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700 Batavick 2017Please type or print in ink. NAME OF FILER (LAST) 8,2±. %/ I *,rk 1. Office, Agency, or Court STATEMENT OF ECONOMIC INTERESTS (FIRST) COVER PAGE Agency Name (Do not use acronyms) t� Division, Board, Dep ent, District, i applicabte Your Position f7l ;k ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: 2. Jurisdiction Of Office (Check at least one box) ❑ State ❑ Multi -County Vity of 1, 3. Type of Statement (Check at least one box) $Annual: The period covered is January 1, 2017, through l� December 31, 2017. .or - The period covered is ---J---J December 31, 2017. ❑ Assuming Office: Date assumed ❑ Candidate: Date of Election Position: RECEIVED Date Initial Filing Received Official Use Only 5 JAN 3 12018 IIIf CrrY OF LA QVIN A rETv ni C �• S G' ka v r ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other ❑ Leaving Office: Date Left 1 1 (Check one) through O The period covered is January 1, 2017, through the date of -or- leaving office. O The period covered is through the date of leaving office. and office sought, if different than Part 1: 4. Schedule Summary (must complete) ► Total number of pages including this cover page: * 1 Schedules attached [Schedule A-1 - Investments - schedule attached Schedule A-2 - Investments - schedule attached Schedule B - Real Property - schedule attached .or - El None - No reportable interests on any schedule 5. Verification 5/schedule C - Income, Loans, & Business Positions - schedule attached gichedule D - Income - Gifts - schedule attached chedule E - Income - Gifts - Travel Payments - schedule attached MAILING ADDRESS STREET CITY STATE ZIP CODE (BusinessorAgencyAddressRecommended- PublicDocument) k.MAIC ADtR JEES�a 01 � ( � I have used all reasonable diligence in preparing this statement. I have reviews statement and to the best of my knowledg ile information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed —B-ceb. --Lz 2, d log Signature (month, day, year) - F f originally signed statement will; your filing official.) / FPPC Form 700 (2017/2018) FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE A-1 CALIFORNIA FORm 700 Investments FAIR POLITICAL PRACTICES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) 0ce;iC Do not attach brokerage or financial statements. ► NAME OF BUSINESS EN ITY 7"11- d QIP,04P GENERAL DESCRIPTION OF 7 BUSINESS -..r,a ft+10r'0t Qjtsoj� Co. FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 Over $1,000,000 NATURE OF INVESTMENT Stock Other RilltJ OU Fu i)A y (Describe) El Partnership D Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: _I_ / 17 �_� 17 ACQUIRED DISPOSED ► NAME OFMUSINESS ENTITY GENERAL DESGRI i OF THIstca SS4 ey -Vtav"-kme*.+ Nvalvp� r� FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 Over $1,000,000 NATURE OF INVE TMENT Stock Other ❑ Partnership Q Income Received of $0 - $499 IJ�x7 Q Income Received of $500 or More (Report on schedule C) IF APPLICABLE, LIST DATE: 1 1 17 _� 1 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $100,001 - $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other ❑ $10,001 - $100,000 ❑ Over $1,000,000 (Describe) ❑ Partnership Q Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 17 I 1 17 ACQUIRED DISPOSED Comments: ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,0oo ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership Q Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: / 17 / 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership Q Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: l 17 1�1. 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $100,001 - $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other ❑ $10,001 - $100,000 ❑ Over $1,000,000 (Describe) ❑ Partnership Q Income Received of $0 - $499 Q Income Received of $500 or More (Report on schedule C) IF APPLICABLE, LIST DATE: ( ) 17 _� 1 17 ACQUIRED DISPOSED FPPC Form 700 (2017/2018) Sch. A-1 FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov NONE SCHEDULE A-2 A •- A•- 11 Investments, Income, and Assets FAIR POLITICAL PRACTICES COMMISSION Name of Business Entities/Trusts • (Ownership Interest is 10% or Greater) iQeuptuie r.� 10- 1. BUSINESS ENTITY OR • TRUST - Name Name Address (Business Address Acceptable) Check one ❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $0 -$1,999 $2,000 - $10,000 -j--j-L7- -j-17 [, $10,001 - $100,000 ACQUIRED DISPOSED ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Partnership ❑ Sole Proprietorship ❑ Other Address (Business Address Acceptable) Check one ❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE IF APPLICABLE, LIST DATE: F-1 $0-$1,999 ❑ $2,000 - $10,000 -J-/ 17 � /17 ❑ $10,001 - $100,000 ACQUIRED DISPOSED [J $100,001 - $1,000,000 [] Over $1,000,000 NATURE OF INVESTMENT ❑ Partnership ❑ Sole Proprietorship ❑ Other YOUR BUSINESS POSITION - -ii YOUR BUSINESS POSITION SHARE OF THE GROSS INCOME TO THE ENTiTY/TRUST) SHARE OF THE GROSS INCOME TO THE ENTITYiTRUST) ❑ $0 - $499 ❑ $10,001 - $100,000 ❑ $0 - $499 ❑ $10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,001 - $10,000 ❑ $1,001 - $10,000 • ••- c .