700 STATEMENT OF ECONOMIC INTERESTS Dale ~'I:Y.LU …...Income Received 01 $!iOC or More jReport OIl...

® -

CALIFORNIA FORM 700 'FAIR ""Oll.1CA= ~RItCTIC:ES COMM!55I:O~

AMENDMENT

STATEMENT OF ECONOMIC INTERESTS COVER PAGE

JU Dale f=ved N ~'I:Y.LU 13'

BY:~ Please type or print In Ink. A PUBliC DOCUMENT

'" , r- r-I j' iFMsn

HAIlE OF RLER

Allen

1. Office, Agency, or Court Agency Name

CA State Assembly

Division, Board, Departmenl Dis1rict, tl applicatle

~ ~ filing 101 multiple pcstlions, I~I below 01 on an aHachmenl

" (YlDOl.£)

Travis

YOUI Position

Agency: _______________ _ Postlion: _______________ _

2. Jurisdiction of OffIce (Check al , ... , O11e box)

I8IStata o Multi-County _____________ _

o City 01 _______________ _

3. Type of Statement (Chtclr il IN., one box)

I8J Annual: The period covered Is January 1, 2012, Ihrough Decernbel 31, 2012.

-or-The period coveled is ----1----1' ____ through Decambel 31. 2012.

o Assuming OffIce: Dale assumed ----1----1 ___ _

o Judge or Court Commission81 (Sletewide Jurisdiction)

o Coonly 01 ______________ _

o Other _____________ _

o leaving Office: DOle Left ----1----1, ___ _ (Chsck one)

o The period covered ~ January 1,2012, through the dOle 01 leaving office.

o The period covered Is ----1----1 ____ through the dale 01 leaving offica.

o Candldele: EIeclion Yeal _____ _ and office soughl, ~ cfdferen1 than Part 1: _____________ _

4. Schedule Summary Check appllCllble .chadu/e. or "None."

I8J Schadule A-1 - Inves/ments - ",hedule aliached

I8J Schadule A-2 - Inveslmen/s - schedule attachad

o Schedu(e B - Reel Properly - schadule attached

-or-

~ Total number of pages Including this cover page: _-,4 __

o Schadule C - Income, Loans, & Business Posffions - schadule attachad

I8J Schedule D - Income - Gifts - schedule attached

o Schedule E - Income - Gifts - Travel Payman/s - schedule Bttachad

O None - No raportBble inlerests on any schadu/e

⁴⁾† ⁾† ⁾†

I certify under penelty 01 pe~ury under the laws

Dale Signed _____ 0.:..5/-'1_7/:...2_0_1_3 __

1-'.""'''''' FPPC Advice Emell: [email protected]

lee Helpline: 86S1275-3772 www.fppc.ca.gov

(d)(5)

SCHEDULE A-1 Investments

Stocks, Bonds, and Other Interests (Ownership Interest Is Less Than 10%)

Do not attach brokerage or finanCIBf statements.

... NAME OF BUSINESS ENTITY

FT J Fundcholce GENERAL DESCRIPTION OF BUSINESS ACTIVITY

Investment FAIR MARKET VALUE o $2,000. $10,000 o $100,001 • $1,000,000

NATURE OF INVESTMENT

~ $10,001 • $100,000

Dover $1,000,000

181 S.- 0 Oth., ____ ==::-___ _ IDncnbel o Psrtner&hlp 0 Income Recefved 01' $0 • $499

o Income Rec.efved 01 $SOO or More jRepolt 011 Schttdu/e Cr

IF APPUCABLE, LIST DATE:

--.l--.l--1L ACQUIRED

~...Q!G--1L


Securities America

DISPOSED

GENERAL DESCRIPTION OF BUSINESS ACTIVlTY

Investment

FAIR MARKET VALUE o $2,000 • $10,000 o $100,001 • $1,000,000


~ $10,001 • $100,000 o Ovor $1,000,000

IBI Slack 0 Othor - ___ ==::-___ _ IDeIQ1be1 o Po"",,""lp o Income ReceIved 01' So • $499

o Income Received 01 $!iOC or More jReport OIl Sch«JuIe C}

IF APPLICABLE, UST DATE:


~...Q!G--1L DISPOSED


GENERAl DESCRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

o $2,000 • $10,000 o $100,001 • $1,000,000

o $10,001 • $100.000

Dover $1,000,000

NATURE OF INVESTMENT o Sto'" 0 Otho, ____ ==::-___ _ (Oescnbel o Pertner&hlp 0 Income Recetved 01 $0 • $499

o IllCOme ReceIved 01 $5(J0 or More l~poIt on Schedule

IF APPLICABLE, LIST DATE:


