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Home My WebLink AboutJan Marx - Form 700 - Candidate 07-23-2012ALIF.ORNIA FORM 700 1 FAIR POLITICAL PRACTICES COMMISSION A PUBLIC DOCUMENT Tlease print in ink. NANt Or rILtR 0K_ (LAST) 1. Office, Agency, or Court Agency Name I jam'' G Division, Board, Departme , DlsW STATEMENT OF ECONOMIC INTERESTS COVER PAGE (FIRST) T'�-W if applicable I. If filing for multiple positions, list below or on an attachment. Agency: 2. Jurisdiction of Office (check at least one box) Your Position Position: JUL 21202 ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi- County ` ❑ County of City of .r�l - ❑ Other _...__ . 3, Type of Statement (Check at least one box) ❑ Annual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left_ -or- December 31, 2011, (Check one) The period covered is�1. through O The period covered is January 1, 2011, through the date of December 31, 2011, leaving office. ❑ Assuming Office: Date assumed O The period covered is _ the date of leaving office. [►Candidate: Election Year (� Office sought, if different than Part 1 through 4. Schedule Summary Check applicable schedules or 'None, > Total number of pages including this cover page: ❑ Schedule A -1 - Investments - schedule attached 19/schedule C - Income, Loans, & Business Positions - schedule attached r'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, El None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE LIP CODE (Business or Agency Address Recommended - Public Document) / a F� UA"fTIME TELEPHONE NUMBER E -MAIL ADDRESS (OPTIONAL) I have used all reasonable diligence in preparing this statement. I have revie ed this statement and to the best of my knowledge the information captained_ 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 f 2 . Signature : �y yla1 'Statement withynl*T&A)oiricei) FPPC Form 700 (201112012) FPPC Toll -Free Helpline: 8661275 -3772 www.fppc.ca.gov SCHEDULE A -2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) �eve,1rG -u ,� rw� d �- Name !�16 5� X416 W�- Dr), VC Ste. (.li,l at: ?- 61 Address (Business Address Acceptable) f3Y-aJ- go to 2 ❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $0 - $1,999 ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ACQUIRED DISPOSED ❑ $100,001 - $1,000,000 i] Over $1,000,000 NATURE OF INVESTMENT Sole Proprietorship ❑ Partnership 9 Other YOUR BUSINESS POSITION ❑ $0 - $499 W$10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,001 - $10,000 Check one box: b;TINVESTMENT F] REAL PROPERTY Name of Business E ty, if Investment, Q Assessor's Parcel Number or Street Address of Real Property Description of Business Activity pr City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,00l - $100,000 $100,001 - $1,000,000 ACQUIRED DISPOSED Over $1,000,000 NATURE OF INTEREST ❑ Property Ownership /Deed of Trust E] Stock + _ �❑ Partnership ❑ Leasehold( Other m Yrs. reaining 7 ❑ Check box if additional schedules reporting investments or real property are attached Comments: Name Name Address (Business Address Acceptable) Check one ❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $0 - $1,999 [f $2,000 - $10,000 ❑ $10,001 - $100,000 ACQUIRED DISPOSED ❑ $100,001 - $1,000,000 J_.j Over $1,000,000 I NATURE OF INVESTMENT Sole Proprietorship ❑ Partnership ❑ Other YOUR BUSINESS POSITION ❑ $0 - $499 ❑ $10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,001 - $10,000 Check one box: []INVESTMENT I&REALPROPERTY ( s(s a,- � ?nqf �Gto � � ' Name of Business Entity,'if InvW1rnenl, or ��3� Assessor's Parcel Number or Street Address of Real Property T 'w G447 Description of Business Activity a City or Other Precise Location of Real Property FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 &$100,00! - $1,000,000 ❑ Over $1,000,000 NATURE OF INTEREST M_ Property Ownership /Deed of Trust IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED E] Stock ❑ Partnership Leasehold ❑ Other Yrs. remaining Y'+ Check box if additional schedules reporting investments or real property are attached FPPC Form 700 (2011/2012) Sch. A -2 FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov SCHEDULE 6 Interests in Real Property (Including Rental Income) ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS 26 S ,q (- e4 Dr) v-,- CITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 .