HomeMy WebLinkAboutAnnual 2003
Date Received
STATEMENT OF ECONOMIC INTERESTS OfflcialUseOnly
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CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
COVER PAGE
Please type or print in ink
A Public Document
NAME (LAST)
MAILING AD ESS
(May be business address)
M2 t/iC7VflI
IJb t15
1. Office, Agency or Court
Name of Office, Agency or Court:
CITY CI~ G-/L-Roft'
Division, Board, District, if applicable:
Your Position:
Co{)!tJCy t..41{~1l1 &-z
- If filing for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency: .ScFG /J/r/{Q/rMpA/r
Community Development Agency
Position: Member
2. Jurisdiction of Office (Check at least one box)
o State
o County of
~of
G-it..,LJ-J/}/ I e1-
,
o Multi-County
I 0 Other
3. Type of Statement (Check at least one box)
o Assuming Office/Initial
o
Date: --1--1_
Annual: The period covered is January 1, 2003,
through December 31, 2003.
-or-
efThe period covered is ~~1!J2 through
December 31, 2003.
o Leaving Office Date Left: --1--1_
(Check one)
a The period covered is January 1, 2003, through
the date of leaving office.
-or-
a The period covered is ----1----1_, through
the date of leaving office.
o Candidate
4. Schedule Summary
(Check applicable schedules or "No reportable interests.")
- During the reporting period, did you have any reportable
interests to disclose on:
Schedule A-1 0 Yes - schedule attached
Investments (Less than 10% Ownership)
Schedule A-2 0 Yes - schedule attached
Investments (10",1, or greater Ownership)
Schedule B
Real Property
Schedule C ~ - schedule attached
Income & Business Positions (Income Other than Loans. Giffs, and Travel)
DYes - schedule attached
Schedule D 0 Yes - schedule attached
Income - Loans
Schedule E 0 Yes - schedule attached
Income - Gifts
Schedule F 0 Yes - schedule attached
Income - Travel Payments
-or-
- 0 No reportable interests on any schedule
Total number of pages
completed including this cover page:
3
5. Verification
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 certify under penalty of perjury under the laws ofthe State
of California that the foregoing is true and correct.
Signature
Date Signed
FPPC Form 700 (2003/2004)
FPPC Toll-Free Helpline: 866/ASK-FPPC
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SCHEDULE C
Income & Business Positions
(Income Other than Loans, Gifts, and
Travel Payments)
> NA~RCE
-~~ 2/7~~ S7~/2Yic&
ADDRESS
I &:'d-6 71/6' /Jt,./1 /fJd),1 #~07
BUSINESS ACTIVITY, IF ANY, OF SOURCE /
'- \"'e2l/iD:: (F LE01L- ,tJA1('"r~
YOUR BUSINESS POSITION
p;a!)~~ se/2.(/8-
GROSS INCOME RECEIVED
05500 - 51,000 051,001 - 510,000
~01 - 5100,000 0 OVER 5100,000
CO~RATION FOR WHICH INCOME WAS RECEIVED
~alary 0 Spouse's income 0 Loan repayment
o Sale of
o Commission or
(Property, car, boat. etc)
o Rental Income, list each source of $10,000 or more
o Other
(Describe)
> NAME OF SOURCE
a-/f-?l....DV f'~~ ~t1c:.C
~
/ 'S l//C:1CJ~d M., 6-/~V
BUSINESS ACTIVITY, IF ANY, OF SOURCE /
..5 a<. /, GS ;' ~/1L -m
YOUR BUSINESS POSITION
Qiu' ;V~
GROSS INCOME RECEIVED
05500 - 51,000 0 $1,001 - $10,000
~O,OOl - 5100,000 0 OVER 5100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
~ry 0 Spouse's income 0 Loan repayment
o Sale of
o Commission or
(Property, car. boat, etc)
o Rental Income, list each source of $10,000 or more
o Other
(Describe)
Comments:
> NAME OF SOURCE
G-;U201/6"' Q'JtJJC/L-
ADDRESS
73S / f!{)~Ift";11J,J / GtLl?lY, C1
BUSINESS ACTIVITY, IF ANY, OF SOURCE '
CtJt/iVL./L-
YOUR BUSINESS POSITION
U'Y//LbLMv
GROSS INCOME RECEIVED
05500 - 51,000 ~01 - 510,000
o 510,001 - 5100,000 0 OVER S100,OOO
~ON~ERATION FOR WHICH INCOME WAS RECEIVED
~alary 0 Spouse's income 0 Loan repayment
o Sale of
o Commission or
(Property, car. boat, etc)
o Rental Income, list each source Of $10,000 or more
o Other
(Descnbe)
> NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
o 5500 - 51,000 0 51,001 - 510,000
o 510,001 - 5100,000 0 OVER 5100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
o Salary 0 Spouse's income 0 Loan repayment
o Sale of
o Commission or
tProperty, car, boat, etc}
o Rental Income, list each source of $10,000 or more
o Other
(Descnbe)
FPPC Form 700 (2003/2004) 5ch. C
FPPC Toll-Free Helpline: 866/ASK-FPPC
- ,
Attachment naming additional agencies on Form 700 for Robert T.
Dillon.
Santa Clara County Library Joint Powers Authority
South County Regional Wastewater Authority