HomeMy WebLinkAbout2016.08.12_Winholtz_Betty_Form 700STATEMENT OF ECONOMIC INTERESTS °� �t kil a, ay
Cityam�ri�a�ra, ay
Please type or print in ink.
NAME OF FILER (LAST) (FIRST)
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
hy a� Morro k;,
Division, Board, 11epartment, District, if applicable
COVER PAGE
Your Position
/2-to vor
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi- County
,City of O/Yo 4S�6�
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2015, through
December 31, 2015.
-or-
The period covered is — I through
December 31, 2015.
❑ Assuming Office: Date assumed
Position:
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left — I
(Check one)
O The period covered is January 1, 2015, through the date of
-or-
leaving office.
O The period covered is I through
the date of leaving office.
jX Candidate: Election year –2-01(o and office sought, if different than Part 1: 1216Kar
4. Schedule Summary (must complete) PP. Total number of pages including this cover page:
Schedules attached
❑ Schedule A -1 - Investments – schedule attached X Schedule C - Income, Loans, & Business Positions– schedule attached
Schedule A -2 - Investments – schedule attached ❑ Schedule D - Income – Gifts – schedule attached
Schedule B - Real Property – schedule attached ❑ Schedule E - Income – Gifts – Travel Payments – schedule attached
.or-
0 None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
Morl-u
DAYTIME TELEPHONE NUMBER I E -MAIL ADDRESS
( -
have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my kno dge 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 Signature ��f l4 U l 7 2_0 //o
(F96he originally signed statement with yourfiling offlciaL)
FPPC Form 700 (2015/2016)
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov
SCHEDULE A -2 CALIFORNIA FORm 700
Investments, Income, and Assets FAIR POLITICAL PRACTICES COMMISSION
Name
of Business Entities/Trusts
��.\ n
(Ownership Interest is 10% or Greater)
0- 1. BUSINESS ENTITY .-
I
Name
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 :kt Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000
0 $1 o,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship ❑
Other
YOUR BUSINESS POSITION
❑ $0 - $499 9 $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
Do- 3. LIST THE NAME OF •• • •
INCOME OF iii OR •
21 None or ❑ Names listed below
lo- 4. INVESTMENTS ■ INTERESTS IN REAL PROPERTY ■ OR
LEASED : OR
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:'
❑ $2,000 - $10,000
❑ $10,001 - $100,000 /15 /15
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
Comments:
lio- 1. BUSINESS ENTITY OR TRUST
Name
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000 --j--j-L5- /,15
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
r Partnership ❑ Sole Proprietorship ❑
Other
UR BUSINESS POSITION
0$0-$499 L1 $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
• • i iii •- •-
❑ None or ❑ Names listed below
lo. 4. INVESTMENTS ■ INTERESTS IN REAL PROPERTY ■ OR
LEASED BY OR
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $1o,001 - $100,000 _ /_/ 15 /15
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
FPPC Form 700 (2015/2016) Sch. A -2
FPPC Advice Email: advice @fppc.ca.gov
FPPCToll- FreeHelpline:866 /275 -3772 www.fppc.ca.gov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOMEII
� \r
(A) in
ADDRESS (Busin s— Address Acceptable)
`- / (
BUSINESS ACTIIVITY, IF ANY, OF SOURCE
- � _Lxbo
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑ $1,001 - $10,000
® $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
[� Salary ❑ Spouse's or registered domestic partner's income
(For self - employed use Schedule A -2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A -2.)
❑ Sale of
(Real properly, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑ Salary ❑ Spouse's or registered domestic partner's income
(For self - employed use Schedule A -2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A -2.)
❑ Sale of
❑ Loan repayment
(Real property, car, boat, etc.)
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
(Describe) (Describe)
❑ Other ❑ Other
(Describe) (Describe)
LOANS •D
* You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a
retail installment or credit card transaction, made in the lender's regular course of business on terms available to
members of the public without regard to your official status. Personal loans and loans received not in a lender's
regular course of business must be disclosed as follows:
NAME OF LENDER* INTEREST RATE TERM (MonthsiYears)
% ❑ None
ADDRESS (Business Address Acceptable)
SECURITY FOR LOAN
BUSINESS ACTIVITY, IF ANY, OF LENDER ❑ None ❑ Personal residence
❑ Real Property
Street address
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
❑. Guarantor
❑ Other
city
(Describe)
FPPC Form 700 (2015/2016) Sch. C
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov