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HomeMy WebLinkAboutJacqueline Bretschneider - Annual 2012Date Received STATEMENT OF ECONOMIC INTERESTS', I COVER PAGE Please type or print in ink. �r( NAME OF FILER (LAST) (FIRST) -"(MIDDLE) Bretschneider 1. Office, Agency, or Court Agency Name City of Gilroy Division, Board, Department, District, if applicable Community Development Department ► If filing for multiple positions, list below or on an attachment. Agency: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Multi- County ©City of 3. Type of Statement (Check at least one box) Annual: The period covered is January 1, 2012, through December 31, 2012. .or- The period covered is December 31, 2012. ❑ Assuming Office: Date assumed ❑ Candidate: Election year 4. Schedule Summary Check applicable schedules or "None." Z Schedule A -1 - Investments — schedule attached ❑ Schedule A -2 - Investments — schedule attached ❑ Schedule B - Real Property — schedule attached Jacqueline Your Position Fire Marshal Position: Theresa ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other ❑ Leaving Office: Date Left I I (Check one) through O The period covered is January 1, 2012, through the date of leaving office. O The period covered is _ the date of leaving office. and office sought, if different than Part 1: o. Total number of pages including this cover page: 3 through Z Schedule C - Income, Loans, & Business Positions — schedule attached ❑ Schedule D - Income — Gifts — 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 ( E -MAIL ADDRESS (OPTIONAL) ( 408 ) 846 -0439 jackiebret @cityofgilroy.org 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 FPPC Form 700 (2012/2013) FPPC Advice Email: adviceC)fppc.ca.gov FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov SCHEDULE A -1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10 %) Do not attach brokerage or financial statements. ► NAME OF BUSINESS ENTITY IBM GENERAL DESCRIPTION OF BUSINESS ACTIVITY Computer company FAIR MARKET VALUE ❑ $2,000 - $10,000 © $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT Q Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 1 12 1 1 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: / / 12 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership 0 Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: /1 12 12 ACQUIRED DISPOSED Comments: CALIFORNIA FORM 7 FAIR POLITICAL PRACTICES COMMI Name Jacqueline •- ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: I / 12 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership Q Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: � 1 12 _ /_� 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 1 12 �_� 12 ACQUIRED DISPOSED FPPC Form 700 (2012/2013) Sch. A -1 FPPC Advice Email: advicegfppc.ca.gov FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov SCHEDULE C CALIFORNIA FORM Income, Loans, & Business FAIR POLITICAL PRACTICES COMMI Positions Name (Other than Gifts and Travel Payments) Jacqueline Bretschneider NAME OF SOURCE OF INCOME IBM ADDRESS (Business Address Acceptable) San Jose BUSINESS ACTIVITY, IF ANY, OF SOURCE Computer Company YOUR BUSINESS POSITION Employee GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 © OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary Z spouse's or registered domestic partner's income ❑ Loan repayment ❑ Partnership n caiP �r `J (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 ❑ $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 (Descnbe) * 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* INTEREST RATE TERM (Months /Years) 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: % ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property ❑ Guarantor ❑ Other Street address city (Describe) FPPC Form 700 (2012/2013) Sch. C FPPC Advice Email: advice@Pfppc.ca.gov FPPC Toll -Free Helpline: 866/275 -3772 www,fppc.ca.gov