uc regent - kozberg - financial disclosure

8/14/2019 UC Regent - Kozberg - Financial Disclosure

1/21

IFORNIA FORM 700POLITICAL PRACTICES COMMISSION

"C OV E R P A GE.. ~

S T A T EM E N T O F E C O N O M IC IN T E R E S TS

type or print in ink,

(FIRSn (MIDDLE)(LAST)

G ADDRESS STREET

use business address)

I No.

STATE' ZIP CODE OPTIONAL: FAX I E-MAIL ADDRESS

Office, Agency, or Court 4. Schedule Summary

me of Qffice, Agenc~, or Court: ~ Total number of pages 0 l ' O

t


2/21

SCHEDULE A-1

Investments

'"'tocks; Bonds, and Other interests(Ownership Interest is Less Than 10%)

Do not attach brokerage or financial statements.

! 5 2 :: : - S 1 : .l JC J

.s:~:c'): - 51,0:)0,000~ 510,001 - S100,000

nOver $1,000,000

NA T

~

KE 0;: :NVESTMENT

Steck

U Ot~er-----;;:;::::::-::-:-:----(Describe)

IF .A.PPLICABLE, LIST DATE:

---1---1~

DISPOSED

~ NAME OF BUSINESS ENTITY

Lbocr'~ N&.~8USINESS ENTITY .

JYlc~({jifJ:krT6ftYcfl7Zod! ~~GENERAL DESCRIPTION OF BUSINESS ACTIVITY

Ftt V J 9 r 1 LIP ( GEB.vicG/FAIR MARKET VALUE

~ $2,000 - $10,000

tj$100,001 - $1,000,0000510,001 - $100.000

o 'Over $1,000,000

NATURE OF INVESTMENT

X~o Other __

(Describe)

IF APPliCABLE, LIST DATE:

LD(~~ACQUIRED

---1----1~

DISPOSED

' . .

. CALIFORNIA FORM 700:FAIR POLITICAL PRACTICES COMMISSION

l ! ~ N~h BUSINE SS E NTITY- ~ 'A A l1 Z .GENERAL DESCRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

~ $2,000 - $10,000

o $100,001 - $1,000,000o $10,001 - 5100,000DOver $1,000,000


f i i f Stock

o Other ------------------------------------(Oescribe)

IF APPLICABLE, LIST DATE:

---1---1~

ACQUIRED

---1---1~

DISPOSED

GENERAL DESCRIPTION OF. BUSINESS ACTIVITY

~/07E~/a6;(/FAIR MARKET VALUE

o $2,000 - $1 0,000 ~ $10,001 - $100,0000$100,001 - $1.000,000 0 Over 81,000,00Q


p ? ( Stock

o Other ------------------------(Describe)


----1........--f~

ACQUIRED

........--f........--f~

DISPOSED

I~ NA~: BUSINESS E NTITY i ' ft-(

',:;!CJ(.M QAN/~ . I 1 t < :1 Md

~ ~-;:-;;-j--!-

--:._--------------

GENERAL DESCRIPTION OF BUSINESS ACTIVITY

f : , ( ( 6c i .dcD'FAIR-"MARKET VALUE

052,000 - 510,000

o S100,001 - $1,000,00025 $10,001 - $100,000'0Over $1,000,000

AIUR" 0" INVI=STM=N-Iv . . - ' " ~ . . - . ~

A S : = 4 StockD Other _

(DeSCribe)


---.l---.l~

ACQUIRED

-1~~DISPOSED

FAIR MARKET VALUE

o $2,000 - $10,0000$100,001 - $1,000,000

. 2 T ' $10,001 - $100,000'0Over $1,000,000

NATURE OF INVESTMENT~ Stock

o Other ----------------(Describe)