• • • •• ••• -• a. ,INCOMEOF I111 • - MORE All INCOMEOF 1111 • • MORE ❑ None or ❑ Names listed below ❑ None or [ Names listed below LEASED BY THE BUSINESS ENTITY OR TRUST■ •' Ctwck one box: Cherk one box: ❑ INVESTMENT ❑ REAL PROPERTY ❑ INVESTMENT ❑ REAL PROPERTY Name of Buelness Entity, if Investment, Q Assessor's Parcel Number or Street Address of Real Property Description of Business Activity Q City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 -j---/-L7 -j--j-L7- j--j17$100,001 $100,001- $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST ❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership ❑ Leasehold ❑ Other Yrs- rornarning ❑ Check box if additional schedules reporting investments or real property are attached Comment - Name of Business Entity, if Investment, Q Assessor's Parcel Number or Street Address of Real Property Description of Business Activity Q City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 11 17 --j .. j 17 ❑ $100,001 - $1,000,000 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 FPPC Form 700 (2017/2018) Sch. A-2 FPPC Advice Email: advice@fppc.ca.gov FPPCToll-FreeHelpline:866/275-3772 www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS , . • CITY ^r T / CIA FAIR MARKET VALUE APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 -1 117 $100,001 - $1,000,000 ACQUIRED DISPOSED Over $1,000,000 NATURE OF INTEREST Ownership/Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000 $10,001 - $100,000 ❑ 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. ❑ None cbzru t I - L adfi ' &) evNk80i'e F►>aS ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS CITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INTEREST ❑ Ownership/Deed of Trust ❑ Leasehold Yrs. remaining IF APPLICABLE, LIST DATE: -J-J-17 -J_/17 ACQUIRED DISPOSED ❑ Easement 1:1 Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ 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. ❑ None You are not required to report 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. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER" ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Comments: NAME OF LENDER" ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable FPPC Form 700 (2017/2018) Sch. B FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov D n 1SCHEDULE C CALIFORNIA FORm700 ' V Income, Loans, & Business TAIP POLITICAL PRACTICES COMMISSION Positions Name (Other than Gifts and Travel Payments) 1INCOME RECEIVED 1- INCOME RECEIVED NAME OF SOURCE OF INCOME NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ No Income - Business Position Only ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of (Real property, car, boat, sic.) ❑ Loan repayment ❑ Commission or ❑ Rental Income, list each source of $90,000 or more (Describe) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ No Income - Business Position Only ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of (Real property, car, boat, etc.) ❑ Loan repayment ❑ Commission or ❑ Rental Income, list each source of $90,000 or more (Describe) ❑ Other ❑ Other (Describe) (Describe) "1 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD * You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER` INTEREST RATE TERM (Months/Years) a ❑ None ADDRESS (Business Address Acceptable) SECURITY FOR LOAN BUSINESS ACTIVITY, IF ANY, OF LENDER ❑ None ❑ Personal residence ❑ Real Property HIGHEST BALANCE DURING REPORTING PERIOD Street address ❑ $500 - $1,000 City ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ Guarantor ❑ OVER $100,000 ❑ Other (Describe) Comments: FPPC Form 700 (2017/2018) Sch. C FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE D Income - Gifts ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) �-1 c ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) $ ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) Comments: ALIFORNIA FORM 700 IR POLITICAL PRACTICES COMMISSION ■ ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) c ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) FPPC Form 700 (2017/2018) Sch. D FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov CALIFORNIA�O�F, SCHEDULE E FAIR POLITICAL PRACTICES COMMISSION Income — Gifts Name Travel Payments, Advances, and Reimbursements "* • Mark either the gift or income box. • Mark the "501(c)(3)" box for a travel payment received from a nonprofit 501(c)(3) organization or the "Speech" box if you made a speech or participated in a panel. These payments are not subject to the gift limit, but may result in a disqualifying conflict of interest. • For gifts of travel, provide the travel destination. ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) CITY AND STATE ❑ 501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S): - __J ---)` AMT: c (if gift) ► MUST CHECK ONE: ❑ Gift -or- ❑ Income O Made a Speech/Participated in a Panel O Other - Provide Description ► If Gift, Provide Travel Destination ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) CITY AND STATE ❑ 501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S): __J__J_ - __J__JAMT: (If gift) ► MUST CHECK ONE: ❑ Gift -or- ❑ Income O Made a Speech/Participated in a Panel O Other - Provide Description ► If Gift, Provide Travel Destination Comments: ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) CITY AND STATE ❑ 501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S): ��- - ��- AMT: (if gam) ► MUST CHECK ONE: ❑ Gift -or- ❑ Income O Made a Speech/Participated in a Panel O Other - Provide Description ► If Gift, Provide Travel Destination ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) CITY AND STATE ❑ 501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S): - __J__J_ AMT: c (if gift) ► MUST CHECK ONE: [:]Gift -or- ❑ Income O Made a Speech/Participated in a Panel O Other - Provide Description ► If Gift, Provide Travel Destination FPPC Form 700 (2017/2018) Sch. E FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov