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65C - WARD 4 VACANCY
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65C - WARD 4 VACANCY
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Last modified
4/13/2019 2:34:33 PM
Creation date
4/11/2019 11:07:01 AM
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City Clerk
Doc Type
Agenda Packet
Agency
Clerk of the Council
Item #
65C
Date
3/22/2019
Destruction Year
2024
Notes
Correction on page 3: "...conduct an election in Fiscal Year 2019-2020 and Fiscal Year 2020-2021." Item 25D adjourned to the Adjourned Regular March 22, 2019 City Council meeting.
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SCHJEDULE C <br />Income, Loans, & Business <br />Positions <br />(Other than Gifts and Travel Payments) <br />NAME OF SOURCE OF INCOME <br />Frontier Communications <br />ADDRESS (Business Address Acceptable) <br />3770 Industry Ave., Lakewood, CA 90712 <br />BUSINESS ACTIVITY, IF ANY, OF SOURCE <br />YOUR BUSINESS POSITION <br />Technician <br />GROSS INCOME RECEIVED ❑ No Income - Business Position Only <br />❑ $500 - $1,000 ❑ $1,001 - $10,000 <br />Q $10,001 - $100,000 ❑ OVER $100,000 <br />CONSIDERATION FOR WHICH INCOME WAS RECEIVED <br />0 Salary ❑ Spouse's or registered domestic partner's Income <br />(For self-employed use Schedule A-2.) <br />❑ Partnership (Loss than 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, list each source of $10,000 or more <br />❑ Other,. <br />op"12 <br />NAME OF SOURCE OF INCOME <br />ADDRESS (Business Address Acceptable) <br />BUSINESS ACTIVITY, IF ANY, OF SOURCE <br />YOUR BUSINESS POSITION P W° <br />lU ta' <br />GROSS INCOME RECEIVED ❑ No Income - Business Position Only <br />❑ $500 - $1,000 ❑ $1,001 - $10,000 <br />❑ $10,001 - $100,000 ❑ OVER $1oo,000 <br />CONSIDERATION FOR WHICH INCOME WAS RECEIVED <br />❑ Salary ❑ Spouse's or registered domestic partner's Income <br />(For aslf-employed use Schedule A-2) <br />❑ Partnership (Less then 10% ownership. For 10% or greater use <br />Schedule A-2.) <br />❑ Sale of <br />(Real property, car, boat, eta) <br />❑ Loan repayment <br />❑ Commission or ❑ Rental Income, list each source of $90,000 ormore <br />❑ Other <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 to <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 />INTEREST RATE TERM (MonthsNeam) <br />% ❑ None <br />SECURITY FOR LOAN <br />❑ None ❑ Personal residence <br />❑ Real Property <br />street address <br />❑ Guarantor <br />❑ Other <br />(Describe) <br />65C-46 FPPC Form 700 (2018/2019) <br />FPPC Adults Emall: advice@fppo.ca.gov <br />FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov <br />e...,. - 1. <br />
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