Form 700 ClearSource Financial 2017 (T. Madsen)STATEMENT OF ECONOMIC INTERESTS
Date Initial Filing Received
'Wf"
Please type or print in ink.
NAME OF FILER (LAST)
Madsen
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
ClearSource Financial Consulting
Division, Board, Department, District, if applicable
(FIRST)
Terence
COVER PAGE
Your Position
President
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency: Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi -County
❑ City of
(MIDDLE)
Michael
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
0 Other Consultant for City of La Quinta
I Type of Statement (Check at least one box)
0 Annual: The period covered is January 1, 2017, through ❑ Leaving Office: Date Leff f 1
December 31, 2017. (Check ane)
-or-
The period covered is through O The period covered is January 1, 2017, through the date of
December 31, 2017. -or-leaving office.
❑ Assuming Office: Date assumed I i O The period covered is ! f through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
14. Schedule Summary (must complete) > Total number of pages including this cover page:
Schedules attached
❑ Schedule A-1 - Investments — schedule attached ❑ Schedule C - Income, Loans, & Business Positrons — schedule attached
❑ Schedule A-2 - Investments — schedule attached ❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule B - Real Property — schedule attached ❑ Schedule B - Income — Gifts — Travel Payments — schedule attached
-of-
❑x None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
7960 B Soquel Drive #363 Aptos CA 95003
DAYTIME TELEPHONE NUMBER E-MAEL ADDRESS
( 831 ) 288-0608 �tmadsen@clearsourcefinancial.com
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 acknowledge this is a public document.
certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date Signed May 17, 2018 SignatureY.
(month, day, year) {File ih originally signed statement with your filing officral.J
FPPC Form 700(2017/2018)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Tall -Free Helpline: 866/275-3772 www.fppc.ca.gov