---.l~~

ACQUIRED

~~~DISPOSED



) & ! Stocko Oiher - _

(Describe)


---.l---.l~

ACQUIRED

-1-1~

DISPOSED

Comments:


4/21

SCHEDULE A~1

Investments

Stocks, Bonds, and Other Interests(Ownership Interest is ~ess Than 10%) TOja,nu L


5/21

SCHEDULE A~1

investments

Stocks. Bonds, and Other Interests(Ow~ership Int~rest is Less Than 10%) :s6~HHI (../ I 1'-'p..g?C/\O: . 1

00 not attach brokerage or financial statements.


FAIR MARKET VALUE

o $2.000 - $10.0000$100,001 - $1.000,000

~$10,001 - $100,000

LJ Over $1,000,000


% Stocko Other -- ---:=_-::-:-- _

(Describe)

IF APPLICABLE. LIST DATE:

----.J __ /~

ACQUIRED

----.J----.J~DISPOSED

~ NA ~O F BU SI NES S E NT IT Y IfVO,w Ck'fEmICA

NAME OF BUSINESS ENTITY

CAf6J7 Q?6q? ~GENERAL DESCRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

o $2,000 - $10,000o $100,001 - $1,000,000

~ $10.001 - $100,000

o 'Over $1,000,000NATURE OF INVESTMENT

~ Stock

o Other _{Describe)


----.J----.J~ACQUIRED

.CAUFORNIA F O R M 1 ' o O i , ; - NAME~ BUSINESS ENTITY

VU)(e. !=N,c;GENERAL DESCRIPTION OF BUSINESS,

U 7 7 & r rIX ($10,001 - $100,000

Ll'Over $1,000,000NATURE OF INVESTMENT

~ Stock

o Other ----- _(Oescribe)


----.J----.J~ACQUIRED

----.J ----.J~DISPOSED

FPPC Form 700 (2008/2009) Sch, A-1

FPPC Toll-Free Helpline: 866/ASK-FPPC www.fppc.ca.gov
http://www.fppc.ca.gov/http://www.fppc.ca.gov/


6/21

SCHEDULE A-1

investments

Stocks, Bonds, and Other Interests(Ownership Interest is Less Than 10%)



l c . do4za /# ( fgbduccr F.AIR MARKET VALUE

[] $2,000 - $10,000

[] $100001 - $1,000,000

l R f $10,001 - $100,000fiover $1.000,000


~ Stock

[] Other _

(Describe)


----1----1~

ACQUIRED

----1----1~

DISPOSED

NAME OFrBUSINESS ENTITY IEC,t:>ON ~:f{rJff776fiA

GENERAL DESCRIPTION OF BUSINESS ACTiVITY

[J52,000 - $10.000o $100,001 - $1,000,000

~$10,001 - $100.000

TI'Over $1,000,000


J ! ! f Stock

o Other ------ _(Describe)


----1----1~

ACQUIRED

----.l~~DISPOSED

NAME OF BUSINESS ENTITY

ElflGGENERAL DESCRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

~ $2,000 - $10,000

'CT$100,001 - $1,000,000o $10,001 - $100,000[] Over $1,000,000


~ Stock

[J Other----------~--------

(DesCribe)

IF APPLICABLE, LiST DATE:

----.l __ LJ)'L.ACQl.iIRED

----.l __ /~

DISPOSED

1

f ~

I h&;,-: 0-"~ts; ~Ik"X,NERAL DESCRIPTION OF BUSIN SS ACTIVITY

flN&ctCOJI &&It.UFAIR MARKET VALUE

o $2,000 - $10,000[J$100,001 - $1.000.000

o $10,001 - $100,000DOver $1.000.000

(Describe)


----1----.l~ACQUIRED

~----.l~DISPOSED

GENERAL DESCRIPTION OF. BUSINESS ACTIVITY

FAIR MARKET VALUE

(;8 [ $2,000 - $10,000tJ' $100,001 - $1.000,000

[J$10,001 - $100,000DOver $1.000.000


~ Stock

Il Other _

(Describe)


----.l----.l~ACQUIRED

~----.l~DISPOSED

FAIR MARKET VALUE0$2,000 - $10,000

0$100,001 - $1,000,000

~$10,001 - $100,000

tJ'Over $1,000,000

~URE OF INVESTMENT

~ Stock

[] Other _

(Describe)


----1----1~

ACQUIRED

----.l----.l ~DISPOSED

omments: _

FPPC Form 700 (2008/2009) Sch. A-1

FPPC Toll-Free Helpline: 866fASK-FPPC www.fppc.ca.gov


7/21

SCHEDULE A~1

Investments

Stocks, Bonds, and Other Interests(Ownership Interest is Less Than 10%) - : r o~Yl nV OO:Z1!X:;t?& I


po NAME OF BUSINESS ENTITY

6-&JJNTE=CHGENERAL DESCRIPTION OF BUSINESS ACTIVITY

f;I6Ti2:x'l c{&~FAIR MARKET VALUE

n$2,000 - 510,000 ~$10,001 - $100,000

LJ S100,001 - $1,000,000 0Over $1,000,000

(Describe)


-----.l-----.l--.SJ!LACQUIRED

----.l-----.l--.SJ!LDISPOSED

i> " NAME OF BUSINESS EN~

6-6/G;1! CXJf'C;GENERAL DESCRIPTibN OF BUSINESS ACTIVITY

a}lvl?610d l c '1 d U ; $ V L 1FAIR MARKET VALUE

