HomeMy WebLinkAbout02-22-2012 Library Commission Meeting Agenda Packet
City of Saratoga
Library Commission
AGENDA
DATE: February 22, 2012
TIME: 4:00 p.m.
LOCATION: Saratoga Library/ Community Room
13650 Saratoga Avenue
Saratoga, CA 95070
Call to Order
Roll Call
Report on Posting of the Agenda: Pursuant to Government Code Section 54954.2, the agenda for this
meeting was properly posted on February 16, 2012.
Accept Agenda Items & Order: No additional items may be added to this agenda pursuant to
Government Code Section 59454.2.
Oral & Written Communications: Any member of the public may address the Commission about any
matter not on the agenda for this meeting for up to three minutes. Commissioners may not comment on
the matter, but may choose to place the topic on a future agenda.
Approval of Minutes: Draft minutes for the December 7, 2011 meeting.
Old Business
1. Library General Obligation Bond & Facility Update
2. Library Commission Work Plan
New Business
3. Form 700 Informational Report
4. Name Tags
5. Historical Display
Reports
6. Melinda Cervantes, Santa Clara County Librarian
7. Gayathri Kanth, Community Librarian
8. Teri Creamer, Friends of the Saratoga Libraries
9. Sharon Andres, Library Commission Chair
Agenda Items for the Next Meeting
Adjournment
In compliance with the Americans with Disabilities Act, if you are a disabled person and you need a
disability-related modification or accommodation to participate in this meeting, please contact the City
Clerk’s Office at 408.868.1269 or ctclerk@saratoga.ca.us. Requests must be made as early as possible
and at least one full business day before the start of the meeting.
Library Commission Agenda Note:
In accordance with the Ralph M. Brown Act, copies of the staff reports and other materials provided to
the Library Commission by City staff in connection with this agenda are available at the office of the City
Manager at 13777 Fruitvale Avenue, Saratoga, California 95070. Any materials distributed by staff after
the posting of the agenda are made available for public review at the office of the City Manager at the
time they are distributed to the Library Commission.
Certificate of Posting of Agenda:
I, Mainini Cabute, Administrative Analyst II for the City of Saratoga, declare that the foregoing agenda
for the meeting of the Library Commission of the City of Saratoga was posted on February 16, 2012 at
the office of the City of Saratoga, 13777 Fruitvale Avenue, Saratoga, CA 95070 and was available for
public review at that location. The agenda is also available on the City’s website at www.saratoga.ca.us.
City of Saratoga
Library Commission
MINUTES
DATE: December 7, 2011
TIME: 10:00 a.m.
LOCATION: Book-Go-Round
14410 Oak Street
Saratoga, CA 95070
Call to Order – 10:30 a.m.
Roll Call
Present: Andres, Baxter, Lemmon, McBane Mulford, Whitcomb
Absent: None
Staff & Liaisons: Melinda Cervantes, Gayathri Kanth, Terrie Creamer, Michael Taylor, Crystal Morrow
Report on Posting of the Agenda: Pursuant to Government Code Section 54954.2, the agenda for this
meeting was properly posted on November 29, 2011.
Accept Agenda Items & Order: No additional items may be added to this agenda pursuant to
Government Code Section 59454.2.
Oral & Written Communications: Any member of the public may address the Commission about any
matter not on the agenda for this meeting for up to three minutes. Commissioners may not comment on
the matter, but may choose to place the topic on a future agenda.
- No oral or written communications
Approval of Minutes: Draft minutes for the October 26, 2011 meeting.
- Whitcomb requested a spelling correction in the minutes.
- MCBANE MULFORD/BAXTER MOVED TO APPROVE THE MINUTES AS AMENDED. MOTION
PASSED 5-0-0.
Old Business
1. Library General Obligation Bond Update
- Morrow provided an update on projects funded through Library General Obligation (GO) Bond
funds, including the remaining balance of the Bond funds.
2. Facility Update
- Morrow reported that improvements to air flow in and outside the Friend’s room have been
corrected, the project to install vinyl flooring in the back work area is out to bid, the roof safety
project is expected to be complete by the end of the month, and the solar project is in progress.
- Cervantes shared information about problems with vinyl flooring at the Los Altos Library.
New Business
3. Approval of New Library Improvement Project – Fire Alarm Repair
- Taylor presented a report and requested Commission authorization to use savings from the roof
safety project, $4,600, to fund fire alarm repairs. Taylor explained that the alarm is going off
when it should not and the problem may be fixed by replacing underground cabling for the
alarm system.
- BAXTER/WHITCOMB MOVED TO AUTHORIZE USE OF ROOF SAFETY PROJECT SAVINGS FOR THE
FIRE ALARM REPAIR PROJECT. MOTION PASSED 5-0-0.
4. Library Commission Work Plan and Accomplishments
- Andres introduced the item and invited McBane Mulford to share information on the Work Plan
Subcommittee’s progress.
- McBane Mulford reported that the subcommittee spoke with Kanth and Cervantes about how
the Library Commission can support County Library efforts to increase support for the Library
and the number of Library Cardholders. McBane Mulford suggested holding workshop to map
community assets as a first step. The workshop would help the Commission identify resources in
the community to help achieve County Library strategic plan objectives. The asset map could
also be used for other purposes or by other organizations in the community.
- Cervantes suggested that the Commissioners speak with Library Commissioners from other
cities at eh Annual Friends and Commissioner’s forum and recommended that the asset
mapping project be done without a specific focus on the library, to attract a broader range of
stakeholders.
- McBane Mulford proposed keeping the workshop open to the public and inviting community
leaders and asking them to bring others who may be interested.
- The Commission discussed timing of a workshop.
- McBane Mulford said she would work with Baxter, Kanth, Cervantes, and Friends of the
Saratoga Libraries to prepare a timeline and project scope to be distributed in January for the
February meeting.
Reports
5. Melinda Cervantes, Santa Clara County Librarian
- Cervantes shared the following information with the Commission:
- The Library has greatly expanded our electronic book collection with the recent addition of
Kindle eBooks. In September, Overdrive and Amazon launched Kindle compatibility to
approximately 11,000 United States public and school libraries in its network. On a related
note, circulation of eBooks for children and adults increased by well over 1,000 percent
from 2008 to 2010.
- The Santa Clara County Library JPA Board discussed several aspects of the non-District
resident library card fee at their October meeting, including concerns expressed in letters
from Los Altos and Los Altos Hills city councils. At the next meeting of the Library JPA Board
on January 26, 2012 at 1:30pm at the Library Administration Offices, 14600 Winchester
Blvd., Los Gatos, staff will present recommendations to:
- provide free WiFi services to all visitors
- establish a fee for daily use of the Library’s networked computers
- exempt Library volunteers who meet certain eligibility guidelines from paying the non-
District resident fee
- review the funding formula in the JPA Agreement, which received its last comprehensive
review in 2001
- JPA agendas and minutes will be posted on the Library website the Friday before each
meeting. www.santaclaracountylib.org
- Administrative Services Manager Gay Strand retired on December 2 after thirteen years of
service to the Library. Recruitment for her successor will be initiated very soon.
- During the past two months, both Campbell and Los Altos libraries have undergone
renovations to update furniture, enhance computer and electrical wiring, install new
carpeting, and paint interior walls.
- Over the summer, the Library implemented online credit and debit card payment of fines
and fees, which has been very well-received. Over the next several months, SCCL will also be
installing cash/credit/debit self-payment stations in each library.
- At the California Library Association’s (CLA) Annual Conference in Pasadena on November
11-13, Patricia Lorenzo, the Santa Clara County Library Service Manager for Outreach and
Public Awareness, will receive the prestigious Outstanding Librarian in Support of Literacy
Award for her work managing The Reading Program. In addition, at the same conference,
Deputy County Librarian Derek Wolfgram will be sworn in as Vice President/President-Elect
of CLA.
- Silicon Valley Reads celebrates its 10th Anniversary in 2012 kicking off on Wednesday,
January 25, 2012 at 7:30pm at the Campbell Heritage Theater in Campbell. Two authors,
Sumbul Ali-Karamali and G. Willow Wilson, whose books on what it is like to be both Muslim
and American have been selected for Silicon Valley Reads 2012, the regional program that
asks everyone in Santa Clara County to read the same books, at the same time, and talk
about them. Santa Clara County Library is one of three co-sponsors along with the San Jose
Public Library Foundation and the Santa Clara County Office of Education.
