Therapist
X
X