Los Angeles City Ethics Commission May 26, 2015 The Honorable City Council c/o Holly Wolcott, City Clerk 200 North Spring Street City Hall - 3rd Floor Los Angeles CA 90012 Re: Council File Number 15-0292 Appointment of Heather Repenning to the Board of Public Works Dear Councilmembers: FOR COUNCIL CONSIDERATION Heather Repenning was appointed by the Mayor to the Board of Public Works on March 12, 2015. The Ethics Commission received Ms. Repennings s pre-confirmation financial disclosure statement on May 21, 2015. In compliance with Los Angeles Municipal Code 49.5.10, a copy of Ms. Repenning s financial disclosure statement is enclosed. If you have questions, please feel free to contact me at (213) 978-1960. Enclosures: CA Form 700 CEC Form 60 cc: Mayor Eric Garcetti 200 North Spring Street, Suite 2410 Los Angeles CA S0012 phone (213) 978-1960 «fax (213) 978-1988 ethics.lacity.org
CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION A PUBLIC DOCUMENT STATEMENT OF ECONOMIC INTERESTS COVER PAGE LOS ANGELES CITY OfficioI Use Only MAY 21 2015 Your Position Commissioner If filing for multiple positions, list below or on an attachment.
SCHEDULE A-2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name Heather Repenning 1. BUSINESS ENTITY OR TRUST PESSAH CINEMATOGRAPHY 1 BUSINESS ENTITY OR TRUST Name Address (Business Address Acceptable) Address (Business Address Acceptable) Check one Check one Trust, go to 2 0 Business Entity, complete the box, then go to 2 Trust, go to 2 Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF BUSINESS ACTIVITY Cinematography Production Company GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE: $0 - $1,999 $0 - $1,999 $2,000 - $10,000 $2,000 - $10,000 $10,001 - $100,000 ACQUIRED DISPOSED $10,001 - $100,000 ACQUIRED DISPOSED $100,001 - $1,000,000 $100,001 - $1,000,000 Over $1,000,000 Over $1,000,000 NATURE OF INVESTMENT NATURE OF INVESTMENT Partnership D Sole Proprietorship gj Husband S Company other I_j Partnership rj Sole Proprietorship YOUR BUSINESS POS T ON None YOUR BUSINESS POSITION Other 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME IQ THE ENTITY/TRUST) 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF S10,000 OR MORE lallach i?p3ralo.heel II necessary) 2 IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO R'ATA SHARE OF THE GROSS INCOME IQ THE ENTITY/TRUST) $0 - $499 $10,001 - $100,000 $0 $499 J $10,001 $100,000 J $500 - $1,000 J OVER $100,000 $500 $1,000 J OVER $100,000 0 $1,001 - $10,000 $1 001 110.000 0 None 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF $10,000 OR MORE (Allacti a wlaulb Uwel il nec<4s3>y.) None 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 oox: INVESTMENT J REAL PROPERTY Name of Business Entity, If Investment, gr Assessor's Parcel Number or Street Address of Real Property Name of Business Entity, If Investment, or Assessor's Parcel Number or Street Address of Real Property Description of Business Activity gr City or Other Precise Location of Real Property Description of Business Activity gr City or Other Precise Location of Real Property FAIR MARKET VALUE $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000 IF APPLICABLE. LIST DATE: ACQUIRED DISPOSED FA R MARKET VALUE IF APPLICABLE, LIST DATE: $2,000 $10,000 M $10,001 $100,000 n $100,001 - $1,000,000 ACQU RED DSPOSED Over $1,000,000 NATURE OF INTEREST n Property Ownership/Deed of Trust NATURE OF INTEREST M Stock n Partnership j Property Ownership/Deed of Trust Stock Partnership "J Leasehold Other Yrs. remaining Check box If additional schedules reporting Investments or real property are attached Leasehold H Other Yrs. remaining Check box if additional schedules reporting Investments or real property are attached Comments: FPPC Form 700 (2012/2013) Sch. A-2
FPPC Form 700 (2012/2013) Sch. C
Comments: ---------------------------------------------------------------------------- ---------- ---------- ----------- ----------------------------------- FPPC Form 700 (2012/2013) Sch. C
SCHEDULE D p, Name Income - Girts Heather Repenning Peace Officers Research Association of California Sacramento, CA 95834 BUSINESS ACTIVITY, IF ANY. OF SOURCE Legislative Relations DATE (rnm/dd/yy) VALUE DESCRIPTION OF GIFT(S) ATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) 05 /06 / 14 «37.72 Legislative Reception / / $ / / $ / / $ /. / $ J. 1 $ DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) -----1---- J $ / / f / J $ /! $ / / * / / If DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) /. J $ / / S / / $ / / $ / / $ / / $ Comments: FPPC Form 700 (2014/2015) Sch. D
CALIFORNIA FORM 700 FPPC Form 700 (2014/2015) Sch. E
3. INCOME City Ethics Commission 200 N Spring Street City Hall 24th Floor Los Angeles, CA 90012 Mail Stop 129 (213) 978-1960 Restricted Source Financial Disclosure Statement CEO Form 60 The following income was received from a restricted source. Name of restricted source: Address of restricted source: Business activity of source: Your business position: Income received by: CUMe Cl My spouse/registered domestic partner My dependent child Value of income: $500 $1,000 $1,001 $10,COO $10,0C1 $100,000 Dover $100,000 Income was: Salary/Commission Loan repayment Rental income Sale of (e.g., car, boat, etc.) Other: Do you have additional income to report? DNo OYes, and additional pages are attached. 4. GIFTS The following gifts cumulatively valued at $50 or more were received from a restricted source. Name of restricted source: Address of restricted source: Business activity of source: Gifts received by: Me My spouse/registered domestic partner My dependent child Dates received: / / 20 ; / / 20 Value of gifts: Description of gifts: Do you have additional gifts to report? No Yes, and additional pages are attached 5. BOARD POSITIONS The following position was held on the board of a restricted source. Name of restricted source: Address of restricted source: Position title: Position held by: Me My spouse/registered domestic partner My dependent child Do you have additional positions to report? No Yes, and additional pages are attached. 6. NO INTERESTS I had no reportable interests in real property, investments, income, gifts, or board positions associated with restricted sources during this reporting period. April 2014 Los Angeles Municipal Code 49.5.2, 4S.5.9, 49.5.10 Page 2 of 2