MON Ic..f\-
OPTIONAL: FAX I E-MAIL ADDRESS
MAILING ADDRESS STREET CITY STATE ZIP CODE
(May use business address)
4. Schedule Summary
, ~ Total number of pages
including this cover page: ...;..__
o Multi-County ----------------
-or-
o Other -------------------
o No reportable interests on any schedule
3. Type of Statement (Check at least one box)
(Check one)
o The period covered is January 1, 2008, through the HftVCh /& I ;JOt') 1
date of leaving office.
-or-
"1 "'-,
Date Signed ------------------
(month. day, year)
o
$2.000 • $10,000
$100,001 . $1,000,000 III Over $1.000,000 o $100.001 " $1.000,000 DOver $1,000,000
NATURE OF INVESTMENT
NATURE
o Stock
OF INVESTMENT
o Stock
o Other _'Pill.V" ~ US h l e
(DesCribe)
o Other ---------:=---------
(Desclibe)
--1--1~ --1--1~
--1--1~ .--l~~ ACQUIRED DISPOSED
ACQUIRED DISPOSED
NATURE OF INVESTMENT
NATURE
~ Stock
OF INVESTMENT
o Stock
o Omer ~~~------
o Other -----------------
(Describe)
(DesCribe)
Name
f(.?-,JIJ ·rvt!JfV/ft1
Name
o
$2,000 • $10,000
~~08 o $10,001 - $100,000 ~~~ ~----108
$10,001 - $100,000
0$100,001 - $1,000,000
DISPOSED o $100,001 - $1,000,000 ACQUIRED DISPOSED
DOver $1,000,000
DOver $1,000,000
NATURE OF INVESTMENT
NATURE OF INVESTMENT
o Sale Proprietorship 0 Partnership 0 ---------- o Sale Proprietorship 0 Partnership 0 ----------
Other
Other
YOUR BUSINESS POSITION ---------------
YOUR BUSINESS POSITION ---------------
o
$500 - $1,000
$1,001 - $10,000
DOVER $100,000
o $1,001 - $10,000
o
Check one box:
o
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
o $2,000 - $10,000
o
$2,000 - $10,000
$10,001 - $100,000
~----1 08 ~~~ o $10,001 - $100.000
~~
ACQUIRED
08 ~----1
DISPOSED
08
o $100,001 - $1,000,000
ACQUIRED DISPOSED 0$100,001
DOver
- $1,000,000
$1,000,000
DOver $1,000,000
NATURE OF INTEREST
o o
NATURE OF INTEREST
o o o Partnership
o Property Ownership/Deed Df Trust Stock Partnership Property Ownership/Deed of Trust Stock
o o o Other ----------
o Leasehold Yrs. remaining
Other -----------
o
Leasehold 'Irs. remaining
are attached
comments: FPPC Form 700 (2008/2009) Sch. A-2
FPPC TolI.Free Helpline: 866/ASK-FPPC www.(ppc.ca.gov
SCHEDULE C CALIFORNIA FORM 700
Income, Loans, & Business FAIR POLITICAL PRACTICES COMMISSION
Name
Positions
(Other than Gifts and Travel Payments)
NAME
ADDRESS
~
OF SOURCE Of
~ ~rl lO
21
W\
INCOME
P{Dwe¥"
V\
ADDRESS
Drro-cy Co .
BUSINESS ACTIVITY. IF ANY. OF SOURCE
5l/1) ~. 'B~~ Vt~i7L , l>lJr~~hK, tt:\.
BUSINESS ACTIVITY. IF ANY, OF SOURCE
____~~~~S~~D~~~
YOUR BUSINESS POSITION"
_
YOUR BUSINESS
~DtI\V7l ()t D ll\t~ frlt.
POSITION
]>'1t, lISt., c-tt.
b'~vk .
GROSS INCOME RECEIVED
GROSS INCOME RECEIVED
o $500 - $1,000 0 $1.001 - $10,000
0$500 - $1.000 0 $1,001 - $10.000
~ $10.001 - $100.000 ~OVER $100.000
~ $10,001 - $100,000 0 OVER $100.000
* 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:
ADDRESS
-----% 0 None
SECURITY FOR LOAN
o $500 - $1.000
o $1,001 - $10.000
o Guarantor ----
city
_
o $10.001 - $100.000
DOVER $100.000
o Other (Describe)
Comments:
'\.T.
N,~E OF SOURCE OF iNCOME '
NAME OF SOURCE OF INCOME {,.
VV e U'\ jtHr-i- ~ V,V1vi vt""h uY'V citl i}v"llt',- W-rC( ~h (vdt:. FO\.A l/1c-Lej,hrh.
ADDRESS
ADDRESS
io!55 vV
I
l'-lJ~ t-v'-t0~ ~ tJ~? Oat 1?1 n"{j (~\.
BUSINESS ACTIVITY. IF ANY, OF SOURCE
BUSINESS ACTIVITY, IF ANY. OF SOURCE
j ,..
Fa V\.V'\ t{h~ l{
@ Vt i'1. C{Ci ,f, u~,
YOUR BUSINESS POSITION
YOUR BUSINESS POSITiON
1). [ly c- fcl'l'L
o Loan repayment
o Loan repayment
o Sale of -----------------
o Saie of --------------------
(Property. car. boat. etc.)
(Property car, boac f'lC.)
o Other (Desc:rfbej
o Other
(Describe)
* 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
avai!able 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:
INTEREST RATE TERM (MonthsiYears)
NAME OF LENDER'
____ % 0 None
ADDRESS
SECURiTY FOR LOAN
o
----"-.,
Rea! Property Stroot adeiress
o S10,001 - S100,000
Comments:
FPPC Form 700 (2008i2009) Sch, C
FPPC Toll-Free Helpline: 866IASK-FPPC wwwJppc.ca.gov