California State Assembly
Division, Board, District. jf applicable:
.. Total number of pages including this cover page: _ __ ... Check applicable schedules or "No reportable interests." I have disclosed interests on one or more of the attached schedules: Schedule A-l
Your Position;
Assemblymember
... If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet jf necessary.) Agency: ___________________________________
0 0
Yes - schedule attached
Investments (Less than 10% Ownership)
Schedule A-2
Yes - schedule attached
Investments (10% or Greater Ownership)
Position: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Schedule B
Real Property
DYes - schedule attached
Schedule C
DYes - schedule attached
2. Jurisdiction of Office
[gJ State
(Check at least one box)
Income, Loans, & Business Positions (Income Other t/wn Gifts and Travel Payments)
o County of o City of o Multi-County o Other
3. Type of Statement
(Check at least one box)
Date:~~_ _
Schedule D
Income - Gifts
IZJ Yes
- schedule attached
Schedule E
[g! Yes - schedule attached
Income - Gifts - Travel Payments
-or-
o
No reportable interests on any schedule
0 181
Assuming Office/Initial
5. Verification
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the infonnation contained herein and in any attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Annual: The period covered is January 1, 2009, through December 31, 2009.
-orO
The period covered is December 31, 2009.
~~_ _ ,
through
Leaving Office (Check one)
Date Left:
~~_ _
o
O
The period covered is January 1, 2009, through the date of leaving office.
-orThe period covered is ~~_ _ , through the date of leaving office, Election Year:
FPPC Form 700 (200912010) FPPC ToU-Free Helpline: 866/ASK-FPPC www.fppc.ca.gov
filing official)
0
Candidate
CALIFORNIA FORM
700
SCHEDULE D Income - Gifts
FAIR POLITICAL PRACTICES COMMISSION
Name
Isadore Hall, III
... NAME OF SOURCE
... NAME Of SOURCE
Bass for Assembly
ADDRESS (Bus!ness Address Acceptable)
California Democratic Party
ADDRESS (Business Address Acceplable)
BUSINESS ACTIVITY. IF ANY, Of SOURCE
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy)
VALUE
DESCRIPTION OF GIFT(S)
DATE (mmldd/yy)
VALUE
DESCRIPTION OF GIFT(S)
~~09
~8/9109
$
72.51 11.95 59.55
Jacket Breakfast & Lunch Freshman Dinner
~~~~... NAME Of SOURCE
$_---
73.27
Dinner
$
$,----
~~09
... NAME OF
•
$,----
sou Ref
Ron Chatman & Staff of St. Timothy's Church & Scho
AQDRESS (Business Address Acceptable)
California Tribal Business Alliance
ADDRESS (Business Address Acceptable)
1020 12th St.. Suite 110. Sacramento. CA 95814
BUSINESS ACTIVITy IF ANY, OF SOURCE
1530 J Street. Suite 250
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Sacramento. CA 95814
DATE (mm/dd/yyl VALUE
DESCRIPTION OF GIFT(S) DATE (mmlddlyy) VALUE DESCRIPTION OF GIFT(S)
$
164.00
Edible arrangement
~~-
,
$
88.77
Back to Session Bash
~~-
,---$
$,----
... NAME OF SOURCE
... NAME OF SOURCE
Senator Mark DeSaulner
AQQRESS (Business Address Acceplable)
Cigar Association of America
ADDRESS (Business Address Acceptable)
Califomia Construction Industrial Materials Associatio
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Tobacco
DATE (mmlddlyy) VALUE
DESCRIPTION OF GIFT(S)
Manufacturing
DATE (mmlddlyy) VALUE
DESCRIPTION OF GtFT(S)
$
100,00
Dinner', Cigar Caucus
---1--1_
$,_-.::8::,7:.::,0::..0
Dinner & Reception
$_--=-60=-,,-,-00:..
$, _ _ __
...
NAME OF SOURCE
...
