Statement of Economic Interests Cover Page A Public Document

Similar documents
STATEMENT OF ECONOMIC INTERESTS COVER PAGE

Statement of Economic Interests Cover Page A Public Document

Council File Number Reappointment of Evangelos Ambatielos to the Board of Building and Safety Commissioners

' ; XiJ i ra? Los Angeles City Ethics Commission. May 24, 2017

Maureen. Position: -or-

: V/ *r;4. f i. Los Angeles City Ethics Commission. June 26, Debra Debbie Wehbe was reappointed by the Mayor to the Board of Neighborhood

Council File Number Reappointment of Jaime L. Lee to the Los Angeles City Employees Retirement System Board

STATEMENT OF ECONOMIC INTERESTS COVER PAGE

Member. County of. Other. or-

Los Angeles City Ethics Commission. May 26, 2015

20II;F~,~c;L};(j~~C~:~~

County of Santa Clara Form 700 Filer Reference

Application Instructions Owner-Occupancy Exemption

The information furnished in and with this Questionnaire is true, complete, and correct to the best of my knowledge.

Notification of Intent to Market form: One form must be completed for each project you are requesting VAMA letters for.

How to Petition for a Review of Your Property Taxes: County Board of Equalization

To update your status as a signatory to the new VAMA program, please sign the enclosed Signatory Card and return it to us at:

PACE Program Comparative Matrix

GOLDEN EAGLE CHARTER SCHOOL

SPECIAL POWER OF ATTORNEY

Transfer and Assignment of Shares

APPLICATION FOR EXEMPTION FROM PROPERTY TAXATION

DISPOSITION OF PERSONAL PROPERTY WITHOUT ADMINISTRATION

IDX Paperwork Cover Sheet

-- OFFICIAL NOTICE -- City of Beverly Hills Rent Registration Notice. Rental Property. Property Owner name Property Owner C/O Address City, State, Zip

VIRGINIA ASSOCIATION OF REALTORS APPLICATION FOR LEASE (This is a legally binding contract. If not understood, seek competent advice before signing.

RELOCATION FOR OWNER/RELATIVE OCCUPANCY (INSTRUCTIONS)

APPRAISAL MANAGEMENT COMPANY CERTIFICATE OF REGISTRATION APPLICATION

t 3. PROPERTY IDENTIFICATION INFORMATION

Please allow a minimum of two business days for processing, provided the application is complete and payment received.

NO PETS/ANIMALS ALLOWED FOR RENTALS

Notice of Completion for Windsor Estates City of Encinitas Tentative Map No Public Water Improvements

Checklist for Filing Operating and Maintenance Expense Petitions ONLY

Fees. Type of Application. Type of License. Business Information

COOK COUNTY ASSESSOR S OFFICE 2015 CLASS 9 AFFIDAVIT. Control Number: Application Address:

APPLICATION FOR EXEMPTION OF PROPERTY OWNED AND USED FOR STRICTLY CHARITABLE OR SCHOOL PURPOSES

NEVADA COUNTY COMMUNITY DEVELOPMENT AGENCY

MetroList Services, Inc. Clerical User Registration Form Application Sacramento Administrative Center

REPORT. Action to Amend Appendix A of San Diego Housing Commission Conflict of Interest Code and Related Provisions

A. Applicants must be at least eighteen (18) years of age or older and must allow a photo-copy of driver's

APPLICATION FOR INDIAN PREFERENCE CERTIFICATION. Firm Name (Exactly as you want it to appear on UTERO documents): Address: City: State: ZIP Phone:

Credit Card Authorization Form

GEORGIA CODE Copyright 2008 by The State of Georgia All rights reserved.

OFFICE OF THE ASSESSOR COUNTY OF LOS ANGELES JEFFREY PRANG ASSESSOR

Please allow a minimum of two business days for processing, provided the application is complete and payment received.

Fax #: (707)

Pittsfield Charter Township

Transfer and Assignment of Shares

California 30% DISCOUNT FIRST-TIMEUSERSONLY FREESHIPPING ATSHOW ONLY. Tax

INSTRUCTIONS FOR TRANSFERRING ASSETS TO TRUST

EXECUTIVE SUMMARY HOUSING COMMISSION EXECUTIVE SUMMARY SHEET. DATE: January 12, 2018 HCR18-002

COMMONWEALTH OF KENTUCKY TRANSPORTATION CABINET DIVISION OF RIGHT OF WAY AND UTILITIES INVITATION FOR PROPOSAL/BID

TRANSACTION CHECKLIST - IMPORTANT - Submit all items on the checklist below with your form to ensure faster processing.

A. LARRY BERREN, ESQUIRE THE BERREN LAW FIRM 197 TAUNTON AVENUE, SUITE 202 EAST PROVIDENCE, RI 02914

PARCEL MAP WAIVER APPLICATION SUBMITTAL INSTRUCTIONS

BUILDING PERMIT APPLICATION

Short Sale Contingent Approval

INSTRUCTION SHEET ACCOMPANYING PETITION FOR RENT INCREASE FORM

NEW HOME BUILDER REGISTRATION APPLICATION - RENEWAL APPLICATION. Instructions

Doug Swanson BRE

Please contact this office at the numbers listed above should you have any questions about the program, its requirements, or procedures.

Fresno Local Agency Formation Commission Change of Organization/Reorganization Application

RESOLUTION NO

New Home Tax Disclosure Report

SDCERS Special Durable Power of Attorney

Rhonda R. Novak, CIAO/I Office: (815) Chief County Assessment Officer Fax: (815) M E M O R A N D U M

Heritage Green Apartments Rental Policies 56 S. SHADDLE AVE. MUNDELEIN, IL or Cell # SAVE THIS SHEET FOR YOURSELF

APPLICATION FOR CERTIFICATE OF PARCEL MERGER

REQUEST FOR EVALUATION FOR POTENTIAL HISTORIC SIGNIFICANCE

GROUND LEASE (PHASE II) by and between the COUNTY OF ORANGE. and the CAPITAL FACILITIES DEVELOPMENT CORPORATION. Dated as of [DATED DATE]

Conflict of Interest Code EXHIBIT A (Final Draft)

SAN FRANCISCO MUNICIPAL TRANSPORTATION AGENCY BOARD OF DIRECTORS. RESOLUTION No

COUNT+ OF SAN MATE0 Inter-Departmental Correspondence

Business Property Assessment Return (907)

Fresno Local Agency Formation Commission Change of Organization/Reorganization Application

ABOUT YOUR APPLICATION 2014

SHORT TERM VACATION RENTAL APPLICATION AND INFORMATION OUTLINE

SUPERIOR COURT OF CALIFORNIA COUNTY OF LOS ANGELES. In the matter of: Case No. BP PC 9611

Assessor-County Clerk-Recorder and Elections (ACRE)

HIGHPOINT-ON-HUDSON. Highpoint On Hudson Owners Inc. SALE REQUIREMENTS FOR BOARD APPROVAL

Application for Boundary Line Adjustment (12/2010)

HERO Financing Program Application. P: 855-HERO-411 A: W. Bernardo Drive, San Diego, CA, E:

Bois Forte Reservation Bois Forte Reservation

DECLARATION OF INTENT TO EVICT FOR LANDLORD OCCUPANCY

ADDENDUM NO. 1 TO BID PACKAGE MAY 27, 2011

Licensing of Rental Property Application Checklist

KRS 324A A.150 Definitions for KRS 324A.150 to 324A.164. Effective: June 25, 2013

TAFFREPORT. Steven A. Preston, FAICP, City Manager. Jennifer Davis, Community Development Director W trm-?f>

CANNABIS TESTING LABORATORY PERMIT APPLICATION

J.R. OLSEN BONDS & INSURANCE BROKERS, INC. Broker/Agent Lic. # LOST NOTE/ RECONVEYANCE/ BENEFICIARY BONDS

Desired Date of Occupancy: Apt. Size Apt. # RENTAL APPLICATION

Kahiku at Mehana Affordable Unit Lottery Registration Form

DEPARTMENT OF CITY PLANNING APPLICATION

APPLICATION COVER LETTER

THE CITY OF ROCKDALE AND THE COUNTY OF MILAM JOINT APPLICATION FOR TAX ABATEMENT ASSISTANCE

APPLICATION FOR MEMBERSHIP

2015 NJ REALTORS CIRCLE EXCELLENCE SALES AWARD APPLICATION

Recording Requested by and When Recorded Return to: City of Pacifica Attn: Cecilia Quick City Hall 170 Santa Maria Avenue Pacifica, CA 94044

LIST OF DOCUMENTS AND REQUIREMENTS FOR WATER SERVICE CONNECTION TRANSFERS

Real Estate Council of Ontario

Transcription:

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: 03/31/2019 08:17 PM SAN: 021600123-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 94403 Daytime telephone number Email 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 03/31/2019 08:17 PM Signature Electronic Submission (month, day, year) (File the originally signed paper statement with your filing official.) Page - 5

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

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

Schedule A-2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) CALIFORNIA FORM 700 1. business entity or trust HowToMedia Inc. 415 Sonora Dr., San Mateo, CA 94402 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 - $1,000 3. 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

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]

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 94402 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 94065 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