Statement of Economic Interests Cover Page A Public Document

Transcription

1 Please type or print in ink. Agency (Do not use acronyms) City of San Mateo Division, board, Department, District, if applicable Statement of Economic Interests Cover Page A Public Document of FileR (Last) (First) (Middle) Rodriguez Eric T 1. Office, Agency, or Court City Council If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Your Position City Council Member Date Initial Filing Received Official Use Only Filed Date: 03/31/ :17 PM SAN: STH-0123 Agency: SEE ATTACHED LIST Position: 2. Jurisdiction of Office (Check at least one box) State Multi-County City of San Mateo Judge or Court Commissioner (Statewide Jurisdiction) County of 3. Type of Statement (Check at least one box) Candidate: Date of Election and office sought, if different than Part 1: Leaving Office: Date Left / / (Check one circle.) The period covered is / /, through the date of leaving office. 4. Schedule Summary (must complete) Schedules attached Total number of pages including this cover page: 6 Schedule A-1 - Investments schedule attached Schedule A-2 - Investments schedule attached Schedule B - Real Property schedule attached Schedule C - Income, Loans, & Business Positions schedule attached Schedule D - Income Gifts schedule attached Schedule E - Income Gifts Travel Payments schedule attached Annual: The period covered is January 1, 20, through -or- December 31, 20. The period covered is / /, through December 31, 20. Assuming Office: Date assumed / / The period covered is January 1, 20, through the date of leaving office. -or- -or- None - No reportable interests on any schedule 5. Verification Mailing AddreSS Street CIty State Zip Code (Business or Agency Address Recommended - Public Document) 330 W. 20th Avenue San Mateo CA Daytime telephone number address ( ) erodriguez@cityofsanmateo.org 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 03/31/ :17 PM Signature Electronic Submission (month, day, year) (File the originally signed paper statement with your filing official.) Page - 5

2 STATEMENT OF ECONOMIC INTERESTS COVER PAGE ATTACHMENT FAIR POLITICAL PRACTICES COMMISSION EXPANDED STATEMENT LIST Agency Division, Board, Department, District Position or Title Jurisdiction Type of Statement Period Covered Courtesy Filers Peninsula Clean Energy Authority Alternate County of San Mateo Annual / Leaving 01/17/ - 01/22/19 Courtesy Filers Peninsula Traffic Congestion Relief Alliance Liaison County of San Mateo Annual 01/17/ - 12/31/ Courtesy Filers Emergency Services Council Liaison County of San Mateo Annual / Leaving 01/17/ - 01/22/19

3 of business entity Oracle Corporation Enterprise Software Schedule A-1 Investments s, Bonds, and Interests (Ownership Interest is Less Than 10%) Investments must be itemized. Do not attach brokerage or financial statements. of business entity Restricted Units of business entity of business entity of business entity of business entity Comments: Page - 7

4 Schedule A-2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) CALIFORNIA FORM business entity or trust HowToMedia Inc. 415 Sonora Dr., San Mateo, CA Address (Business Address Acceptable) Check one Trust, go to 2 Business Entity, complete the box, then go to 2 Educational Online Media 1. business entity or trust Address (Business Address Acceptable) Check one Trust, go to 2 Business Entity, complete the box, then go to 2 $0 - $1,999 $2,000 - $10,000 $100,001 - $1,000,000 / $0 - $1,999 / / / $2,000 - $10,000 $100,001 - $1,000,000 Partnership Sole Proprietorship S-Corporation CEO & Co-Founder Partnership Sole Proprietorship 2. identify the gross income received (include your pro rata share of the gross income to the entity/trust) 2. identify the gross income received (include your pro rata share of the gross income to the entity/trust) $0 - $499 $500 - $1, List the name of each reportable single source of income of $10,000 or more (Attach a separate sheet if necessary.) $0 - $499 $500 - $1,000 None or s listed below None or s listed below SEE ATTACHED 3. List the name of each reportable single source of income of $10,000 or more (Attach a separate sheet if necessary.) 4. investments and interests in real property held or leased by the business entity or trust Check one box: Investment Real Property 4. investments and interests in real property held or leased by the business entity or trust Check one box: Investment Real Property of Business Entity, if Investment, or Assessor s Parcel Number or Street Address of Real Property of Business Entity, if Investment, or Assessor s Parcel Number or Street Address of Real Property Description of Business Activity or City or Precise Location of Real Property Description of Business Activity or City or Precise Location of Real Property $2,000 - $10,000 $100,001 - $1,000,000 Nature of interest Property Ownership/Deed of Trust Partnership / $2,000 - $10,000 / / / $100,001 - $1,000,000 Nature of interest Property Ownership/Deed of Trust Partnership Leasehold Yrs. remaining Check box if additional schedules reporting investments or real property are attached Leasehold Yrs. remaining Check box if additional schedules reporting investments or real property are attached Comments: Page - 9

5 SCHEDULE A-2 Attachment FAIR POLITICAL PRACTICES COMMISSION BUSINESS ENTITY OR TRUST : HowToMedia Inc. LIST OF REPORTABLE SINGLE SOURCES OF INCOME OF $10,000 OR MORE Google Inc. [Mountain View, CA] Campus Explorer [Santa Monica, CA] QuinStreet [Foster City, CA] content.ad [Irvine, CA] Esyoh LLC [San Diego, CA]

6 Schedule C Income, Loans, & Business Positions ( than Gifts and Travel Payments) 1. Income Received of source of income HowToMedia Inc. address (Business Address Acceptable) 415 Sonora Dr., San Mateo CA business activity, if any, of source Educational Online Media CEO & Co-Founder 1. Income Received of source of income Oracle Corporation address (Business Address Acceptable) 100 Oracle Pkwy, Redwood City, CA business activity, if any, of source Enterprise Software (Spouse) Attorney gross income received No income - Business position only gross income received No income - Business position only $500 - $1,000 $500 - $1,000 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.) 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 property, car, boat, etc.) Sale of (Real property, car, boat, etc.) Loan repayment Loan repayment Commission or Rental Income, list each source of $10,000 or more Commission or Rental Income, list each source of $10,000 or more 2. loans Received or outstanding during the reporting period * You are not required to report loans from a commercial lending institution, 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: of Lender* interest rate Term (Months/Years) address (Business Address Acceptable) % None Security for Loan business activity, if any, of Lender None Personal residence Highest Balance During Reporting Period $500 - $1,000 Real Property Guarantor Street address City Comments: Page - 13