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Statement of Economic Interest CALIFORNIA FORM 700 FA!R POLITICAL PRACTICES COMMISSION rõ) ~~~~~~~;,; ~ Wi fE fñì trù AUG 1 2 2005 UJ) STATEMENT OF ECONOMIC INTERESTS COVER PAGE Please type or print in ink A Public Document CUPERTINO CITY CLERK NAME DAYTIME TELEPHONE NUMBER (lAST) j1I}a.þ01'1{,' )íIRST) ¡ Urr,,,, STREET CITY STATE ZIP CODE f'Vl,'vc¡..., (}./\/( ¡( l (o'[7(Y'/';"O G <¡SOIL! MAILING ADDRESS (May use business address) I () '/1..0 1. Office, Agency, or Court Name of Office, Agency, or Court: C,iy L(}(h1CI'I Division, Boafc1, District, if applicable: Your P~i~~mi L/f,/ ér;JUhC,'I fYJ(~/'t/' , - If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Office (Check at least one box) o State o County of C 0'1"7(, I;" ¡) , ~CitYOf o Multi-County o Other 3. Type of Statement (Check at least one box) o Assuming OfficellnitiaJ . Date:~~_ o Annual: The period covered is January 1, 2004, through December 31, 2004. -or- a The period covered is ~~_, through December 31, 2004. o Leaving Office Date Left: ~~_ (Check one) o The period covered is January 1, 2004, through the date of leaving office. -or- e The period covered is ---1---..-1_. through the date of leaving olfice. Candidate (MIDDLE) 40'ö) 72')-/767 OPTIONAL: FAX I E-MAIL ADDRESS orYï'n """H< Ao<'l' éJ ~lIj""Cc...s ." ( I- 4. Schedule Summary (Check applicable schedules or "No reportable ínterests.'7 - During the reporting period, did you have any reportable interests to disclose on: Schedule A-1 ~ Yes - schedule attached Investments (Less than 10% Ownership) Schedule A-2 0 Yes - schedule attached Investments (10% or greater Ownership) Schedule B Real Property o Yes - schedule attached Schedule C 0 Yes - schedule attached Income, Loans, & Business 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 0 Yes - schedule attached Income - Travel Payments -or- - D No reportable interests on any schedule Total number of pages completed including this cover page: 2- 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 Signature FPPC Form 700 (200412005) FPPC TolI~Free Helpline: 8661ASK-FPPC SCHEDULE A-1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10%) Do not attach brokerage or financial statements. CALIFORNIA FORM 700 FAIR P01.ITICAL PRACTICES COMMISSION N~e A/1 0/"/;" /,/(1 ~(J/II > NAME OFBUSINEpS ENTITY /7 k J hi?o,v(ell-rá( c.ý GENERAL DESCRIPTION OF BUSINESS ACTIVITY {'v '""('7..,( ("r )'V/f)< I1vl", {¡." rr.... , > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE 0$2,000 . $10,000 ¡xJ $100,001 - $1,000,000 NATURE OF INVESTMENT Dr! Stock D Other 0$10,001 . $100,000 DOver $1,000,000 FAIR MARKET VALUE D $2,000 - $10.000 0$100,001 - $1,000,000 D $10.001 - $100,000 DOver $1,000,000 NATURE OF INVESTMENT o Stock D Other (Describe) (Describe) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: ---1---1.JM... ACQUIRED ---1---1.JM... DISPOSED ---1---1.JM... ACQUIRED ---1---1.JM... DISPOSED ,. NAME OF BUSINESS ENTITY ,. NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE D $2,000 - $10,000 0$100,001 . $1,000,000 0$10,001 . $100,000 DOver $1,000,000 FAIR MARKET VALUE o $2,000 . $10,000 o $100,001 . $1,000,000 0$10,001 - $100,000 DOver $1,000,000 NATURE OF INVESTMENT D Stock D Other NATURE OF INVESTMENT D Stock D Other (Describe) (Describe) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: ---1---1.JM... ACQUIRED ---1---1.JM... DISPOSED ---1---1.JM... ACQUIRED ---1---1.JM... DISPOSED > NAME OF BUSINESS ENTITY > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE 0$2,000 . $10,000 0$100,001 - $1,000,000 D $10,001 . $100,000 DOver $1,000,000 FAIR MARKET VALUE D $2,000 - $10,000 0$100,001 . $1,000,000 0$10,001 - $100,000 DOver $1,000,000 NATURE OF INVESTMENT D Stock o Other NATURE OF INVESTMENT D Stock o Other (Describe) (Describe) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: ---1---1.JM... ACQUIRED ---1---1.JM... DISPOSED ---1---1.JM... ACQUIRED ---1---1.JM... DISPOSED Comments: FPPC Form 700 (2004/2005) Sch. A-1 FPPC Toll-Free Helpline: 866/ASK-FPPC