- The Muslim Next Door by Sumbul Ali-Karamali and The Butterfly Mosque by G. Willow
Wilson present two perspectives on their experiences as young American women who are
also Muslim. Their stories provide insight into Islam including misconceptions about the
faith and cultural traditions.
- Silicon Valley Reads companion books for younger readers are: It’s OK to Be Different, a
picture book by Todd Parr, One Green Apple by Eve Bunting (K-2), My Name is Bilal by Asma
Mobin-Uddin (grades 3-6) and Skunk Girl by Sheba Karim (grades 7 and up).
- The 2012 Library Friends and Commissioners Forum will be held in February 2012 at the
Library Administration Offices. The date of the Forum has been tentatively scheduled for
Saturday, Feb. 4th from 8:30am – Noon. Please save the date.
- Silicon Valley Puzzle Fest: January 28-29, 2012. Pre-registration is open for the upcoming
6th annual Silicon Valley Puzzle Fest. Each year, Puzzle Fest is an entire weekend filled with
crossword puzzles, Sudoku, and other word and logic puzzles. People from all over California
and as far away as Arizona join us for workshops for all levels of puzzle lovers on Saturday
and competed in our tournaments, featuring puzzles provided by NY Times puzzlemaster
Will Shortz and Sudoku world champion Thomas Snyder, on Sunday. The Silicon Valley
Puzzle Fest is sponsored by the Morgan Hill Library Foundation.
http://svpuzzle.org/index.html
6. Gayathri Kanth, Community Librarian
- Kanth indicated should would email her report to Morrow to be distributed to the Commission.
7. Teri Creamer, Friends of the Saratoga Libraries
- Creamer shared the following information with the Commission:
- 2012 membership drive kicked off in November
- Silicon Valley Read- The Muslim Next Door author Sumbul Ali-Karamali will be at the
Saratoga Library on Feb. 5.
- Paperback book sale is January 21-22 in the Community Room.
- Next Author Series is February 1 in the Community Room.
- December 6- 7 PM: Friends Holiday Open House was at the Saratoga Library, the Redwood
Choir performed, about 70 kids. We had a full house, standing room only!
8. Sharon Andres, Library Commission Chair
- Andres had nothing additional to report
Agenda items for the Next Meeting
- Library Commission Work Plan
Adjournment – 12:05 p.m.
Minutes submitted by:
Crystal Morrow, City Clerk
City of Saratoga – City Manager’s Office
Memo
To: Library Commission
From: Thomas Scott, Facilities Maintenance Supervisor
Date: February 14, 2012,
Re: Library Projects Update
The information below is an update, as of February 14, 2012, of all
completed and current/ongoing facilities projects at the Saratoga Library.
Completed
• Selected material and color for backroom work floor project.
• Found Flooring contractor to install backroom vinyl flooring.
Current/Ongoing Projects
• Installation of ladder safety cage and 4 ladder safety extension poles
are planned for February or March 2012.
• Installation of solar panels on the Library roof will be lead by the Public
Works Department.
• PIV fire alarm repair project has received funding approval.
Contractor must determine the date to begin the project.
• Three additional contractors are prepared to work on the backroom
flooring project: equipment handler, furniture company and electrical
contractor.
City of Saratoga Facilities Department
City of Saratoga
Memorandum
To: City of Saratoga Library Commission
From: Mainini Cabute, Administrative Analyst II
City of Saratoga
Date: February 22, 2012 Library Commission Meeting
Subject: Form 700
At the beginning of each year, public officials at every level of state and local government are
asked to complete the Statement of Economic Interests, otherwise known as the Form 700.
This form is due on April 1st and requires public officials, and also those who advise them, to
disclose their financial interests for two reasons. First, the form alerts public officials to
financial interests that might be affected while making government decisions. Second, the
disclosure informs the public about any potential conflicts of interest.
The City of Saratoga requires Commission members to complete the Form 700 because
Commissioners, at some capacity, participate in making governmental decisions that could
affect their private financial interests. In cases where a public official has a conflict of interest,
the official must recuse herself or himself from participating in the decision-making process.
Attached with this memo is a complete Form 700 with instructions. Public Officials must file
this form each year. The filed forms are public documents and are available to anyone who
requests them. To read more information about the Form 700, please visit
http://www.fppc.ca.gov/index.php?id=500. If you have specific questions or would like advice
regarding your obligations, please contact the Fair Political Practices Commission (FPPC) at
advice@fppc.ca.gov or call its toll-free number at 1-866-ASK-FPPC. You may also visit the FPPC
website link at http://www.fppc.ca.gov/index.php?id=189.
December 2011
2011/2012
Statement of
Economic Interests
Form 700
California Fair Political Practices Commission
428 J Street, Suite 620 • Sacramento, CA 95814
Toll-free advice line: 1 (866) ASK-FPPC • 1 (866) 275-3772
Telephone: (916) 322-5660 • Website: www.fppc.ca.gov
A Public Document
Also available on the FPPC website:
• Form 700 in Excel format
• Reference Pamphlet for Form 700
What’s New
Reporting Investments – Exchange traded funds and similar
fi nancial investments that resemble mutual funds are not
reportable for most individuals. The term “investment” no
longer includes certain exchange traded funds, closed-end
funds, or funds held in an Internal Revenue Code qualifi ed plan.
These non-reportable investment funds (1) must be bona fi de
investment funds that pool money from more than 100 investors,
(2) must hold securities of more than 15 issuers, and (3) cannot
have a stated policy of concentrating their holdings in the same
industry or business (“sector funds”). In addition, the fi ler may not
infl uence or control the decision to purchase or sell the specifi c
fund on behalf of his or her agency during the reporting period
or infl uence or control the selection of any specifi c investment
purchased or sold by the fund. (Regulation 18237)
Reportable investments, such as stock, held in a brokerage
account or other type of managed account continue to be
reportable regardless of whether you have control over
those investments.
Who must fi le:
Elected and appointed offi cials and candidates listed in
Government Code Section 87200
Employees and appointed offi cials fi ling pursuant to a confl ict-
of-interest code (“code fi lers”). Obtain your disclosure
categories, which describe the interests you must report,
from your agency; they are not part of the Form 700
Candidates running for local elective offi ces that are
designated in a confl ict-of-interest code (e.g., county sheriffs,
city clerks, school board trustees, and water board members)
Members of newly created boards and commissions not yet
covered under a confl ict-of-interest code
Employees in newly created positions of existing agencies
See Reference Pamphlet, page 3, at www.fppc.ca.gov or obtain
from your fi ling offi cer.
Where to fi le:
87200 Filers
State offi ces Your agency
Judicial offi ces The clerk of your court
Retired Judges Directly with FPPC
County offi ces Your county fi ling offi cial (e.g. Clerk
of the Board of Supervisors)
City offi ces Your city clerk
Multi-County offi ces Your agency
Code Filers — State and Local Offi cials and Employees
Designated in a Confl ict-of-Interest Code:
File with your agency, board, or commission unless otherwise
specifi ed in your agency’s confl ict-of-interest code (e.g.,
Legislative staff fi les directly with FPPC). In most cases, the
agency, board, or commission will retain the statements.
Members of Boards and Commissions of Newly Created
Agencies: File with your newly created agency or with your
agency’s code reviewing body.
Employees in Newly Created Positions of Existing Agencies:
File with your agency or with your agency’s code reviewing body.
See Reference Pamphlet, page 3.
Candidates: File with your local elections offi ce.
How to fi le:
The Form 700 is available at www.fppc.ca.gov. Form 700
schedules are also available in Excel format. All statements
must have an original “wet” signature or be duly authorized by
your fi ling offi cer to fi le electronically under Government Code
Section 87500.1. Instructions, examples, FAQs, and a reference
pamphlet are available to help answer your questions.
When to fi le:
Annual Statements
March 1, 2012
- Elected State Offi cers
- Judges and Court Commissioners
- State Board and Commission Members listed in
Government Code Section 87200
April 2, 2012
- Most other fi lers
Individuals fi ling under confl ict-of-interest codes in city and county
jurisdictions should verify the annual fi ling date with their local
fi ling offi cers.