--.l--.l--1L DISPOSED

Comments: _________________



FAIR MARKET VALUE

o $2,000 - $10,000 o $100,001 • $1,000,000

NAlURE OF INVESTMENT

o $10,001 • $100,000

Dover $1,000,000

o S.- 0 Othor ___ ---,== ___ _ IDescrtbel o Pertnerlhlp 0 IllCOme ReceIved 01 $0 • $499

o IllCOme ReceIved of $500 or More IReport 011 ~ Cj





FAIR MARKET VALUE o $2,000 - $10,000 o $100,001 • $1,000,000

NAlURE OF INVESTMENT

o $10,001 • $100,000

DOver $1,000,000

o S.- 0 Othor ___ ---,== ___ _ IDetatbej o Pertner&hlp 0 IllCOme ReceIved of SO • $499

o IllCOme ReceIved of $500 or Mom I~port on ScI'tltdultJ Cj


--.l--.l--1L ACQUiRED


- -

Filer's Verification

Print Name Trevls Allen

Office, Agency orCourt CA Stete Assembly

Statement Type 0 2D1212013 Annuel

I8I~Annu'l '1'1

o Assuming 0 leeving o CerKIldale

I heve used all ree90n.able diligence In PI epertng this slalemenl. ) heve

revJewed this stalemenl end 10 the basi of my knowledge the InformetJon

contained helein end In eny etteched 9chedules Is true and complele.

⁃⁊⁾† ⁾››†

(d)(5)

SCHEDULE A-2 Investments, Income, and Assets

of Business EntitieslTrusts (Ownership Interest Is 10% or Greater)

Wealth Strategies Group Name

950 South Coast #115, Costa Mesa, CA 92626 Addre!l! (Susins33 AddreS3 AccePlltbll'J

Ch&ek one o Trust. go 10 2 o BUlllness Entity, complete the 00", then QO to 2

GENERAL DESCRIPTION OF BUSINESS ACTIVITY

Investment

FAIR MARKET VAt.UE IF APPLICABLE, UST DATE:

~ ~,~~Ol,~~O.OOO $10,001 • $100.000

$100,001 • $1,000,000

Over $1,000,000

---1---1...1£ ACQUIRED

---1---1...1£ DISPOSED

NATURE OF INVESTMENT o Sol. Propristonhlp 0 Pa""""hlp 181 ..:S-=--::C:.:o"rp"-=-___ _ 0tIw

YOUR BUSINESS POSITIoN President

II- 2. JD~NnFY THE GROSS. tNCrn.·tI~.: ReJ:e:JVED {UiCLtiOe. Y-OU.R PRO RA.TA SHAR.€ OF THE GROSS tNCQNl~ TO THE ENTIfYifflUSTj

0$0, $499 o $500 - $1,000 o $1,001 • $10,000

1&1 $10,001 • $100,000 DOVER $100,000

.. J. UST THE NAME OF EACH REP'ORi'ABLE: SINGLE SOtmCE: OF INCOMf OF t HJ c-oa 00 MORe: ·1I..9""h ... ~~P'"~''' ~h"'t If "I><u.,,="'¥;

o Non.

Filer's Verifi catio n

Print Name Travis Allen

110 ~. fNV.E STiflE N1S AND lNT~Re:STS IN REAL PROPERlY HElD 0" LEASED a'l THE: BUS!N£SS ENTITY OR fRUST

Cher;k one box"

o INVESTMENT ~ REAL PROPERTY

950 South Coast #115, Costa Mesa, CA 92626 Name 01 BUline!l!l EntIty, If Investment. m Aaaesltor', Percel Number or Stresl Address of Rltsl Property

Investment Description of Buslnltu ActivIty m Ctty Of Other Preciu Location of Raal Property

FAIR MARKET VALUE

o $2,000 ' $10,000 ~ $10,001 • $100,000 0$100,001 • $1,000,000

DOver $1.000,000

NAlURE OF INTEREST

o Property OwnItr&hipJDeed 01' Truel

IF APPLICABLE. LIST DATE:

---1---1...1£ ---1---1...1£ ACQUIRED DISPOSED

DPsrtnerah'"

I8J Lltltsehold 0 91'1 r8lT\8.InIJ'Ig

DrnMc ______________ ___

o Check bo .. II additional schedule! reporting IrlVMtmltrna or real property are attached

Comments: _________________ _

OfflCe,Agen~Orcourt_C-A--S-t-a-te-As--s-e-m-b-l~y----------------------____________________________ _

Slatement Type 0201212013 Annuel 181~ Annuel 0 Assuming 0 Leevlng 0 Cendldale

I have used all reasonabla diligence In prepar ⁶⁾† ⁒⁉⁃※※›※※※※※›※‷※※※※※※››⁾†conlalned herein and In any attached ached

I certlfy under penalty of pe~ury under t

Dete S Ignod _____ .:.05;::''''3'''1'.;:2::;.01;,:3: lmomh. day. YNIJ

FPPC Form 700 Amendmenl (201212013) FPPC Advice Emell: [email protected]

FPPC TolI,Flee Helpline: 86S1275-3772 www.fppc.ca.gov

(d)(5)

SCHEDULE D Income - Gifts

... NAME OF SOURCE (No! Itn Acronym)

John Perez for Assembly 2012 ADDRESS (8usine33 Addres3 AlX&ptablfJ)

