700 Statement of Economic Interests TATEMENT OF ECONOMIC INTERESTS
COVI.R PAGE
Please type or print in ink. A Publlt: Document
~ ~~ f.
Date Received ~ ~
O~yy~ip~-Use Only. ~~~~ ~ ~~
CU~'ERTINO CITY CLERK
NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER
~ i1,1 !q ~",~ n.1, '(~1LE H~ S l~ (~-tog-) &~6 •-~ t U 'Z
MAILING ADDRESS STREET CITY -STATE ZIP CODE OPTIONAL: FAX / E-MAIL ADDRESS
(May use business address) ~ "'
1. Office, Agency, or Court
Name of Office, Agency, or Court:
G- y o r Ct~ ~ C-1~-'11 tv fl
Division, Board, District, if applicable:
Your Position:
GTY C~uN ~L
- If filing for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. JurlsdlCtlon Of Office (Check at least one box)
^ State
^ County of
City of _ C.tJI~ E-vL-I l r~ 7i
^ Multi-County
^ Other
I3. Type of Statement (Check at least one box)
^ Assuming Office/Initial Date: _J_.J.
^ Annual: The period covered is January 1, 2008,
through December 31, 2008.
-or-
O The period covered is -~_/ ,through
December 31, 2008.
^ Leaving Office Date Left: -J_/
(Check one)
O The period covered is January 1, 2008, through the
date of leaving office.
-or-
O The period covered is _J_~ ,through
the date of leaving office.
~andidate Election Year: ~~ ~ Q
4. Schedule Summary
- Total number of pages
including this cover page:
- Check applicable schedules or "No reportable
interests."
I have disclosed interests on one or more of the
attached schedules:
Schedule A-1 ^ Yes -schedule attached
Investments (Less than 10% Ownership)
Schedule A-2 hGYes -schedule attached
Investments (10% or greater Ownership)
Schedule B ^ Yes -schedule attached
Real Property
Schedule C I~s -schedule attached
Income, Loans, & Business Positions (Income other wan Gibs
and Travel Payments)
Schedule D ^ Yes -schedule attached
Income -Gigs
Schedule E ^ Yes -schedule attached
Income -Gigs -Travel Payments
-or-
^ No reportable interests on any schedule
;i. Verification
I have used all reasonable diligence in preparing this
:statement. I have reviewed this statement and to the best
~~f 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 ~ ~ ~( ~
(month, day, year)
Signature Vim
(File the signed statement with your filing offidal.)
FPPC Form 700 (2008/2009)
FPPC Toll-Free Helpline: 866/ASK-FPPC t+vww.fppc.ca.gov
CHf=DULE A-2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
.•
G\ F I' S o~ C_r. ~ ~ ~ -.- c-
Name
Address (~} ~p
Check one ~ /
^ Trust, go to 2 l1J/Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
^ $z,ooo - $10,000
10,001 - $100,000 ~~ 08 ~_~ 08
^ $100,001 - $1,000,000 ACQUIRED DISiOSED
! ^ Over $1,000,000
NATURE OF INVESTMENT S C (7 v~.
^ Sole Proprietorship ^ Partnership
/~ Other
YOUR BUSINESS POSITION T /!'~ Sl b ~- /~fT
~ err ~ ra ~ • •~
• •• ~ ~
^ $o -sass ^ $ 0,001 - $100,000
^ ssoo - $1,000 ~VER $100,000
^ $1,001 - $10,000
••~
~~~ .- .-
-.•
.•
Check one box:
^ INVESTMENT ^ REALPROPERTY
Name of Business Entity Q
Street Address or Assessor's Parcel Number of Real Property
Description ct Business Activity 4t
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE.:
^ $4,000 - $10,000
^ $10,001 - s1oD,ooo ~~ ~8 _/_J08
^ $100,001 - $1,000,000 ACQUIRED DISPOSED
^ Over $1,000,000 ',
NATURE OF INTEREST
^ Property OwnershiplDeed of Trust ^ Stock ^ ParV ership
^ Leasehold ^ Other
Yrs. remaining
^ Check box iF additional schedules reporting investments or real property
are attached
~• ~ •~
~.
Name
IAA HC-SN N~~~1J~~A,~/
.~
Lw-~cM~ ~v~ raw- ~. ~c,.~~LF,r~~
Name
-TSV. y1 ~~^vt~ ~ . ~~~ c~.a,.c..A, c..q ~~ st
Address
Check one
^ Trusl, go to 2 ~usiness Entity, complete the box, then go to Z
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
^ $z,ooo - $1o,ooa
~o,oot - $100,000 _J_/08 ~_~08
^ $100,001 - $1,000,000 ACQUIRED DISPOSED
^ Over $1,000,000
NAT E OF INVESTMENT
Sole Proprietorship ^ Partnership ^
Other
YOUR BUSINESS POSITION ~ti% ~--
~ ~~ • ra ~ ra ••
~ • ra ~ •
^ so -sass ^ $10,001 - $100,000
^ $500 - $1,000 ~VER $100,000
^ $1,001 - $10,000
~•~
~~~ .- .-
t ~ ~~~ ~
•.•
.•
Check one box:
^ INVESTMENT ^ REALPROPERTY
Name of Business Entity oL
Street Address or Assessor's Parcel Number of Real Property
Description of Business Activity Qr
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
^ $2,DOD - $10,000
^ $10,001 - $100,000 ~~ 08 ~~ 08
^ $100,001 - $1,D00,000 ACQUIRED DISPOSED
^ Over $1,000,000
NATURE OF INTEREST
^ Property Ownership/Deed of Trust ^ Stock ^ Partnership
^ Leasehold ^ Other
Yrs. remaining
^ Check box if additional schedules reporting investments or real property
are attached
Comments: FPPC Form 700 (2008/2009) Sch. A-2
FPPC Toll-Free Helpline: 666/ASK-FPPC tlvww.fppc.ca.gov
(:HEDULE C
Income, (Loans, ~ Business
Positions
(Other than ~3ifts and Travel Payments)
NAME OF SOURCE OF INCOME 1- ~~
DDR S
su Nw y u~+t~, c~ ~u~ ~~
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
^ $soo - $1,000 ^ $1,001 - $10,000
$10,001 - sloo,ooo ^ ovER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
~alary ^ Spouse's or registered domestic partner's income
^ Loan repayment
^ Sale of
(Property. car, boaC etc.J
^ Commission or ^ Rental Income, tisr each source of 570.000 a more
^ Other
(Describe)
' ~' ~'
•.
Name
S A N ES N 1s 1 N A t.,4,,.~
NAME OF SOURCE OF INCOME
~'~TN ~ vJ t~,~ is
ADDRESS ~9,p r`'t ~ ~ ~~ ~ ~~
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
S~-c-FS ~~ ~ 4 w TF
GROSS INCOME RECEIVED
^ $soo - $1,000 ^ $1,001 - $10,000
0,001 - $100,000 ^ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse's or registered domestic partner's income
^ Loan repayment
^ Sale of
(Property, rar, beat, etc.J
^ Commission Or ^ Rental Income, list each source o! 110,000 or mare
^ Other
* You are not required to report loans from commercial lending institutions, or any indebtedness created as part
of a retail installment or credit card transactiDn, made in the lender's regular course of business on terms
available to members of the public without rt:gard to your official status. Personal loans and loans received
not in a lender's regular course of business must be disclosed as follows:
AME OF LENDER'
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOD
^ $soo - $1,000
^ $1,001 - $10,000
^ $10,001 - $100,000
^ OVER $100,000
Comments:
INTEREST RATE TERM (Months/Years)
^ None
SECURITY FOR LOAN
^ None ^ Personal residence
^ Real Property
Street address
city
^ Guarantor
^ Other
(Describe)
(Describe)
FPPC Forth 700 (2008/2009) Sch. C
FPPC Toll-Free Helpline: 866/ASK-FPPC www.fppc.ca.gov