Schedule A-2, Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10 percent or greater)

Ownership Interest is 10 Percent or Greater)

California Form 700 (2013-2014) Fair Political Practices Commission
FPPC Toll-Free Helpline: 1 (866) ASK-FPPC - (866) 275-3772

Name:

1. BUSINESS ENTITY OR TRUST

Name of business entity or trust:

Address of business entity or trust (Business Address Acceptable):

Check one: Trust, go to 2 Business Entity, complete the box (the following questions), then go to 2

General Description of this Business Activity:

Fair Market Value: $0 - $1,999 $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000

If applicable, list date in 2013: Acquired: month/day: Disposed: month/day:

Nature of Investment: Partnership Sole Proprietorship Other : Describe other:

Your Business Position:

2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/ TRUST)

$0 - $499 $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 Over $100,000

3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.)

None

Source of Income:

Source of Income:

Source of Income:

4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST (Check one box)

Investment Real Property

Name of Business Entity, if Investment, or Assessor's Parcel Number or Street Address of Real Property

Description of Business Activity or City or Other Precise Location of Real Property

Fair Market Value: $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000

If applicable, list date in 2013. Acquired: month/day: Disposed: month/day:

Nature of Interest: Property Ownership/Deed of Trust Stock Partnership Leasehold   If leasehold, years remaining:

Other  If other, describe:

Check this box if additional schedules reporting investments or real property are attached

Comments:

1. BUSINESS ENTITY OR TRUST

Name of business entity or trust:

Address of business entity or trust (Business Address Acceptable):

Check one: Trust, go to 2 Business Entity, complete the box (the following questions), then go to 2

General Description of this Business Activity:

Fair Market Value: $0 - $1,999 $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000

If applicable, list date in 2013: Acquired: month/day: Disposed: month/day:

Nature of Investment: Partnership Sole Proprietorship Other : Describe other:

Your Business Position:

2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/ TRUST)

$0 - $499 $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 Over $100,000

3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.)

None

Source of Income:

Source of Income:

Source of Income:

4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST (Check one box)

Investment Real Property

Name of Business Entity, if Investment, or Assessor's Parcel Number or Street Address of Real Property

Description of Business Activity or City or Other Precise Location of Real Property

Fair Market Value: $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000

If applicable, list date in 2013. Acquired: month/day: Disposed: month/day:

Nature of Interest: Property Ownership/Deed of Trust Stock Partnership Leasehold   If leasehold, years remaining:

Other  If other, describe:

Check this box if additional schedules reporting investments or real property are attached

Comments:

 

[End of Schedule A-2: Investments, Income, and Assets of Business Entities/ Trusts]