Statements postmarked by the fi ling deadline are considered fi led
on time.
Assuming Offi ce and Leaving Offi ce Statements
Most fi lers fi le within 30 days of assuming or leaving offi ce
or within 30 days of the effective date of a newly adopted or
amended confl ict-of-interest code.
Exception:
If you assumed offi ce between October 1,2011, and December
31, 2011, and fi led an assuming offi ce statement, you are not
required to fi le an annual statement until March 1, 2013, or April 2,
2013, whichever is applicable. The annual statement will cover the
day after you assumed offi ce through December 31, 2012. See
Reference Pamphlet, pages 6 and 7, for additional exceptions.
Candidate Statements
File no later than the fi nal fi ling date for the declaration of
candidacy or nomination documents.
Amendments
Statements may be amended at any time. You are only required
to amend the schedule that needs to be revised. It is not
necessary to amend the entire fi led form. Obtain amendment
schedules at www.fppc.ca.gov.
There is no provision for fi ling deadline extensions.
Statements of 30 pages or less may be faxed by the deadline as
long as the originally signed paper version is sent by fi rst class
mail to the fi ling offi cial within 24 hours.
The Political Reform Act (Gov. Code Sections 81000-
91014) requires most state and local government offi cials
and employees to publicly disclose their personal assets
and income. They also must disqualify themselves
from participating in decisions that may affect their
personal economic interests. The Fair Political Practices
Commission (FPPC) is the state agency responsible for
issuing the attached Statement of Economic Interests,
Form 700, and for interpreting the law’s provisions.
Gift Prohibition
Gifts received by most state and local offi cials, employees,
and candidates are subject to a limit. For 2011-2012, the
gift limit remains at $420 from a single source during a
calendar year. This gift limit is effective until December 31,
2012.
In addition, state offi cials, state candidates, and certain
state employees are subject to a $10 limit per calendar
month on gifts from lobbyists and lobbying fi rms registered
with the Secretary of State. See Reference Pamphlet,
page 10.
State and local offi cials and employees should check with
their agency to determine if other restrictions apply.
Disqualifi cation
Public offi cials are, under certain circumstances, required
to disqualify themselves from making, participating in, or
attempting to infl uence governmental decisions that will
affect their economic interests. This may include interests
they are not required to disclose (i.e., a personal residence
is often not reportable, but may be disqualifying). Specifi c
disqualifi cation requirements apply to 87200 fi lers (e.g.,
city councilmembers, members of boards of supervisors,
planning commissioners, etc.). These offi cials must identify
orally the economic interest that creates a confl ict of interest
and leave the room before a discussion or vote takes
place at a public meeting. For more information, consult
Government Code Section 87105, Regulation 18702.5, and
the Overview of the Confl ict of Interest Laws at
www.fppc.ca.gov.
Honorarium Ban
Most state and local offi cials, employees, and candidates
are prohibited from accepting an honorarium for any speech
given, article published, or attendance at a conference,
convention, meeting, or like gathering. See Reference
Pamphlet, page 10.
Loan Restrictions
Certain state and local offi cials are subject to restrictions on
loans. See Reference Pamphlet, page 14.
Post-Governmental Employment
There are restrictions on representing clients or employers
before former agencies. The provisions apply to elected
state offi cials, most state employees, local elected offi cials,
county chief administrative offi cers, city managers,
including the chief administrator of a city, and general
managers or chief administrators of local special districts
and JPAs. The FPPC website has fact sheets explaining
the provisions.
Late Filing
The fi ling offi cer who retains originally-signed statements of
economic interests may impose on an individual a fi ne for
any statement that is fi led late. The fi ne is $10 per day up to
a maximum of $100. Late fi ling penalties may be reduced
or waived under certain circumstances.
Persons who fail to timely fi le their Form 700 may be
referred to the FPPC’s Enforcement Division (and, in some
cases, to the Attorney General or district attorney) for
investigation and possible prosecution. In addition to the
late fi ling penalties, a fi ne of up to $5,000 per violation may
be imposed.
For assistance concerning reporting, prohibitions, and
restrictions under the Act:
Call the FPPC toll-free at (866) 275-3772.
See the booklet entitled “Your Duty to File: A Basic
Overview of State Economic Disclosure Law and
Reporting Requirements for Public Offi cials” available
at www.fppc.ca.gov.
Form 700 Public Access
Statements of Economic Interests are public
documents. The fi ling offi cer must permit any
member of the public to inspect and receive a copy
of any statement.
Statements must be available as soon as possible
during the agency's regular business hours, but
in any event not later than the second business
day after the statement is received. Access to the
Form 700 is not subject to the Public Records Act
procedures.
No conditions may be placed on persons seeking
access to the forms.
No information or identifi cation may be required
from persons seeking access.
Reproduction fees of no more than 10 cents per
page may be charged.
Introduction
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 1
Instructions — Cover Page
Enter your name, mailing address, and daytime telephone
number in the spaces provided. Because the Form 700 is a
public document, you may list your business/offi ce address
instead of your home address.
Part 1. Offi ce, Agency, or Court
Enter the name of the offi ce sought or held, or the agency
or court. Consultants must enter the public agency name
rather than their private fi rm’s name. (Examples: State
Assembly; Board of Supervisors; Offi ce of the Mayor;
Department of Finance; Hope County Superior Court)
Indicate the name of your division, board, or district, if
applicable. (Examples: Division of Waste Management;
Board of Accountancy; District 45)
Enter your position title. (Examples: Director; Chief
Counsel; City Council Member; Staff Services Analyst)
If you hold multiple positions (i.e., a city council member
who also is a member of a county board or commission),
you may be required to fi le statements with each agency.
To simplify your fi ling obligations, you may complete an
expanded statement.
To do this, enter the name of the other agency(ies) with
which you are required to fi le and your position title(s)
in the space provided. Attach an additional sheet if
necessary. Complete one statement covering the
disclosure requirements for all positions. Each copy must
contain an original signature. Therefore, before signing
the statement, make a copy for each agency. Sign each
copy with an original signature and fi le with each agency.
Example:
Scott Baker is a city council member for the City of Lincoln
and a board member for the Camp Far West Irrigation
District – a multi-county agency that covers Placer and
Yuba counties. Scott will complete one Form 700 using full
disclosure (as required for the city position) and covering
interests in both Placer and Yuba counties (as required for
the multi-county position) and list both positions on the Cover
Page. Before signing the statement, Scott will make a copy
and sign both statements. One statement will be fi led with
City of Lincoln and the other will be fi led with Camp Far West
Irrigation District. Both will contain an original signature.
Remember that if you assume or leave a position after a
fi ling deadline, you must complete a separate statement.
For example, a city council member who assumes a
position with a county special district after the April 2
annual fi ling deadline must fi le a separate assuming offi ce
statement. In subsequent years, the city council member
may expand his or her annual fi ling to include both
positions.
Part 2. Jurisdiction of Offi ce
Check the box indicating the jurisdiction of your agency
and, if applicable, identify the jurisdiction. Judges, judicial
candidates, and court commissioners have statewide
jurisdiction. All other fi lers should review the Reference
Pamphlet, page 13, to determine their jurisdiction.
If your agency is a multi-county offi ce, list each county in
which your agency has jurisdiction.
If your agency is not a state offi ce, court, county offi ce, city
offi ce, or multi-county offi ce (e.g., school districts, special
districts and JPAs), check the “other” box and enter the
county or city in which the agency has jurisdiction.
Example:
This fi ler is a member of a water district board with jurisdiction
in portions of Yuba and Sutter Counties.
Part 3. Type of Statement
Check at least one box. The period covered by a statement
is determined by the type of statement you are fi ling. If you
are completing a 2011 annual statement, do not change the
pre-printed dates to refl ect 2012. Your annual statement is
used for reporting the previous year’s economic interests.
Economic interests for your annual fi ling covering January 1,
2011, through December 31, 2011, will be disclosed on your
statement fi led in 2012. See Reference Pamphlet, page 4.
Combining Statements: Certain types of statements may be
combined. For example, if you leave offi ce after January 1,
but before the deadline for fi ling your annual statement, you
may combine your annual and leaving offi ce statements. File
by the earliest deadline. Consult your fi ling offi cer or the
FPPC.
