HomeMy WebLinkAboutCandidate 2005
CALIFORNIA FORM 700
FAIR POLITICAL PRACTiCeS COMMISSION
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AUS 2005
CITY CLERKS omCE
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GIlROy' CA ~.
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
(MIDDLE)
Please type or print in ink
A Public Document
'-
NAME (lASl)
ff);t.LrA;J
(FIRSl)
MAILING ADDRESS STREET
(May use business address)
(
OPTIONAL: F
ZIP CODE
1. Office, Agency, or Court
Name of Office, Agency, or Court:
& t..IJ( JCI C/T Y Cot/,vC/l..-
Division, Board, District, if applicable:
G/'-l!1J<l ClrI C6)V)JOl-
Your Position:
C/TY ~(/VClL~~
- If filing for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
o State
[]-6lunty of 5"~1} Cl..~
./'...1' J1I'JAUI.
o City of c.r. -..:;.u_
o Multi-Gounty
o Other
3. Type of Statement (Check at least one box)
o Assuming Officellnitial
Date:~~_
o Annual: The period covered is January 1, 2004,
through December 31, 2004.
-or-
a The period covered is ---.l~_, through
December 31, 2004.
o Leaving Office Date Left: ---.l---.l_
(Check one)
a The period covered is January 1, 2004, through the
date of leaving office.
-or-
a The period covered is ---.l---.l_, through
~e date of leaving office.
~ Candidate
4. Schedule Summary
(Check applicable schedules or aNo reportable interests. '7
- 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 ~s - schedule attached
Investments (10% or greater Ownership)
Schedule B
Real Property
DYes - schedule attached
Schedule C 0 Yes - schedule attached
Income, Loans, & Business Positions (Income Other than Gifts and
Travel Payments)
Schedule D (Eliminated - report loans on Schedule C)
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: ~
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 of the State
of California that the foregoing is true and correct.
Date Signed tf J1> !DS'
, (month, day, year)
Signature
FPPC Form 700 (200412005)
FPPC Toll-Free Helpline: 866/ASK-FPPC
--
SCHEDULE A-2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
. . .
1J1f1Zr r. f}I/L.oJJ
Name
as" 1/I~_:4 /))!!JV&
Address &' 1 / C1- <:j'S()~
Check one
o Trust, go 10 2 ~ness Entity, complete the box, then go 10 2
GENERA~ D}f5'yTI~USINESS ACTIVITY
GI u::J.) a-~ S;::P..//ICG
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
o $2,000 - $10,000
[B-11b,001 - $100,000
0$100,001 - $1,000,000
DOver $1,000,000
--.l--1 04
ACQUIRED
---.1--1 04
DISPOSED
NAT~E OF INVESTMENT
~ole Proprietorship 0 Partnership 0
YOUR BUSINESS POSITION ~AD.
Other
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COM~lISSION
Name
~ r. I]/~
,
~ 1. BUSINESS ENTITY OR TRUST
Name
Address
Check one
o Trust, go to 2
o Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
A
FAIR MARKET VALUE
o $2,000 - $10,000
o $10,001 - $100,000
0$100,001 - $1,000,000
DOver $1,000,000
NATURE OF INVESTMENT
o Sole Proprietorship 0 Partnership
YOUR BUSINESS POSITION
IF APPLICABLE, LIST DATE:
---1---.1 04
ACQUIRED
-__1-..--.1 04
DISPOSED
o
Clther
~ 3. LIST THE NAME OF EACH REPORTABLE SiNGLE SOURCE OF
INCOME OF $10.000 OR MORE j,JUach d s~p..f<lle ~11f..;fd d fll'LessiHyl
~ 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST
Check one box:
o INVESTMENT
o REAL PROPERTY
Name of Business Entity Q[
Street Address or Assessor's Parcel Number of Real Property
Description of Business Activity Q[
City or Other Precise Location of Real Property
>> 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10.000 OR MORE l.Jlll! h J '>lfl':Hdle she..t 11I1cLe,S':Hvj
Check one box:
o INVESTMENT
>>4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST -
o REAL PROPERTY
Name of Business Entity Q[
Street Address or Assessor's Parcel Number of Real Property
Description of Business AClivity Q[
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE
o $2,000 - $10,000 ---.1---.1 04 ---.1---.1 04 o $2,000 - $10,000 ---1---1 04 --.l---.1 04
0$10,001 - $100,000 o $10,001 - $100,000
0$100,001 - $1,000,000 ACQUIRED DISPOSED o $100,001 - $1,000,000 ACQUIRED DISPOSED
DOver $1,000,000 DOver $1,000,000
NATURE OF INTEREST NATURE OF INTEREST
o Property Ownership/Deed of Trust o Stock o Partnership o Property Ownership/Deed of Trust o Stock o Partnership
o Leasehold
o Other
Vrs. remaining
o Check box if additional schedules reporting investments or real property
are attached
Comments:
o Leasehold
Vrs. remaining
o Other
o Check box if additional schedules reporting investments or real property
are attached
FPPC Form 700 (200412005) 5ch. A-2
FPPC Toll-Free Helpline: 866/A5K-FPPC