o $2,000 - $10,000o $100,001 - 51,000,000

~ 510,001 - $100,000

n 'Over $1,000,000

(Describe)


-----.l-----.l ~ACQUIRED

----.l-----.l~DISPOSED

I > - NAME OF BUSINESS ENTITY

&MA-:C'"" NA~OF BUSINESS ENTITY : .I t }


8/21

SCHEDULE A~1

Investments

Stocks, Bonds, and Other Interests I Name 1/ (Ownership Interest is Less Than 10%) JOI4V\n4-- n()~6-1

00 not attach brokerage or financial statements. I

FAIR MARKET VI\LUE

o $2,000 - S10,000o S100,001 - $1,000,000

~$10,001 - S100,000

nOver $1,000,000


% Stocko Other -- _

(Describe)

IF APPLICABLE, liST DATE:

----..l----..l....QLDISPOSED

~ N l i OF BUSINESjS ~NT!TY I6GJH6;e-5'


HD6fT!'~/tyFAIR MARKET 'VALUI::

~2,000 - $10,000 0$10,001 - $100,000U$100,001 - $1,000,000 iiOver $1,000,000

(DesCribe)

iF APPLICABLE, LIST DATE:

----..l----..l....QLACQUIRED

----..l----..l~DISPOSED


.:z::ilts


:611GENERAL DESCRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

o $2,000 - $10,000o $100,001 - $1,000,000

~$10,001 - $100,000

'[]' Over $1,000,000

aURE OF INVESTMEf'.JT

~ Stock

r- ~Cl.ef------------~~----------

(O~scribe)

___ ! /...illL

~!S;:OS=[;

1 [ ~NAME OF BUSINESS ENTITY I

~CJ&d/6(:ALGENEF

FAIR MARKET VALU

o $2,000 - $10,0000$100,001 - $1,000,000

~$10.001 - $100,000

trOver $1,000,000

(Describe)

IF APPLICABLE, LIST DfoTE:

----..l----1...illL

ACQUIRED

----..l----..l...!1LDISPOSED

FAIR MARI


9/21

SCHEDULE A-1

investments

Stocks, Bonds, and Other Interests - -l ''0'"'' ~ (Ownership Interest is Less Than 10%) ' - . l cr2 u lo ~ ~UrE:.I6- I

00 not attach brokerage or financial statements. '


H e d 1 1 1 (.4-FAIR MARKET VALUE082,000 - $10,000

08100,001 - $1,000,000

iR'SI0,001 - 8100,000

tlover $1,000,000

(Describe)

IF APPLICABLE, UST DATE:

~~-.lliL.ACQUIRED

---1~~

DISPOSED

~ NAME OFJUSINESS ENTITY

-

~ NA ME pF ~ S IN ES S EN TI TY

Jt' M oA6-M - CtrMcfGENERAL DESCRiPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

o $2,000 - $10,000o $100,001 - 81,000,000

~SI0,001 - $100,000

o Over 81,000,000NATURE OF INVESTMENT

~ Stock

o Other --- _(Describe)


----.l----.l-.lliL.

ACQUIRED---1----.l-.lliL.

DISPOSED

1 r ~

NAM~SINESS ENTITY~

Y;0C: A - - ~(3/j'JGENERAL D56CRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

o $2,000 - $10,0000$100,001 - $1,000,000

~$10,001 - $100,000

DOver $1,000,000


% Stocko Other _

(Describe)


----.l~-.lliL.

ACQUIRED

----.l~~

DISPOSED

GENERAL DE,CRIPTION OF. BUSINESS ACTIVITY

6dM C itll & r A .v/( fFAIR MAR KEf VALUE

o $2,000 - 810,0000$100,001 - $1,000,000

R J " $10,001 - 8100,000~ Over $1,000,000


~ Stock

o Other ----- _{Describe)


----.l----.l~

ACQUIRED

----.l----.l-'1JL

DISPOSED

~


FAIR MARKET VALUE

o $2,000 - $10,000o $100,001 - 81,000,000

~ $10,001 - $100,000

DOver $1,000,000


~ Stock

o Other -- ___:_~___:____:_------(Describe).


~----.l-.lliL.

ACQUIRED---1----.l~

DISPOSED

~ NAMg;;Zh-EN/i r s d sGENERAL DESCRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

o $2,000 - $10,0000$100,001 - $1,000,000

~ $10,001 - $100,000

'dOver $1,000.000


% , , ' Stocko Olher _

{Describe)


---1---1~ACQUIRED

~---1~DISPOSED

Comments:

FPPC Form 700 (2008/2009) Sch. A-1

FPPC Toll-Free Helpline: 866/ASK-FPPC wINw.fppc.ca.gov


10/21

\nvestments

stocks, Bonds, and other Interests(ownership Interest is Less Than ~O%)

Do not a t tach brokerage or financial statements

;SINESS EN111Y

ESCRIPTION 01' BUSINESS ACTIViTY

ET VALUE

$10,000

01 - $1,000,000

C 5 < : I 510,001 - $100,000

1]'Over 51,000,000

OF INVESIMENI

K

e r - - - - - - - -- - - - - - - - - - - - - -~ ~ : : ~ - - - - - - - -- - - - - - -tOescribe)