NAME OF SOURCE
Califomia Assoc of Wine Grape Growers
ADDRESS (Business Address Acceptable)
CA Council for Environment & Economic Balance
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Beer & Wine
DATE (mmlddlyy) VALUE
DESCRIPTION OF GIFT(8)
Environment
DATE (mmldd/yy) VALUE
DESCRIPTION OF GIFT(S)
~ 28
I
09
$,_-=-87:..:,,,,-00,,$ _ _ __
Dinner
--1--1_ --1--1_
57 $_--'0.:..:,,,,-00,,$ _ _ __
Dinner
_
~'--1__
$ _ _ __
...
NAME OF SOURCE
I Verification
Print Name Isadore Hall. III
Office Agency . . or co~rt California State Assembly
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Statement Type
DATE (mmldd/yy)
-~!~----1---1__
iZ12009/2010 Annual
VALUE
o -- Annual
(y()
0 0
Assuming Candidate
0
Leaving
DESCRIPTION OF G1FT(S)
$_---$ _ _ _ __
I
I have used all reasonable diKgence 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 certify under penalty of perjury under the laws of the State of California that the foregOing is true and oorree(,
-~-
$---
Signature
Comments: _______________________________________________________________________________________
FPPC Form 700 Amendment (2009/2010) Sch. D FPPC Toll-Free Helpline: 866/ASK-FPPC
.'
.,',
' ,
!?.ECElVED
APR 20 2010
, :
.. NAME OF SOURCE
.. NAME OF SOURCE
Fight Crime: Invest in Kids
ADDRESS (Business Address Acceptable)
AT&T, Inc. & Affiliates
ADDRESS (BuSiness Address Acceptable)
211 Sutter St., Ste 401, San Francisco, CA 94108
BUSINESS ACTIVITY, IF ANY, OF SOURCE
1215 K Street, Suite 1800, Sacrarnento, CA 95814
BUSINESS ACTIVITY. IF ANY. OF SOURCE
Anti-Crime advocates
DATE (mmlddiyy) VALUE DESCRIPTION OF GIFT(S)
Public utility
DATE (mmlddlyy) VALUE DESCRIPTION OF GIFT(S)
Plaque
_ _1---1__
$ _ _ __
LA Lakers Tickets/Refr
.. NAME OF SOURCE
.. NAME OF SOURCE
Metropolitan Water District
ADDRESS (Business Address Acceptable)
Consurner Attorneys of California
ADDRESS (Business Address Acceptable)
700 N. Alameda St., Los Angeles, CA 90012
BUSINESS ACTIVITY, IF ANY. OF SOURCE
770 L Street, Ste 1200, Sacrarnento, CA 95814
BUSINESS ACTIVITY, IF ANY. OF SOURCE
Public Utility
DATE tmmlddlyyl VALUE
$
Lobbyist
DESCRIPTION OF GIFT(S) DATE (mmlddiyy) VALUE DESCRIPTION OF GlfT:(S)
~~.~
147.63
Water Inspection trip
Dinner
-,
::
.--1.--1.. NAME OF SOURCE
$,_ _ __
(.j
-,'.
"~
~
--y •
...:->
, V~rjfjcatjon
Print Name
California Beer & Beverage Distributors
ADDRESS (Business Address Acceptable)
1415 L Street, Ste 890, Sacrarnento, CA 95814
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Office, Agency California _ _ _Assernbly _ _ _ _ _ __ orCourt _ _ _ _ _ _ _ State _ _ _ _
Statement Type
Beer & Wine
DATE {mmlddiyy) VALUE
$
DESCRIPTION OF GIFT(S)
0-- Annual (y<,
1812009/2010 Annual
0
0
Assuming Candidate
0
Leaving
_8_.~
09
295.07
Luncheon
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 certify under P,~;.::t:;;;i~Y California that tt the laws of the State of
NOTE: _ _ arnends 700 filing___________________________ _________________________ Schedule D dated 2/28/10, to add type and/or address for businesses Comments: _ _ _ _This _ _ _ _ _ _ _
~ ~
FPPC Form 700 Amendment (2009/2010) Sch. D FPPC TolI~Free Helpline: 866/ASK·FPPC
LiT
! ,-
t,
Income -
SCHEDUL~ ..
.~
... NAME OF SOURCE
...
NAME. OF SOURCE
California Coalition for Youth
ADDRESS (Business Address Acceptable)
2244 Walnut Grove Ave., Rosernead, CA 91770
BUSINESS ACTIVITY, IF ANY. OF SOURCE
46575 Road 417, Bldg. C, Coarsegold, CA 93614
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Public Utility
DATE (mmlddlyy) VALUE
Indian Affairs/Garning
DESCRIPTION OF GIFT(S) DATE (mm/ddlyy) VALUE DESCRIPTION OF GlFT(S)
Holiday ornarnent
--.-1--.-1_ --.-1--.-1__
... NAME OF SOURCE
$, _ _ __
~J!l.; 09
•
184.50
MeallHotel accornrnod
--.-1--.-1_ --.-1--.-1_
.' _ _ __ • _ _ __
c
•
Verification
Print
California Wornen for Agriculture
ADDRESS (Business Address Acceptable)
Name Isadore Hall, III
P.O. Box 249, Durharn, CA 95938
BUSINESS ACTIVITY, IF ANY. OF SOURCE
Office Agency . . or Co~rt California State Assembly Statement Type
Agriculture advocates
DATE (mmldd/yy) VALUE
DESCRIPTION OF GIFT(S)
o -- Annual
(yr)
lZI2009/2010 Annual
0 0
Assuming Candidate
0
Leaving
Box of oranges
, I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my the Information contained herein and In any is true and complete.
I certify under California that
_~f---,_' _ _
laws of the State of correct.
$, _ _ __
C
ommen
Is
NOTE: This amends 700 filing, Schedule D : ______________________ ____________
~
~~
dated 2/28/10, to add type of business andlor address ________________ _________________________
~
FPPC Form 700 Amendment (2009/2010) Sch. D FPPC TolI~Free Helpline: 866/ASK~FPPC
/
L'i
...
NAME OF SOURCE
...
NAME OF SOURCE
AES Pacific
ADDRESS (Business Address Acceptable)
Pfizer
ADDRESS (Business Address Acceptable)
690 N. Studebaker Rd .. L.B., CA 90803
BUSINESS ACTrvlTY. If ANY, OF SOURCE
1201 K Street, Ste 1010, Sacramento, CA 95814
BUSINESS ACTlVITY, IF ANY, OF SOURCE
Electrical power
DATE (mm/ddlyy) VALUE
DESCRIPTiON OF G{FT(S)
Pharmaceutical
DATE (mmlddlyy) VALUE DESCRIPTION OF GIFT(S)
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contamed herein and in any attached schedules true and complete.
th,v!aws of the State of
Date .