Part 4. Schedule Summary
Enter the total number of completed pages including the
cover page and either:
Check the box for each schedule you use to disclose
interests;
- or -
if you have nothing to disclose on any schedule, check the
“No reportable interests” box. Please do not attach any
blank schedules.
Part 5. Verifi cation
Complete the verifi cation by signing the statement and
entering the date signed. When you sign your statement,
you are stating, under penalty of perjury, that it is
true and correct. Only the fi ler has authority to sign the
statement. An unsigned statement is not considered fi led and
you may be subject to late fi ling penalties.
State Judge or Court Commissioner (Statewide Jurisdiction)
Multi-County County of
City of Other
2. Jurisdiction of Offi ce (Check at least one box)
Agency Name
Division, Board, Department, District, if applicable Your Position
1. Offi ce, Agency, or Court
► If fi ling for multiple positions, list below or on an attachment.
Agency: Position:
South Sutt er Water District
Board Member
X Porti ons of Yuba & Sutt er Counti es
Leaving Offi ce: Date Left //
(Check one)
The period covered is January 1, 2011, through the date of
leaving offi ce.
The period covered is //, through
the date of leaving offi ce.
Annual: The period covered is January 1, 2011, through
December 31, 2011.
The period covered is //, through
December 31, 2011.
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
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.
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)
3. Type of Statement (Check at least one box)
State Judge or Court Commissioner (Statewide Jurisdiction)
Multi-County County of
City of Other
2. Jurisdiction of Offi ce (Check at least one box)
Candidate: Election Year Offi ce sought, if different than Part 1:
Assuming Offi ce: Date assumed //
Date Received
Offi cial Use Only
Please type or print in ink.
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
Agency Name
Division, Board, Department, District, if applicable Your Position
1. Offi ce, Agency, or Court
4. Schedule Summary
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Check applicable schedules or “None.”
Schedule A-1 - Investments – schedule attached
Schedule A-2 - Investments – schedule attached
Schedule B - Real Property – schedule attached
► Total number of pages including this cover page:
MAILING ADDRESS STREET CITY STATE ZIP CODE
( )
DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS (OPTIONAL)
(Business or Agency Address Recommended - Public Document)
Signature
(File the originally signed statement with your fi ling offi cial.)
5. Verifi cation
Schedule C - Income, Loans, & Business Positions – schedule attached
Schedule D - Income – Gifts – schedule attached
Schedule E - Income – Gifts – Travel Payments – schedule attached
-or-
None - No reportable interests on any schedule
A PUBLIC DOCUMENT
► If fi ling for multiple positions, list below or on an attachment.
Agency: Position:
-or-
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 3
Common Reportable Interests
Schedule A-1: Stocks, including those held in an IRA or a 401K
Schedule A-2: Business entities (including certain independent contracting), sole proprietorships,
partnerships, LLCs, corporations, and trusts
Schedule B: Rental property in the jurisdiction
Schedule C: Non-governmental salaries of public offi cial and spouse/registered domestic partner
Schedule D: Gifts from non-family members (such as tickets to sporting or entertainment events)
Schedule E: Travel payments from third parties (not your employer)
Common Non-Reportable Interests
Schedule A-1/A-2: Insurance policies, government bonds, diversifi ed mutual funds, certain funds similar
to diversifi ed mutual funds (such as exchange traded funds) and investments held in
certain retirement accounts. See Reference Pamphlet, page 12 for detailed information.
(Regulation 18237)
Schedule A-1/A-2: Savings and checking accounts and annuities
Schedule B: A residence used exclusively as a personal residence (such as a home or vacation
cabin)
Schedule C: Governmental salary (such as a school district)
Schedule D: Gifts from family members
Schedule E: Travel paid by your government agency
Remember:
Mark the “No reportable interests” box on Part 4 of the Schedule Summary on the Cover Page
if you determine you have nothing to disclose and fi le the cover page only. Make sure you
carefully read all instructions to ensure proper reporting.
The Form 700 is a public document.
Most individuals must consult their agency’s confl ict-of-interest code for reportable interests.
Most individuals fi le the Form 700 with their agencies.
Which Schedule Do I Use?
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 4
General
Q. What is the reporting period for disclosing interests
on an assuming offi ce statement or a candidate
statement?
A. On an assuming offi ce statement, disclose all
reportable investments, interests in real property, and
business positions held on the date you assumed
offi ce. In addition, you must disclose income (including
loans, gifts and travel payments) received during the
12 months prior to the date you assumed offi ce.
On a candidate statement, disclose all reportable
investments, interests in real property, and business
positions held on the date you fi le your declaration of
candidacy. You must also disclose income (including
loans, gifts and travel payments) received during the
12 months prior to the date you fi le your declaration of
candidacy.
Q. I hold two other board positions in addition to my
position with the county. Must I fi le three statements of
economic interests?
A. Yes, three are required. However, you may complete
one statement listing the county and the two boards
on the cover page or an attachment as the agencies
for which you will be fi ling. Report your economic
interests using the largest jurisdiction and highest
disclosure requirements assigned to you by the three
agencies. Make two copies of the entire statement
before signing it, sign each copy with an original
signature, and distribute one original to the county
and to each of the two boards. Remember to
complete separate statements for positions that
you leave or assume during the year.
Q. I am a department head who recently began acting as
city manager. Should I fi le as the city manager?
A. Yes. File an assuming offi ce statement as city
manager. Persons serving as “acting,” “interim,”
or “alternate” must fi le as if they hold the position
because they are or may be performing the duties of
the position.
Q. As a designated employee, I left one state agency to
work for another state agency. Must I fi le a leaving
offi ce statement?
A. Yes. You may also need to fi le an assuming offi ce
statement for the new agency.
Investment Disclosure
Q. I have an investment interest in shares of stock
in a company that does not have an offi ce in my
jurisdiction. Must I still disclose my investment interest
in this company?
A. Probably. The defi nition of “doing business in the
jurisdiction” is not limited to whether the business has
an offi ce or physical location in your jurisdiction. See
Reference Pamphlet, page 13.
Q. My spouse and I have a living trust. The trust
holds rental property in my jurisdiction, our primary
residence, and investments in diversifi ed mutual funds.
I have full disclosure. How is this trust disclosed?
A. Disclose the name of the trust, the rental property and
its income on Schedule A-2. Your primary residence
and investments in diversifi ed mutual funds registered
with the SEC are not reportable.
Q. I am required to report all investments. I hold many
stocks through an account managed by a brokerage
fi rm. Must I disclose these stocks even though I did
not decide which stocks to purchase?
A. Yes. Disclose on Schedule A-1 or A-2 any stock worth
$2,000 or more in a business entity located in or doing
business in your jurisdiction.
Q. I own stock in IBM and must report this investment
on Schedule A-1. I initially purchased this stock in
the early 1990s; however, I am constantly buying
and selling shares. Must I note these dates in the
“Acquired” and “Disposed” fi elds?
A. No. You must only report dates in the “Acquired” or
“Disposed” fi elds when, during the reporting period,
you initially purchase a reportable investment worth
$2,000 or more or when you dispose of the entire
investment. You are not required to track the partial
trading of an investment.
Q. On last year’s fi ling I reported stock in Encoe valued
at $2,000 - $10,000. Late last year the value of this
stock fell below and remains at less than $2,000. How
should this be reported on this year’s statement?
A. You are not required to report an investment if the
value was less than $2,000 during the entire reporting
period. However, because a disposed date is not
Questions and Answers
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 5
required for stocks that fall below $2,000, you may
want to report the stock and note in the “comments”
section that the value fell below $2,000. This would be
for informational purposes only; it is not a requirement.
Income Disclosure
Q. I reported a business entity on Schedule A-2. Clients
of my business are located in several states. Must
I report all clients from whom my pro rata share of
income is $10,000 or more on Schedule A-2, Part 3?
A. No, only the clients doing business on a regular basis
in your jurisdiction must be disclosed.
Q. I believe I am not required to disclose the names of
clients from whom my pro rata share of income is
$10,000 or more on Schedule A-2 because of their
right to privacy. Is there an exception for reporting
clients’ names?
