Statement of Economic Interest
CALIFORNIA FORM 700
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Offlde/ Use Only
AUG 1 1 2005
S
CUPERTINO CITY CLERK
STATEMENT OF ECONOMIC INTERES
COVER PAGE
Please type or print in ink
A Public Document
(FIRST) (MIDDLE)
Martin H
CITY STATE ZIP CODe
Cupertino Ca 95014
NAME
(LAST)
Miller
MAILING ADDRESS STREET
(May use business address)
20348 Clay Street
1. Office, Agency, or Court
Name of Office, Agency, or Court:
City Council
Division, Board, District, if applicabie:
Your Position:
Council Member
- 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
[JCity of Cupertino, California 95014
o Multi-County
o Other
3. Type of Statement (Check at least one box)
o Assuming Officellnitial
Date: ___L__...1_
o Annual: The period covered is January 1, 2004,
through December 31,2004.
-or-
o The period covered is ----1----1_, through
December 31,2004.
o Leaving Office Date Left: ----1----1_
(Check one)
o The period covered is January 1, 2004, through the
date of leaving office.
-or-
o The period covered is ----1----1_, through
the date of leaving office.
[J Candidate
DAYTIME TELEPHONE NUMBER
253-1168
OPTIONAL: FAX / E-MAIL ADDRESS
4. Schedule Summary
(Check applicable schedules or "No reportable Interesfs. "
- 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 00 Yes - schedule attached
Investments (10% or greater Ownership)
Schedule B
Real Property
00 Yes - schedule attached
Schedule C 0 Yes - schedule attached
Income, Loans. & Business Positions (Income Other then Gifts end
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·
- 0 No reportable interests on any schedule
Total number of pages
completed Including this cover page:
3
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 Stale
of California that the foregoing is true and correct.
\} /;~kf:
Date Signed
Signature
FPPC Fonn 700 (200412005)
FPPC Toll-Free Helpline: 8861ASK·FPPC
SCHEDULE A-2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
> 1 BUSINESS ENTITY OR TRUST
Miller Development Co., Inc.
Name
20348 Clay Street, Cupertino, Ca. 95014
Add....
Check one
D Trust, go to 2
III Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Real estate sales and investments
FAIR MARKET VALUE
0$2.000 - $10.000
0$10.001 - $100,000
iii $100.001 - $1,000,000
DOver $1,000,000
NATURE OF INVESTMENT
o Sole Proprietorship 0 Partnership
IF APPLICABLE, LIST DATE:
---1---1 04
ACQUIRED
---1---1 04
OISPOSED
00 SCOrp
0Ih0"
YOUR BUSINESS POSITION President
CALIFORNIA FORM 700
11,11, hJLlllc ilL ;-'1,,\1 I, L ,,)I.H,ll Id·'¡
Name
Martin H. Miller
» 1 BUSINESS ENTITY OR TRUST
Name
Address
Check one
o Trust, go to 2
D Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VAlUE
0$2,000 - $10,000
0$10,001 - $100,000
0$100,001 . $1,000,000
DOver $1.000,000
NATURE OF INVESTMENT
o Sole Proprietorship 0 Partnership 0
IF APPLICABLE, LIST DATE:
---1---1 04
ACQUIREO
---1---1 04
DISPOSED
0Ih0"
YOUR BUSINESS POSITION
o $0 - $499
o $500 - $1,000
o $1,001 - $10,000
!XI $10.001 - $100.000
DOVER $100,000
0$10,001. $100,000
DOVER $100.000
» 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF 510000 OR MORE tI t t t
estate of John Hayden
Nabeeh T otah
)- t INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST
Check one box:
