Clint Zollinger - Annual 2017STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
Please type or print in ink.
Date
NAME OF FILER (LAST) (FIRST) (MID
Zollinger Clinton John
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
P. 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
❑x City of
3. Type of Statement (Check at least one box)
0 Annual: The period covered is January 1, 2017, through
December 31, 2017.
-or-
The period covered is —J I through
December 31, 2017.
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
Position:
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❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left J_ I
(Check one)
O The period covered is January 1, 2017, through the date of
-or-
leaving office.
O The period covered is I through
the date of leaving office,
and office sought, if different than Part 1:
4. Schedule Summary (must complete) o. Total number of pages including this cover page:
Schedules attached
❑ Schedule A -1 - Investments – schedule attached
Q Schedule A -2 - Investments – schedule attached
❑ Schedule B - Real Property – schedule attached
-or-
E] None - No reportable interests on any schedule
5. Verification
❑ Schedule C - Income, Loans, & Business Positions – schedule attached
❑ Schedule D - Income – Gifts – schedule attached
❑ Schedule E - Income – Gifts – Travel Payments – schedule attached
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
Gilroy CA 95020
DAYTIME TELEPHONE NUMBER E -MAIL AUURESS
(
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 and correct.
Date Signed 3/30/18 Signature
(month, day, year) ( )
FPPC Form 700(2017/2018)
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)
Fritter, Schulz & Zollinger Physical & Occupational Thera I
9460 No Name Uno, Suite 140
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 /,17 /.17
❑ $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/Physical Therapist
YOUR BUSINESS POSITION
❑ $0 - $499 ❑X $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
11- 3. LIST THE NAME OF ••• TABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.)
❑ None or ❑ Names listed below
Physical Therapy Services /Partnership
111- 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY • •-
LEASED _ Y THE BUSINESS ENTITY OR TRUST
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, p2
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
Comments:
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
P 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 117 1,/ 17
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship ❑
Other
YOUR BUSINESS POSITION
IDENTIFY -• • . (INCLUDE YOUR • RATA
SHARE OF -• SS INCOME TO THE ENTITY/TRUST)
❑ $0 - $499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
1- 3. LIST THE NAME OF ••- TABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a separate sheetif necessary.)
❑ None or ❑ Names listed below
1- 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD .-
LEASED - TRUST
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ 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 (2017/2018) Sch. A -2
FPPC Advice Email: advice @fppc.ca.gov
FPPCToll- FreeHelpline:866 /275 -3772 www.fppc.ca.gov
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, Suite 140
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 ❑X 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 $10,000 or more
(Describe)
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
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 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 $10,000 or more
(Describe)
❑ Other I I ❑ Other
(Describe) (Describe )
1- 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:
NAME OF LENDER`
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (MonthsNears)
❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ Guarantor —
❑ $10,001 - $100,000
❑ OVER $100,000
❑ Other
Comments:
Street address
city
(Describe)
FPPC Form 700 (2017/2018) Sch. C
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866 1275 -3772 www.fppc.ca.gov