A. Regulation 18740 provides a procedure for requesting
an exemption to allow a client’s name not to be
disclosed if disclosure of the name would violate a
legally recognized privilege under California law. This
regulation may be obtained from our website at
www.fppc.ca.gov. See Reference Pamphlet, page 14.
Q. I am sole owner of a private law practice that is not
reportable based on my limited disclosure category.
However, some of the sources of income to my law
practice are from reportable sources. Do I have to
disclose this income?
A. Yes, even though the law practice is not reportable,
reportable sources of income to the law practice of
$10,000 or more must be disclosed. This information
would be disclosed on Schedule C with a note in the
“comments” section indicating that the business entity
is not a reportable investment. The note would be for
informational purposes only; it is not a requirement.
Q. I am the sole owner of my business. Where do I
disclose my income - on Schedule A-2 or Schedule C?
A. Sources of income to a business in which you have an
ownership interest of 10% or greater are disclosed on
Schedule A-2. See Reference Pamphlet, page 8, for
the defi nition of “business entity.”
Q. How do I disclose my spouse’s or registered domestic
partner’s salary?
A. Report the name of the employer as a source of
income on Schedule C.
Q. I am a doctor. For purposes of reporting $10,000
sources of income on Schedule A-2, Part 3, are the
patients or their insurance carriers considered sources
of income?
A. If your patients exercise suffi cient control by selecting
you instead of other doctors, then your patients, rather
than their insurance carriers, are sources of income to
you. See Reference Pamphlet, page 14 for additional
information.
Real Property Disclosure
Q. During this reporting period we switched our principal
place of residence into a rental. I have full disclosure
and the property is located in my agency’s jurisdiction,
so it is now reportable. Because I have not reported
this property before, do I need to show an “acquired”
date?
A. No, you are not required to show an “acquired” date
because you previously owned the property. However,
you may want to note in the “comments” section that
the property was not previously reported because
it was used exclusively as your residence. This
would be for informational purposes only; it is not a
requirement.
Gift Disclosure
Q. If I received a gift of two tickets to a concert valued at
$100 each, but gave the tickets to a friend because I
could not attend the concert, do I have any reporting
obligations?
A. Yes. Since you accepted the gift and exercised
discretion and control of the use of the tickets, you
must disclose the gift on Schedule D.
Q. Mary and Joe Benson, a married couple, want to give
a piece of artwork to a close friend who is a county
supervisor. Is each spouse considered a separate
source for purposes of the gift limit and disclosure?
A. Yes, each spouse may make a gift valued at $420
during 2011-2012. Therefore, the Bensons may give
the supervisor artwork valued at no more than $840.
The supervisor must identify Joe and Mary Benson as
the sources of the gift.
Questions and Answers
Continued
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 6
Q. I am a Form 700 fi ler with full disclosure. Our agency
holds a holiday raffl e to raise funds for a local charity. I
bought $10 worth of raffl e tickets and won a gift basket
valued at $120. The gift basket was donated by
Doug Brewer, a citizen in our city. At the same event,
I bought raffl e tickets for, and won a quilt valued at
$70. The quilt was donated by a coworker. Are these
reportable gifts?
A. Because the gift basket was donated by an outside
source (not an agency employee), you have received a
reportable gift valued at $110 (the value of the basket
less the consideration paid). The source of the gift
is Doug Brewer and the agency is disclosed as the
intermediary. Because the quilt was donated by an
employee of your agency, it is not a reportable gift.
Q. My agency is responsible for disbursing grants. An
applicant (501(c)(3) organization) met with agency
employees to present its application. At this meeting,
the applicant provided food and beverages. Would
the food and beverages be considered gifts to the
employees? These employees are designated in our
agency’s confl ict-of-interest code and the applicant is a
reportable source of income under the code.
A. Yes. If the value of the food and beverages consumed
by any one fi ler, plus any other gifts received from the
same source during the reporting period total $50 or
more, the food and beverages would be reported using
the fair market value and would be subject to the gift
limit.
Questions and Answers
Continued
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 7
“Investment” means a fi nancial interest in any business
entity that is located in, doing business in, planning to do
business in, or that has done business during the previous
two years in your agency’s jurisdiction in which you, your
spouse or registered domestic partner, or your dependent
children had a direct, indirect, or benefi cial interest totaling
$2,000 or more at any time during the reporting period. See
Reference Pamphlet, page 13.
Reportable investments include:
Stocks, bonds, warrants, and options, including those
held in margin or brokerage accounts and managed
investment funds (See Reference Pamphlet, page 13.)
Sole proprietorships
Your own business or your spouse’s or registered
domestic partner’s business (See Reference Pamphlet,
page 8, for the defi nition of “business entity.”)
Your spouse’s or registered domestic partner’s
investments that are legally separate property
Partnerships (e.g., a law fi rm or family farm)
Investments in reportable business entities held in a
retirement account (See Reference Pamphlet, page 15.)
If you, your spouse or registered domestic partner,
and dependent children together had a 10% or
greater ownership interest in a business entity or trust
(including a living trust), you must disclose investments
held by the business entity or trust. See Reference
Pamphlet, page 15, for more information on disclosing
trusts.
Business trusts
You are not required to disclose:
Insurance policies, government bonds, diversifi ed
mutual funds, certain funds similar to diversifi ed
mutual funds (such as exchange traded funds) and
investments held in certain retirement accounts. See
Reference Pamphlet, page 12 for detailed information.
(Regulation 18237)
Bank accounts, savings accounts, money market
accounts and certifi cates of deposits
Insurance policies
Annuities
Commodities
Shares in a credit union
Government bonds (including municipal bonds)
Retirement accounts invested in non-reportable interests
(e.g., insurance policies, diversifi ed mutual funds, or
government bonds) (See Reference Pamphlet, page 15.)
● Government defi ned-benefi t pension plans (such as
CalPERS and CalSTRS plans)
Interests held in a blind trust (See Reference Pamphlet,
page 16.)
Use Schedule A-1 to report ownership of less than 10%
(e.g., stock). Schedule C (Income) may also be required if
the investment is not a stock or corporate bond. See second
example below.
Use Schedule A-2 to report ownership of 10% or greater
(e.g., a sole proprietorship).
To Complete Schedule A-1:
Do not attach brokerage or fi nancial statements.
Disclose the name of the business entity.
Provide a general description of the business activity
of the entity (e.g., pharmaceuticals, computers,
automobile manufacturing, or communications).
Check the box indicating the highest fair market value
of your investment during the reporting period. If you
are fi ling a candidate or an assuming offi ce statement,
indicate the fair market value on the fi ling date or the
date you took offi ce, respectively.
Identify the nature of your investment (e.g., stocks,
warrants, options, or bonds).
An acquired or disposed of date is only required if you
initially acquired or entirely disposed of the investment
interest during the reporting period. The date of a stock
dividend reinvestment or partial disposal is not required.
Generally, these dates will not apply if you are fi ling a
candidate or an assuming offi ce statement.
Examples:
John Smith holds a state agency position. His confl ict-of-
interest code requires full disclosure of investments. John
must disclose his stock holdings of $2,000 or more in any
company that does business in California, as well as those
stocks held by his spouse or registered domestic partner
and dependent children.
Susan Jones is a city council member. She has a 4%
interest, worth $5,000, in a limited partnership located in
the city. Susan must disclose the partnership on Schedule
A-1 and income of $500 or more received from the
partnership on Schedule C.
Instructions – Schedules A-1 and A-2
Investments
Reminders
Do you know your agency’s jurisdiction?
Did you hold investments at any time during the period
covered by this statement?
Code fi lers – your disclosure categories may only
require disclosure of specifi c investments.
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
11 11 11 11
1111
111111
1111
Name
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Comments:
SCHEDULE A-1
Investments
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10%)
Do not attach brokerage or fi nancial statements.
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
FPPC Form 700 (2011/2012) Sch. A-1
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
11
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 9
Use Schedule A-2 to report investments in a business entity
or trust (including a living trust) in which you, your spouse
or registered domestic partner, and your dependent children
together had a 10% or greater interest, totaling $2,000 or
more, during the reporting period and which is located in,
doing business in, planning to do business in, or which has
done business during the previous two years in your agency’s
jurisdiction. See Reference Pamphlet, page 13. A trust located
outside your agency’s jurisdiction is reportable if it holds assets
that are located in or doing business in the jurisdiction. Do
not report a trust that contains non-reportable interests. For
example, a trust containing only your personal residence not
used in whole or in part as a business, your savings account,
and some municipal bonds, is not reportable.
