Statement of Economic Interest
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
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OfficIal Use Only Il!:¿j
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CUPERTINO CITY CLERK
STATEMENT OF ECONOMIC INTE
COVER PAGE
Please type or print in ink
A Public Document
NAME (lAST)
k'wð!G
~f~~l
MAILING ADDRESS STREET
(May use business address)
ftlr nr.¿1'I.
CITY
!If?¿¡4' La,
1. Office, Agency, or Court
Name 01 Office, Agency, or Court:
C't~ (óûnc;/
Division Board, District, if applicable:
C U.Þ-<r+lh· ()
YOuC;:t~nc; / J
mt'mh",Ý
- II filing lor multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet il necessary.)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
o State
o County 01
IVI"Cityol (uMrf¡h II
;=:. I
o Multi-County
o Other
3. Type of Statement (Check at least one box)
Date: _____L_---1_
D Assuming Office/Initial
o
Annual: The period covered is January 1, 2004,
through December 31, 2004.
-or-
a The period covered is ---1---1_, through
December 31, 2004.
o Leaving Office Date Left: ---1---1_
(Check one)
a The period covered is January 1, 2004, through the
date 01 leaving office.
-or-
o The period covered is ----1----1_. through
the date of leaving office.
Candidate
,
(MIDDLE)
DAYTIME TELEPHONE NUMBER
.5
(
OPTIONAL: FAX I E-MAIL ADDRESS
STATE ZIP CODE
,..h /j,
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% or greater Ownership)
Schedule B
Real Property
JXYes - schedule attached
Schedule C 0 Yes - schedule attached
Income, Loans, & BusÎness 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 rx(Yes - schedule attached
Income - Travel Payments
-or-
_ D No reportable interests on any schedule
Total number of pages
completed including this cover page:
f-
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 01 perjury under the laws 01 the State
of California that the for~going is true and correct.
Date Signed
Signature
ile e origin y sign statement with your filing officiaL)
FPPC Form 700 (2004/2005)
FPPC Toll-Free Helpline: 866/ASK-FPPC
SCHEDULE B
Interests in Real Property
(Including Rental Income)
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
Na")f-:,
1á'i-..,,&1 kwt>l:-
> STREET ADDRESS DR PRECISE LOCATION
:2 0766 -r;,.;,/!v
/
» STREET ADDRESS OR PRECISE lOCATION
~/3~1 C6/gmIJus J}V£
CITY
¿ tt¡u,f¡hlJ" ~~
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000
o $10,001 - $100,000
0$100,001 - $1,000,000
)Crover $1,000,000
NATURE OF INTEREST
---1---1.M.. ---1---1 04
ACQUIRED DISPOSED
fTV.L
CITY
t;'¿¡Y'!?hI'( /
FAIR MARKET v=:::;¡-
0$2,000 - $10,000
0$10,001 - $100,000
0$100,001 - $1,000,000
.5(üver $1,000,000
NATURE OF INTEREST
~ Ownership/Deed of Trust
o Leasehold
Ck
IF APPLICABLE, LIST DATE:
.£¡ tŸ I 04 ---1---1 04
ACQUIRED DISPOSED
o Easement
~wnershjp/Deed of Trust
o Easement
Yr1;. remail1ing
o
Other
o Leasehold 0
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
D $0 - $499 0 $500 - $1,000 0 $1,001 - $10,000
0-$10,001 - $100,000 0 OVER $100,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
ß!I:$O - $499 0 $500 - $1,000 0 $1.001 - $10,000
0$10,001 . $100,000 0 OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source õf
income of $10,000 or more.
Þf... .14~
F"..eLm ìfn
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
/II~JJ.e
NAME OF LENDER*
NAME OF LENDER*
ADDRESS
ADDRESS
BUSINESS ACT!VITY OF LENDER
BUSINESS ACTIVITY OF LENDER
INTEREST RATE
j..
