700 Statement of Economic Interests ~
~ _ ---- i~
STATEMENT Of= ECONOMIC INTE S Date Recei~
Official Use Or
A.UG i ~~~y
COVER PAGE
Please type or print in ink. A PubZlC DOCUmt?rit ~ CU!'ERTINO CITY CLERK
NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER
i
MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX / E-MAIL ADDRESS
(May use business address)
~.O ? ~
`a ~~ tee. u. -ei- t ~, ~ a. `~'So
1. Office, Agency, or Court
Name of Office, gency, or Court:
C ~~.
Divisio ,Board, District, f applicable:
~.
~ C'
Your Position:
- If filing for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. JUI'ISdICtIOn Of Office (Check at least one box)
^ State
^ County of ~
City of ~~! LU.:~ ~ ~~~~
^ Multi-County
^ Other
3. Type of Statement (Check at least one box)
^ Assuming Office/Initial Date: ~-J
^ Annual: The period covered is January 1, 2008,
through December 31, 2008.
-or-
O The period covered is ~-J ,through
December 31, 2008.
^ Leaving Office Date Left: -J_/
(Check one)
O The period covered is January 1, 2008, through the
date of leaving office.
-or-
O The period covered is _J-~ ,through
the date of leaving office.
Candidate Election Year:. ~ O O
4. Schedule Summary
- Total number of pages
including this cover page:
- Check applicable schedules or "No reportable
interests."
have disclosed interests on one or more of the
attached schedules:
Schedule A-1 ^ Yes -schedule attached
Investments (Less rnan fo% ownership)
Schedule A-2 Yes -schedule attached
Investments (10% or greater ownership)
Schedule B Yes -schedule attached
Real Property
Schedule C ^ Yes -schedule attached
Income, Loans, & Business Po5ltions (income orner rnan Gifts
and Travel Payments)
Schedule D ^ Yes -schedule attached
Income -Gigs
Schedule E ^ Yes -schedule attached
Income -Gigs -Travel Payments
-or-
No reportable interests on any schedule
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 ~ ~
( onth, day, year)
~ ~~ -
~ ~
Signatur ~
(F a the origins si ned statement with your filing official.)
FPPC Form 700 (2008/2009)
FPPC Toll-Free Helpline: 866/ASK-FPPC www.fppc.ca.gov
r~~o~~~
SCHEDULE: A-2
AUG 7 ?~0~
n estments, Income, and Assets
of Business Enti~ties/Trusts
CUPERTlNO CITY CLERK (Ownership Interest is 1Q% or Greater)
••
Q
Na e
Address
Check one
^ Trust, go to 2 Business Entity, complete the box, then go to 2
GENERAL ESCRIPTI N BUST SS CTIVITY -!-'
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
^ $2,000 - $10,000
^ $10,001 - $100,000 _/~ 08 ~~ 08
$100,001 - $1,000,000 ACQUIRED DISPOSED
Over $1,000,000
NATURE OF INVESTMENT
^ Sole Proprietorship ^ Partn hip ^
~ her
YOUR BUSINESS POSITION - r~s ~ ~
• •~ • ~
^ $o - sass ^ $10,001 - $100,000
^ $500 - $1,000 ~,QVER $100,000
^ $1,001 - $10,000
• ~~• • •
~ •~• ~
~•
Check one box:
^ INVESTMENT ^ REALPROPERTY
Name of Business Entity 4C
Street Address or Assessor's Parcel Number of Real Property
Description of Business Activity ~
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
^ $2,000 - $10,000
^ $10,001 - $100,000 ~~ U8 ___/~08
^ $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
Name
.-
Name
Address
Check one
^ Trust, go to 2 ^ Business Entity, complete [he box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
^ $2,000 - $10,000
^ $10,001 - $100,000 ~~08 ~~08
^ $100,001 - $1,000,000 ACQUIRED DISPOSED
^ Over $1,000,000
NATURE OF INVESTMENT
^ Sole Proprietorship ^ Partnership ^
Other
YOUR BUSINESS POSITION
• •~ • ~
^ $o -sass ^ $10,001 - $100,000
^ $500 - $1,000 ^ OVER $100,000
^ $1,001 - $10,000
• •~• ~ ~
~ •~• ~
~•
Check one box:
^ INVESTMENT ^ REAL PROPERTY
Name of Business Entity g
Street Address or Assessor's Parcel Number of Real Property
Description of Business Activity pl
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
^ $2,000 - $10,000
^ $10,001 - $100,000 ~~ 08 ~~ 08
^ $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: FPPC Form 700 (2008!2009) Sch. A-2
FPPC Toll-Free Helpline: 866/ASK-FPPC www.fppc.ca.gov
SCHEDUILE B
Interests in Real Property
(Including Rental Income)
STREET ADDRESS OR PRECISE LOCATION
U g ...~ .~-~~
cl~~
FAIR MAR T VALUE IF PPLICABLE, LIST DATE:
^ $2,000 - $10,000
^ $10,001 - $100,000 ~_~ 08 ~~ 08
$100,001 - $1,000,000 ACQUIRED DISPOSED
Over $1,000,000
NATURE OF INTEREST
^ Ownership/Deed of Trust ^ Ease ent
^ Leasehold 1 L
Yrs. remaining f Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
^ $o - $ass ^ $soo - $1,000 ^ $1,001 - $10,000
^ $10,001 - $100,000 ^ OVER $100,000
SOURCES OF RENTAL INCOME: If you OVJrI a 10% Or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
Name
a)-
a
- STREET ADDRESS OR PRECISE LOCATION
CITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
^ $2,000 - $10,000
^ $10,001 - $100,000 ~~ 08 ~~ 08
^ $100,001 - $1,000,000 ACQUIRED DISPOSED
^ Over $1,000,000
NATURE OF INTEREST
^ Ownership/Deed of Trust ^ Easement
^ Leasehold ^
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
^ $o - $ass ^ $soo - $1,000 ^ $1,001 - $10,000
^ $10,001 - $100,000 ^ OVER $100,000
SOURCES OF RENTAL INCOME: If y0U Own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
* You are not required to report loans from commercial lending institutions 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 ACTIVITY OF LENDER
INTEREST RATE TERM (Months/Years)
^ None
HIGHEST BALANCE DURING REPORTING PERIOD
^ $soo - $1,000 ^ $1,001 - $10,000
^ $10,001 - $100,000 ^ OVER $100,000
^ Guarantor, if applicable
Comments:
NAME OF LENDER`
ADDRESS
BUSINESS ACTIVITY OF LENDER
INTEREST RATE TERM (Months/Years)
^ None
HIGHEST BALANCE DURING REPORTING PERIOD
^ $soo - $1,000 ^ $1,001 - $10,000
^ $10,001 - $100,000 ^ OVER $100,000
^ Guarantor, if applicable
~'~5~~'-I/T G Q~ (iCS2!S cj[J ~~Cii1 (~G~It- ~
FPPC Form 700 (2008/2009) Sch. B
FPPC Toll-Free Helpline: 866/ASK-FPPC www.fppc.ca.gov