Also report on Schedule A-2 investments and real property
held by that entity or trust if your pro rata share of the
investment or real property interest was $2,000 or more
during the reporting period.
To Complete Schedule A-2:
Part 1. Disclose the name and address of the business entity
or trust. If you are reporting an interest in a business entity,
check “Business Entity” and complete the box as follows:
Provide a general description of the business activity of the
entity.
Check the box indicating the highest fair market value of
your investment during the reporting period.
If you initially acquired or entirely disposed of this interest
during the reporting period, enter the date acquired or
disposed.
Identify the nature of your investment.
Disclose the job title or business position you held with the
entity, if any (i.e., if you were a director, offi cer, partner,
trustee, employee, or held any position of management).
A business position held by your spouse is not reportable.
Part 2. Check the box indicating your pro rata share of the
gross income received by the business entity or trust. This
amount includes your pro rata share of the gross income from
the business entity or trust, as well as your community property
interest in your spouse’s or registered domestic partner’s share.
Gross income is the total amount of income before deducting
expenses, losses, or taxes.
Part 3. Disclose the name of each source of income that is
located in, doing business in, planning to do business in, or
that has done business during the previous two years in your
agency’s jurisdiction, as follows:
Disclose each source of income and outstanding loan
to the business entity or trust identifi ed in Part 1 if
your pro rata share of the gross income (including your
community property interest in your spouse’s or registered
domestic partner’s share) to the business entity or trust
from that source was $10,000 or more during the reporting
period. See Reference Pamphlet, page 11, for examples.
Income from governmental sources may be reportable
if not considered salary. See Regulation 18232. 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 offi cial status are not
reportable.
Disclose each individual or entity that was a source
of commission income of $10,000 or more during the
reporting period through the business entity identifi ed
in Part 1. See Reference Pamphlet, page 8, for an
explanation of commission income.
You may be required to disclose sources of income located
outside your jurisdiction. For example, you may have
a client who resides outside your jurisdiction who does
business on a regular basis with you. Such a client, if a
reportable source of $10,000 or more, must be disclosed.
Leave Part 3 blank if you do not have any reportable
$10,000 sources of income to disclose. Adding phrases
such as “various clients” or “not disclosing sources pursuant
to attorney-client privilege” may trigger a request for an
amendment to your statement. See Reference Pamphlet,
page 14, for details about requesting an exemption from
disclosing privileged information.
Part 4. Report any investments or interests in real property
held by the entity or trust identifi ed in Part 1 if your pro rata
share of the interest held was $2,000 or more during the
reporting period. Attach additional schedules or use FPPC’s
Form 700 Excel spreadsheet if needed.
Check the applicable box identifying the interest held as
real property or an investment.
If investment, provide the name and description of the
business entity.
If real property, report the precise location (e.g., an
assessor’s parcel number or address).
Check the box indicating the highest fair market value
of your interest in the real property or investment during
the reporting period. (Report the fair market value of the
portion of your residence claimed as a tax deduction if you
are utilizing your residence for business purposes.)
Identify the nature of your interest.
Enter the date acquired or disposed only if you initially
acquired or entirely disposed of your interest in the
property or investment during the reporting period.
Instructions – Schedule A-2
Investments, Income, and Assets of Business Entities/Trusts
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
11
11 11
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
11 11
SCHEDULE A-2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
Comments:
Name
Address (Business Address Acceptable)
Name
Address (Business Address Acceptable)
FAIR MARKET VALUE
$0 - $1,999
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
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
►4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST
Check one
Trust, go to 2 Business Entity, complete the box, then go to 2
Check one
Trust, go to 2 Business Entity, complete the box, then go to 2
►3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.)
►2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST)
Name
700
Check one box:
YOUR BUSINESS POSITION
FPPC Form 700 (2011/2012) Sch. A-2
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
$0 - $499
$500 - $1,000
$1,001 - $10,000
$10,001 - $100,000
OVER $100,000
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
►4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST
►3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.)
►2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST)
Check one box:
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
$0 - $499
$500 - $1,000
$1,001 - $10,000
$10,001 - $100,000
OVER $100,000
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
►1. BUSINESS ENTITY OR TRUST ►1. BUSINESS ENTITY OR TRUST
NATURE OF INVESTMENT
Sole Proprietorship Partnership
Other
NATURE OF INTEREST
Property Ownership/Deed of Trust Stock Partnership
Leasehold Other
Check box if additional schedules reporting investments or real property
are attached
Yrs. remaining
NATURE OF INTEREST
Property Ownership/Deed of Trust Stock Partnership
Leasehold Other
Check box if additional schedules reporting investments or real property
are attached
Yrs. remaining
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
1111
FAIR MARKET VALUE
$0 - $1,999
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
YOUR BUSINESS POSITION
NATURE OF INVESTMENT
Sole Proprietorship Partnership
Other
11
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 11
Report interests in real property located in your agency’s
jurisdiction in which you, your spouse or registered
domestic partner, or your dependent children had a direct,
indirect, or benefi cial interest totaling $2,000 or more any
time during the reporting period. See Reference Pamphlet,
page 13.
Interests in real property include:
An ownership interest (including a benefi cial ownership
interest)
A deed of trust, easement, or option to acquire property
A leasehold interest (See Reference Pamphlet, page 14.)
A mining lease
An interest in real property held in a retirement account
(See Reference Pamphlet, page 15.)
An interest in real property held by a business entity or
trust in which you, your spouse or registered domestic
partner, and your dependent children together had a
10% or greater ownership interest (Report on Schedule
A-2.)
Your spouse’s or registered domestic partner’s interests
in real property that are legally held separately by him or
her
You are not required to report:
A residence, such as a home or vacation cabin, used
exclusively as a personal residence (However, a
residence for which you claim a business deduction may
be reportable. If reportable, report the fair market value
of the portion claimed as a tax deduction.)
Please note: A non-reportable residence can still
be grounds for a confl ict of interest and may be
disqualifying.
Interests in real property held through a blind trust (See
Reference Pamphlet, page 16, for exceptions.)
To Complete Schedule B:
Report the precise location (e.g., an assessor’s parcel
number or address) of the real property.
Check the box indicating the fair market value of your
interest in the property (regardless of what you owe on
the property).
Enter the date acquired or disposed only if you initially
acquired or entirely disposed of your interest in the
property during the reporting period.
Identify the nature of your interest. If it is a leasehold,
disclose the number of years remaining on the lease.
If you received rental income, check the box indicating
the gross amount you received.
If you had a 10% or greater interest in real property and
received rental income, list the name of the source(s) if
your pro rata share of the gross income from any single
tenant was $10,000 or more during the reporting period.
If you received a total of $10,000 or more from two or more
tenants acting in concert (in most cases, this will apply
to married couples), disclose the name of each tenant.
Otherwise, leave this section blank.
Loans from a private lender that total $500 or more
and are secured by real property may be reportable.
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 offi cial status are not reportable.
When reporting a loan:
-- Provide the name and address of the lender.
-- Describe the lender’s business activity.
-- Disclose the interest rate and term of the loan. For
variable interest rate loans, disclose the conditions
of the loan (e.g., Prime + 2) or the average interest
rate paid during the reporting period. The term of
a loan is the total number of months or years given
for repayment of the loan at the time the loan was
established.
-- Check the box indicating the highest balance of the
loan during the reporting period.
-- Identify a guarantor, if applicable.
If you have more than one reportable loan on a single
piece of real property, report the additional loan(s) on
Schedule C.
Example:
Joe Nelson is a city planning
commissioner. Joe received
rental income of $12,000
during the reporting period
from a single tenant who
rented property Joe owned
in the city’s jurisdiction. If Joe
had received the $12,000
from two or more tenants, the
tenants’ names would not be
required as long as no single
tenant paid $10,000 or more.
A married couple would be
considered a single tenant.
Instructions – Schedule B
Interests in Real Property
Reminders
Income and loans already reported on Schedule B are
not also required to be reported on Schedule C.