NOTE: This amends 700 filing dated 2/28/10, to add of business andlor business addresses. Comments: ________________________ __________________ type_________________________________________
~ ~~
FPPC Form 700 Amendment (2009/2010) Sch. D FPPC Toll-Free Helpline: 866/ASK-FPPC
California Association of Winegrape Growers
ADDRESS (Btlsmess Address Acceptable)
1020 Prospect St., Suite 310, LaJolla, CA 92037
BUSINESS ACTIVITY, IF ANY, OF SOURCE
1325 J Street, Suite 1560, Sacramento, CA 95814
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Health
DATE (mmlddJyy) VALUE DESCRIPTIOf'J OF GIFT(S)
Beer & Wine
DATE (mmlddfyy) VALUE DESCRIPTION OF GIFT(S)
Reception/Dinner
~~~
~ ~§, @9
$
6,61
Welcome Reception
$
87.88
Bill1lt11
...-----1...-----1_
... NAME OF SOURCE
$ _ _ __
...-----1...-----1... NAME OF SOURCE
$ _ _ __
AssemblyMember Fiona Ma
ADDRESS (Business Address Acceptable)
Pacific Gas & Electric
ADDRESS (BuSiness Address Acceptable)
State Capitol, Rm 3091, Sacramento, CA 95814
BUSINESS ACTIVITY, IF ANY, OF SOURCE
1415 L Street, Suite 260, Sacramento, CA 95814
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Legislator
DATE (mmlddlyy) VALUE DESCRIPTION OF GIFT(S)
Power/Electricity
DATE (mmlddlyy) VALUE DESCRIPTION Of GIFT(S)
Ox Piggy Bank
2.J~~
$_-..:.45::.;,-'.19=$ _ _ __
Dinner
...-----1...-----1-
$, _ _ __
...-----1...-----1-...-----1_-,--
$
$ _ _ __
... NAME OF SOURCE
: Verification
Print Name Isadore Hall, III
CA Highway Patrol
ADDRESS (Business Address Acceptable)
601 N, 7th St., Sacramento, CA 95811
BUSINESS ACTIVITY, IF ANY, OF SOURCE
~~~~~~gency California State Assembly
Statement Type
Law Enforcement
DATE (mmtddlyy) VALUE DESCRIPTION OF GIFT(S)
o
1Zl200912010 Annual ~ Annual
0 0
Assuming Candidate
0
Leaving
~2;~
...-----1--,--
$_-=23::.;',::,00=$ _ _ __
Mug,pen,keychair
I
I have used all reasonable diligence in preparing this statement. I have , reviewed this statement and to the best of my knowledge the infonnation contained herein and in any attached schedules is true and complete. I certIfy under penalty of perjury under the laws of the State of California that the foregoIng is true and correct.
A . Date Signed _ _ _ _ _-c2P::n::'1-,1,:.3:..,2:;cO::1:.,;0 _ _ _ __ _
lmonth, day, yearl
Karen Bass For Assembly
ADDRESS (BuSiness Address Acceptable)
California Democratic Party
AODRESS (Business Address Acceptable)
777 S. Figueroa St" Suite 4050, L.A., CA 90017
BUSINESS ACTIVITY, IF ANY. OF SOURCE
1401 21st St., Suite 200, Sacramento, CA 95811
BUSINESS ACTIVITY, IF ANY. OF SOURCE
Political
DATE (mmfddlyy) VALUE DESCRIPTION OF GIFT{S)
Political
DATE (mmJddfyy) VALUE DESCRIPTION OF GIFT{S)
_~~09 ~~09 ~~09
~
$ $ $
72.51 11.95 59.55
Jacket Breakfast & Lunch Freshman Leg. Dinner
~
Dinner
---1---1_
NAME OF SOURCE
$..$_ _ __
NAME OF SOURCE
Ron Chatman, St. Timothy's Church & School
ADDRESS (Business Address Acceptable)
California tribal Business Alliance
ADDRESS (Business Address Acceptable)
1020 12th St., Suite 110, Sacramento, CA 95814
BUSINESS ACTIVITY, IF ANY, OF SOURCE
1530 "J" Street, Suite 250, Sacramento, CA 95814
BUSINESS ACTIVITY. IF ANY, OF SOURCE
Religious
OATE (mmfddlyy) VALUE DESCRIPTION OF GIFT(S)
Indian Affairs/Gaming
DATE (mmlddlyy) VALUE DESCRIPTION OF GtFT{S)
_~_~ 09
$
164.00
Edible Arrangement
_~~ 09
---1---1_ ---1---1_
$_--=-88:..:.:...77:..: .
$, _ _ __
Back to session Bash
---1---1_
$ _ _ __
$
~
$$.._ _ __
NAME OF SOURCE
Verification
Print Name Isadore Hall, III .