~~~DISPOSED

CABLE, L1S1 DATE:

MARKET VALUE

2,000 - $10,000

100,O O I - 5',,000,000

o $10,001 - $100,000o ' O v e r 51,000,000

URE 01' INVESTMENT

StocK

o omer----------------------------------------

FAIR MARKET VALUE

o $2,000 - $\0,0000$100,001 - $1,000,000

~$10,001 - $'100,000

Dover $1,000,000

NATURE Of INVESIMENI

~ StoCK

o O t h e r - - - - - - - - - - - - -- - - - - - (Describe I

IF APPliCABLE, LIST DATE:

FAIR MARKET VALUE

0$2,000 - $10,000

o $100,00i - $1,000,000

~10,001 - $100,000

1]Over $1,000,000

~T\JRE OF INVESIMENT

p\ SiocK

o O t h e r - - - - - - - - - - - -- - - - - - - - (Describe)

IF APPLICABLE, LlSI DATE'

~~~DISPOSED

F APPLICABLE, LiSI DATE',

~~~DISPOSED

GENERAL DESCRIPTION OF BUSINESS ACTIViTY

JU!---FAIR MARKET VALUE

~ $2,000 - $10,000

C - o $100,001 - $1,000,000

0$10,001 - $100,000'

r\Over $1,000,000

- NAME OF BUSINESS ENTiTY

. " ---L-/~~GENERAL DESCRIPTION OF BUSINESS ACTIVITY

_ _ _ _ _ _ , I t G~"LC~f 5 t $10,001 - $100,0o O v e r $1 ,O O O ,Q O OFAIR-MARKET VALUEo $2,000 - $10,000

0$100,001 - $1,000,000

NAI\JRE OF INVESIMENI

o StOCK- b Z O t h e r f . .. .. . .. .. ., ~ r (DeScribe)

~URE OF INVESIMENT

'f " l- Stock

oO t h e r - - - - - - - - - - - - -- - - - - (Describe)