5¡ % o None
HIGHEST BALANCE DURING REPORTING PERIOD
0$500 - $1,000 0 $1,001 - $10,000
o $10,001 . $100,000 !)KOVER $100,000
TERM (Months/Years)
,?J,O J11'1l'rtlfJ
INTEREST RATE
TERM (Months/Years)
% 0 None
HIGHEST BALANCE DURING REPORTING PERIOD
D $500 - $1,000 0 $1,001 - $10,000
0$10,001 - $100,000 0 OVER $100,000
D Guarantor, if applicable
o Guarantor, if applicable
Comments: 2 ( -;J Z I
,
('" /fI.". , Iú /:tv; - ~ ()1 .lJtf'lu tts f ~t/æ; Cp$ ~.5
* Loans from commercial lending institutions made in the lender's regular course of business on terms available to
members 01 the public without regard to your official status are not reportable.
FPPC Form 700 (200412005) Sch. B
FPPC TolI·Free Helpline: 8661ASK.FPPC
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
SCHEDULE F
Income - Gifts
Travel Payments, Advances,
and Reimbursements
Na'Pafw;k I:"u)c:lc
. Reminder - you must mark the gift or income box.
. You are not required to report "income" from government agencies.
TYPE OF PAYMENT: (must check one) 0 Gift Øncome
DESCRIPTION,TVa ~~( ~4h / I nl¡ih!) f1v
~tL ,.TJ ;r.,./ ~~.... ¿t
Ihstw"'I' ß()A~d J 1)/rJ"ih¥o
Comments: 6HIt-rJ ~ ~fzin~ /2I~nltJ~ 1tUdo. r.ÞpfYal$/~
/ø /J'UWlIMo J ý'UJ k ¿:;;tk/~
). fAME OF SOURCE /I 1: ..
v~a,1,1U øj (A/i7-fT'7U~ C;h',~
ADD/POt) I< Sfray
CITY HD STArE _ _ .. _ -,k
Ja.ey~nuwlA. ?If- 4S'iJtf
BUSINESS ACTIVITY, IF ANY, OF SOURCE
¡l-j/ldCtl~ ~(i"Ì.f.5 r1-1/r.t,~ ~.J;Jph-IJ-
dO
DATE(S'¡¿'f 1/6 1~-..1J~ AMT: < 1/Jo/)'-'-
(lfapp/lcabJe)
TYPE OF PAYMENT: (must check one)
> NAME OF SOURCE ,
~¿,ð~~¡},:, ,,¡uj,~ MUlUh.J- })1.5~1
A06REss ~ (7
1~1 $///1 $J-
CITY AND STATE
-
Ni'¥lIV/:; CIf
BUSINESS ACTIVITY, IF ANY, OF SOURCE
R~,Jç,1M¡ ~"l
DATE(S)"} Im.Pi-.2..Jl/1 ø~ AMT $ If/:?,Ç ø.:!
(lfapp/jçable)
ji,';A Il:~:¿;It,,~ ~,~ ,It4J}¿ 1&.øJ7~c""",iIk
ADDRESS
~~~. hI-
CITY AND STATE
¿;,u" ~ ,M/I1JiY~ Ú'Htmrtf-é!L-
BUSINESS A IV¡TY, IF ANY, F SOURCE
-
OATE(S~ IIPLi~ _,J'1/~ AMT $ 55" ð
(If applicable)
TYPE OF PAYMENT: (must check one) D Gift OOncome
DESCRIPTION',+;/'"'IIA fr) alk....J,:., Lnutn'dt~
/YO h..j~ 1J5o/ IA--rJltj
)0 NAME OF SOURCE
ADDRESS
CITY AND STATE
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE(S)'----1----1_-__L_.J_ AMI $
(If applicable)
TYPE OF PAYMENT: (must check one)
o Gift
D Income
DESCRIPTION:
FPPC Form 700 (2004/2005) Sch. F
FPPC Toll-Free Helpline: 866/ASK-FPPC