Senator Mark DeSaulner
AOQRESS (Business Address Acceptable)
State Capitol, Room 2054, Sacramento, CA 94248
BUSINESS ACTIVITY, IF ANY. OF SOURCE
~;~:~~gency California State Assembly
Statement Type
Legislator
DATE (mmlddiyy) VALUE OESCRIPTION OF GIFT{S)
O __ AnnuaJ
(ye)
~
2009/2010 Annual
Leaving
~~ 09
$_---"16:..:.=-00"_
Bottle of Tamayo Wine
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 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct
_
'_---1_
$, _ _ __
Date Signed _ _ _ _ _ _,A:::P"'ri"'l-;,13:;;",,2:;;0;;;1:..:0'--_ _ _ __
(mon/h, day, year)
! Signature _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Comments: This Amends 700 Filing dated 2/28/10; adding type of business and/or business address only!
FPPC Form 700 Amendment (2009/2010) Sch. 0 FPPC Toll-Free Helpline: 866/ASK-FPPC
...
NAME OF SOURCE
...
NAME OF SOURCE
California Poultry Federation
ADDRESS (Business Address Acceptable)
California Rice Commission
ADDRESS (Business Address Acceptable)
4640 Spyres Way, Ste 4, Modesto, CA 95356
BUSINESS ACTIVITY, IF ANY, OF SOURCE
475 N, Palora Ave" Yuba City. CA
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Agriculture
DATE (mmJddiyy) VALUE DESCRIPTION OF GIFT(S)
Agriculture
DATE (mmtddlyy) VALUE DESCRIPTION OF GIFT(S)
192,14
__1---1__ ---1---1__
... NAME OF SOURCE
Dinner & Bus transp,
~JQ..;
09
$,_-,3:.::0-,,-,7-,--7
, _ _ __
, _ _ _ __
Gift Box
,, _ _ __ , _ _ __
---1---1_
~I~I_-
... NAME OF SOURCE
California Citrus Mutual
ADDRESS (Busm8ss Address Acceptable)
CA New Car Dealers Association
ADDRESS (Business Address Acceptable)
512 N, Kaweah Ave" Exeter, CA 93221
BUSINESS ACTIVITY, IF ANY, OF SOURCE
1415 L Street, Ste 70, Sacramento, CA 95814
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Citrus Growers
DATE (mmJddlyy) VALUE DESCRIPTION OF GlFT(S)
RetaiVSales
DATE (mmlddlyy) VALUE DESCRIPTION OF GIFT(S)
~~
09
, _ _5::.:,-=-50,,$--'-'----$
Carton of oranges Box of oranges
~~ 09
---1---1__
~I-.-J__
'-$_-=3-=-6:::,8.=.2
$,_ _ _ __
Reception
10.00
, _____
...
NAME OF SOURCE
Verification
Print Name Isadore Hall, III
California Floral Industry
ADDRESS (Business Address Acceptable)
1521 I Street, Sacramento, CA 95814
BUSINESS ACTIVITY, IF ANY, OF SOURCE
~~;:~~g.ncy California State Assembly
Statement Type
Agriculture
DATE (mmlddlyy) VALUE DESCRIPTION OF GIFT(S)
o "Trir Annual
/ZI2009/2010 Annual
0 0
Assuming Candidate
0
Leaving
$
20,00
Bouquet of flowers
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_-
,---,----
I certify under penalty of perjury under the laws of the State of
I California that the foregoing is true and correct.
Date Signed _ _ _ _ _--':A"'P:'-ri;cl-:;13:'-,,,2:::,0:,1:..:0'---_ _ _ __
(month, day, year!
---'---'--
Signature _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Comments: NOTE: This amends 700 filing dated 2/28/10, to add type of business and/or addresses
FPPC Form 700 Amendment 12009/2010) Sch. 0 FPPC TolI·Free Helpline: 866/ASK·FPPC
, "
.
~
.
'
..
,-; >
,,;~ i
!
...
NAME OF SOURCE
...