IF APPLICABLE, LIST OATS:

~~~OISPOSEO


11/21

SCHEDULE A~1

investments

Stocks, Bonds, and Other interests(Ownership Interest is Less Than 10%)


I- NAME OF BUSINESS ENTITY

MtcA(y;3ey;=-rGENERAL DESCRIPTION OF BUSiNESS ACTIVITY

I N - P e A tyJtfl726c i .& ... .J ~t()WFA.IR MARKET VALUE I

~ $2,000 - $10,000

LJ S100,001 - $1,000,000

o S10,001 - $100,000DOver $1,000,000

(Describe)


__ L.._-.!~ACQUIRED

------.l------.l ~DISPOSED

FAIR MARKET VALUE

o $2,000 - $10,000U$100,001 - $1,000,000

!8f$10,001 - $100.000

'[jOver S1,000,000


~~

o Otoer _(Describe)

IF APPLICABLE, LIST DATE

------.l------.l ~ACQUIRED

~ NAME ~F BUSINESS ENT!T~ , & c i . s N()V~ ~ C t O " 'e : ,> 1

~ NAME OF BUSINESS ENTI~ , I

~ewe!!~dJFl!(jGENERAL DESCRIPTION OF BUSINESS ACTIVITY

C()~;;Ufi76{. 6 c x : J u - C ; r fFAIR MARKET VALUE

o $2,000 - $10,000o S100,001 - $1,000,000~ $10,001 - $100,000

tJ'over $1,000,000


)8 ( Stocko Other _

(Describe)


------.l------.l..!1LACQUIRED

--j--/~

DISPOSED

1 [ ~NAME OF BUSINESS ENTITY

(\JOt)'!AGENERAL DESCRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

g$2,000 ~ $10,000US100.001 - S1,000.000

o $10,001 $100,000DOver $1,000,000


~ Stock



------.l------.l~ACQUIRED

------.l------.l ~DISPOSED

~ NA ME O F BUSI NE SS ENT IT Y / "

IY M:7ffl{ot: c::5~ V/hdU!r'CRI PT !O N FGENERAL DEE

FAIR MARKET VALUE

o $2,000 - $10,000o $100,001 - S1,000,000

12$'$10,001 - $100,000

DOver $1,000,000

NATURE OF iNVESTMENT

' Stock



~r6/~DISPOSED

------.l------.l ~ACQUIRED


11 1 ( r[lY O J!FAIR MARKET VALUE

~ $2,000 - $10,000

0'$100,001 - $1,000,000

o $10,001 - $100,000DOver $1,000,000

~URE OF INVESTMENT

J l . Stock

o Other --- -::-~_::_-----(Describe)


------.l------.l ~ACQUIRED

------.l------.l ~DISPOSED

C O n 1 n 1 e n t s : _

FPPC Form 700 (2008/2009) Sch_ A-1

FPPC Toll-Free Helpline: 866/ASK-FPPC wV\l\'v.fppc.ca,gov


12/21

SCHEDULE A--l

Investments

Stocks, Bonds, and Other Interests(Ownership Interest is Less Than 10%)


nS2,000 - $10,000LJ $100,001 - $1,000,000

~10,001 - $100,000

UOver $1,000,000

(Describe)


----1----1...J)L

ACQUIRED

~J8J~DISPOSED

N,-"ME OF BUSINESS ENTITY

{fo!;Z~I !GH

FAIR MARKET VALUE

0$2,000 - $10,000

0$100,001 - $1,000,000

~$10,001 - $100,000

LJOver $1,000,000

~URE OF iNVESTMENT

~ Stock

(Describe)

IF APPLICABLE, LIST DATE

----1----1...J)LACQUIRED

----1----1 08

DISPOSED--

~ NA~F BUSINESS EN

6"\ DNA~~ UiSS ENTITY I

A :NT7dERAGEf\

_n_n

FAIR MARKET VALUE