$100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INTEREST 0ownership/Deed of Trust ❑ Leasehold _ Yrs remaining ACQUIRED DISPOSED ❑ Easement ❑ Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 Name Kati _qo l,_jat Par,< ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS 1 mss OCCAI K-- (?,( 4 61 6 CITY Derr. o C'4 l '3 41,E) I FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 $10,001 - $100,000 ❑ $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST ,Ownership /Deed of Trust ❑ Easement ❑ Leasehold __ ❑ Yrs remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED 0$0-$499 ❑ $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 ❑ OVER $100,000 SOURCES OF RENTAL INCOME: If you Own a 10% or greater SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of interest, list the name of each tenant that is a single source of income of $10,000 or more, income of $10,000 or more. 0 000, * You are not required to report loans from commercial lending institutions 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* ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE % ❑ None TERM (Months/Years) HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Comments: NAME OF LENDER' ADDRESS (Business Address Acceptable) ~ BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable FPPC Form 700 (2011/2012) Sch. B FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov SCHEDULE C CALIFORNIA FORm Income, Loans, & Business FAIR POLITICAL PRACTICES COMMISSION Positions Name (Other than Gifts and Travel Payments) ja-, qo,,� t1karX NAME OF SOURCE OF INCOME _a' k self- 131�� ADDRES'S ([4Gsiness AddressAccapfabre) & O (v-, f�- '6-, %.cr �- 06a a 0,4 BUSINESS ACTIVITY, IF MY, /O� F SOURCE / y3 yp CO— YOUR BUSINESS POSITION P,ai-f o,r GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 Pq $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED Salary ❑ Spouse's or registered domestic partner's income 7❑ Loan repayment ❑ Partnership ❑ Sale of (Real property car boat, etc.) ❑ Commission or ❑ Rental Income, list each source or $10,000 or more ❑ Other (Describe) NAME OF SOURCE OF INCOME SD Cl fecu r, C, ke^;T r fi j ADDRESS (Business Addres� Acceptable) PO &K a_oo o PLtLkAixv4 C4 %z - BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $50o - $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 ❑ Loan repayment ❑ Partnership ❑ Sale of (Rear property, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source or $10,o00 or mare Other /`^ (Describe) 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' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $1o0,o00 ❑ OVER $100,000 Comments: INTEREST RATE TERM (MonthsNears) ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property ❑ Guarantor ❑ Other Street address city (Describe) FPPC Form 700 (2011/2012) Sch. C FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov SCHEDULE C Income, Loans,. & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME Cal Poly State University _ ADDRESS _ -- San Luis Obispo CA 93407 BUSINESS ACTA11TY, IF ANY, OF SOURCE Higher Education YOUR t3USINESS POSITION Spouse is partly retired faculty member GROSS INCOME RECEIVED $500 - $1,000 F] $1,001 - $10,000 0 510,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED Salary ® Spouse's or registered domestic partner's income ❑ Loan repayment :❑ We of (Properly, car, bank etc) ❑ Commission or ❑ Rental Income, list r ch wince of $10,000 a" more ❑ Other (Describe) r Jan-,Howell Marx ,NAME OF SOURCE OF INCOME Cal Pers Pension ADDRESS P.O. Box 942716 Sacramento CA 94229 -2716 BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION Spouse is pensioner GROSS INCOME RECEIVED ❑ $500 - $1,000 $1,001 - $10,000 Q $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ salary ® Spouse's or registered domestic partner's Income ❑ Loan repayment ❑ Sale of (Property, cer, boaL etc.) n Commission or ❑ Rental Income, list each source cr Sro;oo0 or more ❑ Other (Describe) fi r 1' e l ,1L.6.�,/kY! -J r c C i. r - MGM * 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 (Months/Years) __ -- _ % ❑ None ADDRESS SECURITY FOR LOAN BUSINESS ACTIVITY, IF ANY, OF LENDER J ❑ None ❑ Personal residence _ ❑ Real Property Street address HIGHEST BALANCE DURING REPORTING PERIOD ❑ Mo - $1,000 ❑ $1,001 - svoa0 ❑ slo,001 - $100,000 OVER $100,000 Comments: ❑ Guarantor ❑ Other cIry (Describe) FPPC Form 700 (200812009) Sch. C FPPC Toll -Free Helpfine: 866 1ASK -FIRK www.fppe.ca.gov