Code fi lers – do your disclosure categories require
disclosure of real property?
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
11 11
► ASSESSOR’S PARCEL NUMBER OR STREET ADDRESS
CITY
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.
NATURE OF INTEREST
Ownership/Deed of Trust Easement
Leasehold
Yrs. remaining Other
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $0 - $499 $1,001 - $10,000
$10,001 - $100,000
INTEREST RATE TERM (Months/Years)
% None
HIGHEST BALANCE DURING REPORTING PERIOD
Guarantor, if applicable
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
4600 24th Street
Sacramento, CA 95814
X
X
X
Henry Wells
Sophia Petroillo
2121 Blue Sky Parkway, Sacramento
Restaurant Owner
8 15 Years
X
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
IF APPLICABLE, LIST DATE:
// //
ACQUIRED DISPOSED
11 111111
SCHEDULE B
Interests in Real Property
(Including Rental Income)
Name
► ASSESSOR’S PARCEL NUMBER OR STREET ADDRESS
CITY
INTEREST RATE TERM (Months/Years)
% None
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.
NATURE OF INTEREST
Ownership/Deed of Trust Easement
Leasehold
Yrs. remaining Other
Comments:
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $0 - $499 $1,001 - $10,000
$10,001 - $100,000
HIGHEST BALANCE DURING REPORTING PERIOD
Guarantor, if applicable
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
FPPC Form 700 (2011/2012) Sch. B
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
► ASSESSOR’S PARCEL NUMBER OR STREET ADDRESS
CITY
INTEREST RATE TERM (Months/Years)
% None
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.
NATURE OF INTEREST
Ownership/Deed of Trust Easement
Leasehold
Yrs. remaining Other
Guarantor, if applicable
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $0 - $499 $1,001 - $10,000
$10,001 - $100,000
HIGHEST BALANCE DURING REPORTING PERIOD
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
* 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 offi cial status. Personal loans and
loans received not in a lender’s regular course of business must be disclosed as follows:
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 13
Report the source and amount of gross income of $500 or
more you received during the reporting period. Gross income
is the total amount of income before deducting expenses,
losses, or taxes and includes loans other than loans from a
commercial lending institution. See Reference Pamphlet,
page 11. Also report your job title with each reportable
business entity, even if you received no income during the
reporting period. You must also report the source of income to
your spouse or registered domestic partner if your community
property share was $500 or more during the reporting period.
A source of income must be reported only if the source is
located in, doing business in, planning to do business in,
or has done business during the previous two years in your
agency’s jurisdiction. See Reference Pamphlet, page 13, for
more information about doing business in the jurisdiction.
Reportable sources of income may be further limited by
your disclosure category located in your agency’s confl ict-of-
interest code.
Commonly reportable income and loans include:
Salary/wages, per diem, and reimbursement for expenses
including travel payments provided by your employer
Community property interest (50%) in your spouse’s
or registered domestic partner’s income - report the
employer’s name and all other required information
Income from investment interests, such as partnerships,
reported on Schedule A-1
Commission income not required to be reported on
Schedule A-2 (See Reference Pamphlet, page 8.)
Gross income from any sale, including the sale of a house
or car (Report your pro rata share of the total sale price.)
Rental income not required to be reported on Schedule B
Prizes or awards not disclosed as gifts
Payments received on loans you made to others, including
loan repayments from a campaign committee (including a
candidate’s own campaign committee)
An honorarium received prior to becoming a public offi cial
(See Reference Pamphlet, page 10, concerning your ability
to receive future honoraria.)
Incentive compensation (See Reference Pamphlet, page 12.)
You are not required to report:
Salary, reimbursement for expenses or per diem, or social
security, disability, or other similar benefi t payments
received by you or your spouse or registered domestic
partner from a federal, state, or local government agency.
See Reference Pamphlet, page 11, for more exceptions to
income reporting.
To Complete Schedule C:
Part 1. Income Received/Business Position Disclosure
Disclose the name and address of each source of income
or each business entity with which you held a business
position.
Provide a general description of the business activity if the
source is a business entity.
Check the box indicating the amount of gross income
received.
Identify the consideration for which the income was
received.
For income from commission sales, check the box
indicating the gross income received and list the name of
each source of commission income of $10,000 or more.
See Reference Pamphlet, page 8. Note: If you receive
commission income on a regular basis or have an
ownership interest of 10% or more, you must disclose
the business entity and the income on Schedule A-2.
For income from rental property that is not required to be
listed on Schedule B, enter “Rental Income” under “Name
of Source,” check the box indicating the gross income
received, and, if you had a 10% or greater interest in the
rental property, list the name of each tenant if your pro rata
share of the gross income from that tenant was $10,000 or
more during the reporting period.
Disclose the job title or business position, if any, that you
held with the business entity, even if you did not receive
income during the reporting period.
Part 2. Loans Received or Outstanding During the
Reporting Period
Provide the name and address of the lender.
Provide a general description of the business activity if the
lender is a business entity.
Check the box indicating the highest balance of the loan
during the reporting period.
Disclose the interest rate and the term of the loan.
-- For variable interest rate loans, disclose the conditions of
the loan (e.g., Prime + 2) or the average interest rate paid
during the reporting period.
-- The term of the loan is the total number of months or
years given for repayment of the loan at the time the
loan was entered into.
Identify the security, if any, for the loan.
Instructions – Schedule C
Income, Loans, & Business Positions
(Income Other Than Gifts and Travel Payments)
Reminders
Code fi lers – your disclosure categories may not
require disclosure of all sources of income.
If you or your spouse or registered domestic partner
are self-employed, report the business entity on
Schedule A-2.
Do not disclose on Schedule C income, loans, or
business positions already reported on Schedules A-2
or B.
(Real property, car, boat, etc.)
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
GROSS INCOME RECEIVED
Name
FPPC Form 700 (2011/2012) Sch. C
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
►1. INCOME RECEIVED
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
►1. INCOME RECEIVED
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
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
GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
Comments:
►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 offi cial status. Personal loans and loans received not in a lender’s
regular course of business must be disclosed as follows:
SECURITY FOR LOAN
None Personal residence
Real Property
Guarantor
Other
Street address
City
(Describe)
(Real property, car, boat, etc.)
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse’s or registered domestic partner’s income
Loan repayment Partnership
Sale of
Commission or Rental Income, list each source of $10,000 or more
Other (Describe)
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse’s or registered domestic partner’s income
Loan repayment Partnership
Sale of
Commission or Rental Income, list each source of $10,000 or more
Other (Describe)
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 15
Beginning January 1, 2012, certain gifts you receive
may not be reportable. In other cases, gift rules
changed and are stricter. See the FPPC Gift Fact
Sheets for more information.
A gift is anything of value for which you have not provided
equal or greater consideration to the donor. A gift is
reportable if its fair market value is $50 or more. In
addition, multiple gifts totaling $50 or more received
during the reporting period from a single source must be
reported. Gifts are reportable regardless of where the
donor is located. Additional restrictions may apply to
lobbyists.
It is the acceptance of a gift, not the ultimate use to which
it is put, that imposes your reporting obligation. Except as
noted below, you must report a gift even if you never used
it or if you gave it away to another person.
If the exact amount of a gift is unknown, you must make a
good faith estimate of the item’s fair market value. Listing
the value of a gift as “over $50” or “value unknown” is not
adequate disclosure. In addition, if you received a gift
through an intermediary, you must disclose the name,
address, and business activity of both the donor and the
intermediary.
Commonly reportable gifts include:
Tickets/passes to sporting or entertainment events
Tickets/passes to amusement parks
Parking passes
Food, beverages, and accommodations, including those
provided in direct connection with your attendance at a
convention, conference, meeting, social event, meal, or
like gathering
Rebates/discounts not made in the regular course of
business to members of the public without regard to
offi cial status
Wedding gifts (See Reference Pamphlet, page 16)
An honorarium received prior to assuming offi ce (You
may report an honorarium as income on Schedule C,
rather than as a gift on Schedule D, if you provided
services of equal or greater value than the payment
received. See Reference Pamphlet, page 10, regarding
your ability to receive future honoraria.)
Transportation and lodging (See Schedule E.)
