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Patricia Bentson - Assuming Office 2017 Date Left // (Check one) The period covered is //, through the date STATEMENT OF ECONOMIC INTERESTS COVER PAGE FPPC Form 700 (2016/2017) 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, 2016, through The period covered is //, through December 31, 2016 -ILDDRESS Date assumed FPPC Advice Email: advice fppc.ca.gov@ Dnotuseacronyms Dnotuseacronyms December 31, 2016 the date of The period covered is January 1, 2016, through lntiallng Received 101500115-NFH-0115 Bentson, Patricia City of Gilroy Parks & Recreation Commission Commissioner X Gilroy X 01 23 2017 3 X 7661 Forest Street Gilroy CA 95020 408 607-5276 patbentson@aol.com 04/23/2017 Patricia Bentson E-Filed 04/23/2017 23:00:08 Filing ID: 164736842 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 (2016/2017) 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.) No Income - Business Position OnlyNo Income - Business Position Only 101500115-NFH-0115 Bentson, Patricia City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 Municipal government Retiree X X Longevity Lane Bryant Outlet 8375 Arroyo Circle Gilroy, CA 95020 Retail Part time sales associate 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 (2016/2017) 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.) No Income - Business Position OnlyNo Income - Business Position Only 101500115-NFH-0115 Bentson, Patricia CalPERS 400 Q Street Sacramento, CA 95811 California Public Employee Retirement System pension administration Retiree X X Pension