o $2,000 - $10,000o $100,001 - $1,000,000

~$10,001 - $100,000

DOver $1,000,000


) 8 : [ ' Stock

(Describe)


----1----1...J)LACQUiRED

__ '__ i-.illLDISPOSED

NAMif BUSIN.ESS ENTITY

~6!tc 6~6._. __GENERAL DESCRIPTION OF BUSINESS ACTIVITY

&1G~&7J;f:.FAIR MARKET VALUE

o $2,000 - $10,0000$100,001 - $1,000,000

~$10,001 . $100,000

tJ' Over $1,000,000


J 8 : ( Stock

o Other ------------------(Describe)


----1----1-.illL

ACQUIRED

FAIR MARKET VALUE

o $2,000 - $10,000o $100,001 - $1,000,000

C~~($10,001 - $100,000

tJ'Over $1,000,000

(Describe)


----1----1-.illL

ACQUIRED

----1----1...J)LDISPOSED

GENERAl/DESCRIPTION OF BUSINESS ACTIVITY

FAIR"MARKET VALUE

o $2,000 - $10,0000$100,001 - $1,000,000

P f 1 . $10,001 - $100,000DOver S1,000,000

~URE OF INVESTMENT

~ Stock

o Other __(Describe)


----1----1-.illL

ACQUIRED

----1----1...!JLDISPOSED

omments:


13/21

~rCAUFORNIA FORM 700 - NAME OF BUSINESS ENTITY I7CrAdM (It!


fL.cfft(vCIJ)/ GE~V(cJFAIR MARKET VALUE

~ 52,000 - 510,000

D $100,001 - $1,000,000

0$10,001 - 5100,000

DOver $1,000,000


'f i . Stocko Other ----------------

(Describe)


---1---1~

ACQUIRED

----1---1~

DISPOSED

ments: _


14/21

SCHEDULE A-1

Investments

Stocks) Bonds, a nd O ther Interests -' ,,-,,- ~ (Ownership interest is Less Than 10%) JQa.V'lnt.-6:4!8a6--,



I%fI- ::r:tvYa


15/21

"CALIFORNIA FORM . I t ( j O ~ ) ,.FAIR pour/CAL PRACTICES COMMISSION

SCHEDULE A~1

Investments

Stocks, Bonds, and Other Interests J Name r . : o ,(Ownership Interest is Less Than 10%) : : : . r t " " 3 v r ( " ) L. ~:zA&& I


... NAME OF BUSINESS ENTIT}-j

I ' _( J,{ '-.J ITe.d rALc& ~VII!!0GENERA'- DESCRIPTION OF BUSINESS ACTIV!TY

F."


16/21

SCHEDULE A-1

investments

Stocks, Bonds, and Other Interests [ N a m e K c . .(Ownership Interest is Less Than 10%) :.f O p !V ') n ~(),Zjft!2(6- .


FAIR MARKET VALUE

o $2,000 - $10,000 0'$10,001 - $100,000n$100,001 - $1,000,000 DOver $1,000,000


[J Stock

~ Other i J . 6 ti !J J (Describe)IF APPLICABLE, LIST DATE:

q~5'(08

ACQUIRED ------f------f~DISPOSED

NA,ME OF BUSiNESS ENTITY

GENERAL DESCRIPT'ON OF BUSINESS ACTIViTY

FAIR MARKET VALUE

o $2,000 - $10,0000$100,001 - $1,000.000

o $10,001 - $100,000DOver $1,000,000

NA.TURE OF INVESTMENT

o Stock

D Other "(Describe)


----1------f~ACQUIRED

I > - NArvlE OF BUSINESS ENTITYNAME OF BUSINESS ENTITY

~a ' ; / : 0 / 2 Nih :5Wt41'U-:., L/T

FAIR MARKET VALUE

o $2,000 - $10,000~ S100,001 - $1,000,000