Forgiveness of a loan received by you
You are not required to disclose:
Gifts that were not used and that, within 30 days after
receipt, were returned to the donor or delivered to a
charitable organization without being claimed by you as
a charitable contribution for tax purposes
Gifts from your spouse or registered domestic partner,
child, parent, grandparent, grandchild, brother, sister,
aunt, uncle, niece, nephew, or fi rst cousin (Included in
this exception are gifts from your spouse’s or domestic
partner’s children, parents, brothers, sisters, and the
spouse or registered domestic partner of the individuals
listed above. The exception does not apply if the donor
was acting as an agent or intermediary for a reportable
source who was the true donor.)
Gifts of similar value exchanged between you and an
individual, other than a lobbyist, on holidays, birthdays,
or similar occasions
Gifts of informational material provided to assist
you in the performance of your offi cial duties (e.g.,
books, pamphlets, reports, calendars, periodicals, or
educational seminars)
A monetary bequest or inheritance (However, inherited
investments or real property may be reportable on other
schedules.)
Personalized plaques or trophies with an individual value
of less than $250
Campaign contributions
Gifts given to members of your immediate family unless
you enjoy direct benefi t of the gift, use the gift, or
exercise discretion or control over the use or disposition
of the gift (See Commission Regulation 18943.)
The cost of food, beverages, and necessary
accommodations provided directly in connection with
an event at which you gave a speech, participated in
a panel or seminar, or provided a similar service but
only if the cost is paid for by a federal, state, or local
government agency. This exception does not apply to
a state or local elected offi cer, as defi ned in Section
82020, or an offi cial specifi ed in Section 87200.
To Complete Schedule D:
Disclose the full name (not an acronym), address, and, if
a business entity, the business activity of the source.
Provide the date (month, day, and year) of receipt, and
disclose the fair market value and description of the gift.
Instructions – Schedule D
Income – Gifts
Reminders
Gifts from a single source are subject to a $420 limit.
See Reference Pamphlet, page 10.
Code fi lers – you only need to report gifts from
reportable sources.
SCHEDULE D
Income – Gifts
Comments:
Name
FPPC Form 700 (2011/2012) Sch. D
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
// $
// $
// $
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
// $
// $
// $
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
// $
// $
// $
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
// $
// $
// $
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
// $
// $
// $
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
// $
// $
// $
FPPC Form 700 (2011/2012)
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Instructions - 17
Travel payments reportable on Schedule E include
advances and reimbursements for travel and related
expenses, including lodging and meals.
Gifts of travel may be subject to the gift limit. In addition,
certain travel payments are reportable gifts, but are not
subject to the gift limit. To avoid possible misinterpretation
or the perception that you have received a gift in excess of
the gift limit, you may wish to provide a specifi c description
of the purpose of your travel. See the FPPC fact sheet
entitled “Limitations and Restrictions on Gifts, Honoraria,
Travel, and Loans” at www.fppc.ca.gov.
You are not required to disclose:
Travel payments received from any state, local, or
federal government agency for which you provided
services equal or greater in value than the payments
received
Travel payments received from your employer in the
normal course of your employment that are included in
the income reported on Schedule C
Payments for admission to an event at which you make
a speech, participate on a panel, or make a substantive
formal presentation, transportation, and necessary
lodging, food, or beverages, and nominal non-cash
benefi ts provided to you in connection with the event so
long as both the following apply:
--The speech is for offi cial agency business and you
are representing your government agency in the
course and scope of your offi cial duties.
--The payment is a lawful expenditure made only by
a federal, state, or local government agency for
purposes related to conducting that agency’s offi cial
business.
Note: This exception does not apply to a state or
local elected offi cer, as defi ned in Section 82020, or an
offi cial specifi ed in Section 87200.
A travel payment that was received from a non-profi t
entity exempt from taxation under Internal Revenue
Code Section 501(c)(3) for which you provided equal or
greater consideration
To Complete Schedule E:
Disclose the full name (not an acronym) and address of
the source of the travel payment.
Identify the business activity if the source is a business
entity.
Check the box to identify the payment as a gift or
income, report the amount, and disclose the date(s).
-- Travel payments are gifts if you did not provide
services that were equal to or greater in value than
the payments received. You must disclose gifts
totaling $50 or more from a single source during
the period covered by the statement. Gifts of travel
are reportable without regard to where the donor is
located.
When reporting travel payments that are gifts, you
must provide a description of the gift and the date(s)
received.
-- Travel payments are income if you provided
services that were equal to or greater in value than
the payments received. You must disclose income
totaling $500 or more from a single source during
the period covered by the statement. You have the
burden of proving the payments are income rather
than gifts.
When reporting travel payments as income, you
must describe the services you provided in exchange
for the payment. You are not required to disclose the
date(s) for travel payments that are income.
Example:
City council member Rick Chandler is the chairman of
a trade association and the association pays for Rick’s
travel to attend its meetings. Because Rick is deemed to
be providing equal or
greater consideration
for the travel payment
by virtue of serving
on the board, this
payment may be
reported as income.
Payments for Rick to
attend other events
for which Rick is not
providing services are
likely considered gifts.
Instructions – Schedule E
Travel Payments, Advances,
and Reimbursements
TYPE OF PAYMENT: (must check one) Gift Income
SCHEDULE E
Income – Gifts
Travel Payments, Advances,
and Reimbursements
Name
Comments:
FPPC Form 700 (2011/2012) Sch. E
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
TYPE OF PAYMENT: (must check one) Gift Income
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
You must mark either the gift or income box.
Mark the 501(c)(3) box for a travel payment received from a nonprofi t 501(c)(3)
organization. These payments are not subject to the $420 gift limit, but may result
in a disqualifying confl ict of interest.
DATE(S): // - // AMT: $
(If gift)
DATE(S): // - // AMT: $
(If gift)
TYPE OF PAYMENT: (must check one) Gift Income TYPE OF PAYMENT: (must check one) Gift Income
DATE(S): // - // AMT: $
(If gift)
DATE(S): // - // AMT: $
(If gift)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
CITY AND STATE
BUSINESS ACTIVITY, IF ANY, OF SOURCE
501 (c)(3)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
CITY AND STATE
BUSINESS ACTIVITY, IF ANY, OF SOURCE
501 (c)(3)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
CITY AND STATE
BUSINESS ACTIVITY, IF ANY, OF SOURCE
501 (c)(3)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
CITY AND STATE
BUSINESS ACTIVITY, IF ANY, OF SOURCE
501 (c)(3)
Made a Speech/Participated in a Panel
Other - Provide Description
Made a Speech/Participated in a Panel
Other - Provide Description
Made a Speech/Participated in a Panel
Other - Provide Description
Made a Speech/Participated in a Panel
Other - Provide Description
Library Commissioners Report
Melinda Cervantes, County Librarian
Santa Clara County Library
February 2012
Silicon Valley Reads events continue through April. See the Silicon Valley Reads
2012 booklet or www.siliconvalleyreads.org for information on over 100 programs
to be offered this year.
Through December 31, 4,298 non-resident library cards have been sold, and
6,087 free student limited cards have been issued.
New services, collections, and policies include:
o AWE Early Literacy Stations have been purchased for every library
o Playaway Views have been added to children’s collections
o The new Smart Investing @ the Library portal has been launched on the
Library website at http://www.sccl.org/investing/
o OneClickDigital, a new e-audiobook service, is now available on the
library’s website
o Beginning February 1, library patrons may place holds on all feature film
DVDs
At the JPA Board meeting on January 26, the Board approved the following
actions:
o Requesting the Santa Clara County/Cities Managers’ Association to
review the JPA Funding Formula
o Creating free wireless access in all libraries that does not require
authentication with a library card (anticipated to go live in March)
o Establishing a $4 fee for non-cardholders to use the Library’s networked
computers for a two hour session (anticipated to go live in March)
o Annually issuing free library cards to library volunteers who do not live in
the library district and who have contributed 60 or more hours of volunteer
service in the prior fiscal year
The next meeting of the Santa Clara County Library Joint Powers Authority
Board on February 23, 2012 at 1:30pm at the Library Administration Offices,
14600 Winchester Blvd., Los Gatos. JPA agendas and minutes will be posted on
the Library website the Friday before each meeting: www.sccl.org.