o INVESTMENT
00 REAL PROPERTY
11081 S. Stelling Road, Cu.
Name of Business Entity w:
Street Address or Assessor's Parcel Number of Real Property
Investment
Description of Business Activity 2[
City or Other Precise Location of Real Property
FAIR MARKET VALUE
0$2,000 - $10.000
0$10,001 . $100,000
iii $100.001 - $1,000.000
DOver $1,000,000
NATURE OF INTEREST
IXJ Property Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:
O$"
~..!.!.J It" ---1---1 04
ACQUIRED DISPOSED
o Stook
D Partnership
D Leasehold
Yrs.remaining
DOther
D Check box if additional schedules reporting investments or real property
are attached
Comments:
0$0-$499
0$500· $1,000
o $1,001 - $10,000
)- 3 LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF S1U 000 OR MORE" I 1 1 t
» 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST
Check one box:
o INVESTMENT
o REAL PROPERTY
Name of Business Entity .Q[
Street Address or Assessor's Parcel Number of Real Property
Description of Business Activity 2[
City or Other Precise Location of Real Property
FAIR MARKET VALUE
o $2.000 . $10,000
0$10.001 - $100.000
0$100,001 - $1.000.000
DOver $1,000,000
NATURE OF INTEREST
D Property Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:
---1---104 ---1---1 04
ACQUIRED DISPOSED
o Stook
D Partnership
D Leasehold
DOther
Yrs. remaining
o Check box if additional schedules reporting Investments or real property
are attached
FPPC Form 700 (200412005) Sch. A-2
FPPC TOil-Free Helpline: 8861ASK-FPPC
CALIFORNIA FORM 700
!,...Iki' 11,1 AI If,.."'I I "r.lll IUN
SCHEDULE B
Interests in Real Property
(Including Rental Income)
)0 STREET ADDRESS OR PRECISE LOCATION
20348 Clay Street
CITY
Cupertino, Ca. 95014
FAIR MARKET VALUE
o $2,000 - $10,000
0$10,001 - $100,000
Ii] $100,001 - $1,000,000
DOver $1,000,000
IF APPLICABLE, LIST DATE:
-'-' 04 -,-,04
ACQUIRED DISPOSED
NATURE OF INTEREST
D Ownership/Deed of Trust
D Easement
D Leasehold IKI
Yrs. remaining
home/office
Other
IF RENTAl PROPERTY, GROSS INCOME RECEIVED
0$0 - $499 0 $500 - $1,000 0 $1,001 - $10,000
o $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 of
income of $10,000 or more.
NAME OF LENDER·
ADDRESS
BUSINESS ACTIVITY OF LENDER
INTEREST RATE TERM (MonthslYears)
% D None
HIGHEST BALANCE DURING REPORTING PERIOD
o $SOO - $1,000 0 $1,001 - $10,000
o $10,001 - $100,000 0 OVER $100,000
o Guarantor, if applicable
Name
Martin H. Miller
)0 STREET ADDRESS OR PRECISE LOCATION
CITY
FAIR MARKET VALUE
o $2,000 - $10,000
0$10,001 . $100,000
0$100,001 - $1,000.000
DOver $1.000,000
IF APPLICABLE, LIST DATE:
-,-,04 -'-' 04
ACQUIRED DISPOSED
NATURE OF INTEREST
o Ownership/Deed of Trust
o Easement
D Leasehold D
Yrs. remeining
Other
IF RENTAL PROPERlY, GROSS INCOME RECEIVED
0$0 - $499 0 $500 - $1,000 0 $1,001 - $10,000
o $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 of
income of $10,000 or more.
NAME OF LENDER*
ADORESS
BUSINESS ACTIVITY OF LENDER
INTEREST RATE TERM (Months/Years)
% 0 None
HIGHEST BALANCE DURING REPORTING PERIOD
0$500 - $1,000 0 $1,001 . $10,000
0$10,001 - $100,000 0 OVER $100,000
D Guarantor, if applicable
C Is this is a room in my residence used as an office, for which I take a tax deduction
ommen :
* 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 are not reportable.
FPPC Form 700 (200412005) Sch. B
FPPC Toll-Free Helpline: 8661ASK-FPPC