o $10,001 - $100,000DOver $1,000,000

NA.TURE OF INVESTMENT

o Stock

(Describe)


------f------f~ACQUIRED

------f----1~DISPOSED

l> - NAME OF BUSINESS ENTITYNAME OF BUSINESS ENTITY

GENERAL DESCRIPTION OF BUSINESS ,,,,CTIVITY

FAIR MARKET VALUE

D $2,000 - $10,000

0$100,001 - $1,000,000

o $10,001 - $100,000DOver $1,000,000


o StockD Other _

(Describe)


----1 __ /08

A.CQU:RiOD

------f----1~DISPOSED

GENERAL DESCR!PTION OF. BUSINESS ACTIVITY

FAIR MARKET VALUE

o $2,000 - S10,0000$100,001 - $1,000,000

o $10,001 - $100,000DOver $1,000.000


D Stock

(Describe)


----1------f~ACQUIRED

-------.! -------.! ~DISPOSED


FAIR MARKET VALUE

o $2,000 - $10,000o $100,001 - $1,000,000

n$10,001 - $100,000DOver $1,000.000


o Stock[] Other __

(Describe)

IF APPLICA.BLE, LIST DATE:

----1_~I~

ACQUIRED

----1----1~DISPOSED

mments: __

FPPC Form 700 (200812009) Sch. A-1

FPPC Toll-Free Helpline: 866/ASK-FPPC www.fppc.ca.gov


17/21

SCHEDULE A-2

Investments, Income, and Assets

of Business Entities/Trusts(Ownership Interest is 10% or Greater) . . : : r

Address

Check one

[ ] Trust. go ;0 2 ~ Business Entity, complere rhe box, (hen go ro 2

i GENERAL DESCRIPTION OF BUSINESS ACTIVITY

'/FAIR MARKET VALUE

10S2,000 - S10,000InS10,001 - $100,000,gS100,001 - $1,000,000

ItJ Over $1,000,000I

i NATURE OF INVESTMENT10Sole Proprietorship 0 PartnershipIi YOUR BUSINESS POSITION

IF APPLICABLE, liST DATE

---.l---.l~

ACQUIRED---.l---.l !& ...

DISPOSED

o INVESTMENT ~REAL PROPERTY

--r ~'N FOR-It;H -Pa.r ~~Shopp, . 'n:yName of Business Entity ill

Street Address or Assessor's Parcel Number of Real Property

Description of Business Activity ill

City or Other Precise Location of Real Property

Name

II 80 .:5oufuAddress

Check one

o Trust, go ro 2

! GENERAL DESCRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

0$2,000 - $10,000

0$10,001 - $100,000

gJ $100,001 - $1,000,000DOver $1,000,000


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ACQUIRED

---.l---.l~

DISPOSED


o Sole Proprietorship 0Partnership 0 _Other

YOUR BUSINESS POSITION - - '~ = ip e """" ,- ,U " ,- - , ,~ = = - _

~ 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF

INCOME OF $10,000 OR MORE (att:Jcha separo.e sheet If necessary)

J l ( 1 REAL PROPERTY

Name of Business Entity ill

Street Address or Assessor's Parcel Number of Real Property

?u7 s .o . r&-roadw~ .. "Bos- rv.-nh/

uc regent - kozberg - financial disclosure

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