NAME OF SOURCE
Western Growers
ADDRESS (Business Address Acceptable)
Califomia Hospital Association
ADDRESS (Business Address Acceptable)
1729 Agriculture
Rd" Ste #1, Modesto, CA 95350
1215 K Street, Ste 800, Sacramento, CA 95814
BUSINESS ACTIVITY. IF ANY, OF SOURCE
BUSINESS ACTIVITY IF ANY, OF SOURCE
Health
VALUE
$i _ _",5.c:.0-,-0
DATE (mmlddlyy)
DESCRIPTION OF GIFT(S)
DATE (mmlddlyy)
VALUE
OESCRIPTION OF GIFT(S)
~ 24 i 09
Fresh produce
~~ 09
$"--_1,-,4.::.5.,,,0.::.0
LA Kings Tickets
---.1---.1__
$, _ _ __
---.1---.1__
... NAME OF SOURCE ... NAME OF
$'--_ __
California Building Industry Association
ADDRESS (Busmess Adaress Acceptable)
Chabad of Sacramento
ADDRESS (Business Address Acceptable)
1215 K Street, Ste 1200, Sacramento, CA 95814
BUSINESS ACTIVITY, IF ANY OF SOURCE
T echAmerica
ADDRESS (Business Address Acceptable)
1215 K Street, Ste 2140, Sacramento, CA 95814
BUSINESS ACTIVITY. IF ANY, OF SOURCE
Office Agency . , or co~rt California State Assembly Statement Type
Technology
DATE (mmldd/yy) VALUE
o
~ 2009/2010 Annual
~ Annual
(yr,
0 0
Assuming Candidate
0
Leaving
DESCRIPTION OF GIFT(S)
2..;~ 09
---.1---.1__
1 0 $i_-...:.",0.c:.-,-0
$, _ _ __
Chocolate computer
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 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
NOTE: Thos amends 700 filing __________'-'-____ of business andlor business addresses. CommenB: ________________________ dated 212811 0, to add type _____________________________________
~ ~~
FPPC Form 700 Amendment (2009/2010) Sch. D FPPC Ton·Free Helpline: 866/ASK-FPPC
RECEIVED
MAY 19Ztll0
~
;;;d))
SCHEDULE E; Income - Gifts Travel Payments! f~~J£lngJ;is~: and Reimbursements
• Reminder - you must mark the gift or income box. • You are not required to report income from government agencies.
2350 Kerner Blvd., Suite 250
CITY AND STATE CITY AND STATE
San Rafael, CA 94901
BUSINESS ACnVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE,S)
.11JJ2J~ . .11J~~
(If apphcable)
O AMT $i _ _-"5""0,,,1.,,,2:e..
DATE,S) . .--1.--1_
. .--1.--1_
AMT $ _ _ _ _ __
(If appifGable)
TYPE Of PAYMENT (must check one)
DESCRIPTION
I&l Gift
0
Income
TYPE OF PAYMENT: (must check one)
0
Gift
0
Income
Airfare to Hawaii for Business & Leadership Conference - participated as panelist at conference
DESCRIPTION: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
...
NAME OF SOURCE
Print Name
ADDRESS (Business Address Acceptable)
Isadore Hall, III A888m blymembe r,
CITY AND STATE
or Court
Office, Agency
o·IS triCt 52 . 0 0
Assuming Candidate
I Statement Type
BUSINESS ACTIVITY. IF ANY, OF SOURCE
1812009/2010 Annual -r;;r Annual
o
0
Leaving
DATE,S),.--I.--I_·
.--1.--1_
AMT $_ _ _ _ __
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 certify under California that of perjury under the laws of the State of is true aJ"!7«"",et.
(If applicable)
TYPE OF PAYMENT: (must check one)
0
Gift
0
Income
DESCRIPTION _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Comments: Amendment clarifies that gift of travel was in connection with a speech. Pursuant to Gov't Code sections 89503 and 89506, gift limits do not apply.
FPPC Form 100 Amendment (2009/2010) Sch. E FPPC ToliMFree Helpline: 866JASKMFPPC