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65C - WARD 4 VACANCY
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03/19/2019
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65C - WARD 4 VACANCY
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Last modified
4/13/2019 2:44:36 PM
Creation date
3/13/2019 6:19:51 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Clerk of the Council
Item #
65C
Date
3/19/2019
Destruction Year
2024
Notes
Correction on page 3: "...conduct an election in Fiscal Year 2019-2020 and Fiscal Year 2020-2021."
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SCHEDULE C <br />Income, Loans, & Business <br />Positions <br />(Other than Gifts and Travel Payments) <br />NAME OF SOURCE OF INCOME <br />Zen Digital LA <br />ADDRESS (Sualness Address Acceptable) <br />2301 8th Ave, Los Angeles, CA 90018 <br />BUSINESS ACTIVITY, IF ANY, OF SOURCE <br />Marketing and Creative Services <br />YOUR BUSINESS POSITION <br />Freelancer <br />GROSS INCOME RECEIVED ❑ No Income - Business Position Only <br />❑ $500 - $1,000 ® $1,001 - $10,000 <br />❑ $10,001 -$100,000 ❑ OVER $100,000 <br />CONSIDERATION FOR WHICH INCOME WAS RECEIVED <br />❑ Salary ❑ Spouse's or registered domestic partner's Income. <br />(Far self-employed use Schedule A-2.) <br />❑ Padnershlp (Less then 10% ownership. For 10% or greater use <br />Schedule A-2.) <br />❑ Sale of <br />(Real property, car, boat, etc.) <br />❑ Loan repayment <br />❑ Commission or ❑ Rental Income, der each source of $10,000 or more <br />(Desctlbe) <br />FX1 Other Payment per project <br />(Describe) <br />NAME OF SOURCE OF INCOME <br />California State University, Los Angeles <br />ADDRESS (Buslness Address Acceptable) <br />5151 State University Dr, Los Angeles, CA 90032 <br />BUSINESS ACTIVITY, IF ANY, OF SOURCE <br />Education <br />YOUR BUSINESS POSITION <br />Instructof of Record <br />GROSS INCOME RECEIVED ❑ No Income - Business Position Only <br />❑ $500 - $1,000 Q $1,001 - $10,000 <br />❑ $10,001 - $100,000 ❑ OVER $100,000 <br />CONSIDERATION FOR WHICH INCOME WAS RECEIVED <br />® Salary ❑ Spouse's or registered domestic partner's Income <br />(For soN=omployod use Schedule A-2.) <br />Il Partnership (Less than 10% ownership. For 10% or greater use <br />Schedule A-2.) <br />❑ Sale of <br />(Real property, car, <br />❑ Loan repayment <br />❑ Commission or ❑ Rental Income, list each source of $10,001 more <br />❑ Other <br />(Describe) <br />You are not required to report loans from a commercial lending Institution, or any indebtedness created as part of <br />a retail installment or credit card transaction, made in the lender's regular course of business on terms available t0 <br />members of the public without regard to your official status. Personal loans and loans received not in a lender's <br />regular course of business must be disclosed as follows: <br />NAME OF LENDER` <br />ADDRESS (Business Address Acceptable) <br />BUSINESS ACTIVITY, IF ANY, OF LENDER <br />HIGHEST BALANCE DURING REPORTING PERIOD <br />❑ $500 - $1,000 <br />❑ $1,001 - $10,000 <br />❑ $10,001 - $100,000 <br />❑ OVER $100,000 <br />Comments: <br />N/A <br />INTEREST RATE TERM (Months/Years) <br />❑ None <br />SECURITY FOR LOAN <br />❑ None ❑ Personal residence <br />❑ Real Property <br />❑ Guarantor <br />Street address <br />❑ Other <br />(Deccrlbe) <br />FPPC Form 700 (2018/2019) <br />FITC Advice Email: advice@ff pcu;a.l <br />651 FPPCToll-Free Holpllne:966/275-3772 www.fppc.ca.gov <br />page -13 <br />
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