777 S. Flguerda St #4060. Los Angelos, CA 90017 BUSINESS ACTIVITY, IF ANY, OF SOURCE

Legislator OATE (mmlddlyy) VALUE

..E.J~.E. $ 44.40

..E.J~.E. $ 85.80

..E.J...!iJ.E. $ 35.52

... NAME OF SOURCE (Not en Acronym)

CA Democratic Party

DESCRIPTION OF GIFT(S)

Reception

Glass Bowl

Luncheon

ADDRESS (BuslnrtS3 Address Acceplsb!s)

1407 2nd Street #200, Secramento, CA 95811 BUSINESS ACTIVlTY, IF ANY, OF SOURCE

Political Perty OATE (mmlddlyy) VALUE

~~.E. ,,,--_6_1_.7-'.,1

---1---1___ $~ ____ __

$

... NAME OF SOURCE (Nol en Acrnnym)

The Boeing Company


Lunch

ADDRESS (Busine,ss Addres:s Acceplltbllt)

2201 See I Beach Blvd, Seel Beach, CA 90740 BUSINESS ACTIVITY, IF ANY, OF SOURCE

Aerospece Compeny OATE (mm/dd!yy) VALUE DESCRIPTION OF GIFT(S)

~~.E., 109.09 Lunch

---1---1___ .. $ ______ _

---1---1___ .. $ ______ _

... NAME OF SOURCE (Not en Acronym)

TechNet ADDRESS (Business AddmM Acceptable)

5050 EI Camino Rd, Los Altos, CA 94022 BUSINESS ACTIVITY, IF ANY, OF SOURCE

Technology Development DATE (mmfddlyy) VALUE

.E..J.E..J.E., 135.44

.E..J.E..J.E. $ 165.31

.E..J.E..J.E. $ 57.92

... NAME OF SOURCE (NOI Itn Acronym)

Tech Net ADDRESS (BusinrtS3 Address Acuptable)


Dinner

Lodging

Reception/Meeting

5050 EI Camino Rd, Los Altos, CA 94022 BUSINESS ACTIVITY, IF ANY, OF SOURCE

Technology Development DATE (mmlddlyy) VALUE DESCRIPTION OF GIFT(S)

5~.E. >-' __ 4_5._36_

.E..J~.E. >-$ __ 4_8._04_

---1---1_ .. ' ______ _


Breakfast

Welcome Bag

Print Name Travis Allen

Office, Agency or Court CA Stete Assembly

stelement Type 0201212013 Annuel I&l~AnnUel

o Assuming 0 leevlng DCerKIldele

I heve used eH reesonable diligence In prepartng thts state men!. I heve

⁾† ›››› ⁾⁾‡‡‡‷›⁽⁽″⁝‱⁽‰⁽

Commen~: _____________ ~⁾⁾⁾†

FPPC Form 700 Amendmenl (201212013) FPPCAdvice Email: [email protected]

FPPC ToHree Helpline: 86S1275-3772 'M'IW.fppc.ca.gov

(d)(5)

·_ ':,' RECE~£d STAT~MENT 'OI')~cONOMlc INTERESTS [II'!' CJ. ,_ ~,"c ( ,

, COVER PAGE MAY 012013 ~ Please type or pn"nl in Ink. c "" '''~ f'U~,~i§: QlQCUMENT

• - ., I

NAME OF FtLER

Allen


CA State Assembly

(lAS1)

Di~sion, Board, Departmenl, D~lrict, d applicable

... It finng tol multiple posilions, lisl below 01 on an attachmenl.

(FIRS1)

Travis

YOUI Posllion

Agency: __________________ _ Position: ________________ _

2. Jurisdiction of Office (Check al 1 ... , one box)

181 Siale

o Mulli·Counly _______________ _

o Clly 01 _______________ _

3. Type of Statement (Check al lea51 one box)

I8J Annual: The period ccve<ed is January 1,2012, Ihrough December 31,2012.

-or· The period ccveled is ---1---1 ____ IhlDugh Decembel 31, 2012.

o Assuming Omce: Date assumed ---1---1, ___ _

o Judge 01 Court Commissioner (Slalewide Jurisdiction)

o Counly o/ _______________ ~

OOthel ______________ _

o Leaving OffIce: Dale left ---1---1' ___ _ (Check one)

o The period ccveled is January 1, 2012, thlDugh the dale 01 leaving office.

o The peliod ccveled is ---1---1 ____ Ihrough Ihe dale at leaving office,

o Candldale: Election Yeal _____ _ and office soughl if differenl than Part 1: ______________ _

4. Schedule Summary Check applfc.abfe 5chedufes or "None. n

I8J Schedule A·1 • Inveslmenls - schedule allached

I8J Schedule A·2 • Investmems - schedule allached

o Schedule B • Reel Property - schedule allached

·or·

~ Total number of pages Including this cover page: --Lf' .... -o Schedule c· )ncome, Loans, & Business Positions - schedule allached

I8J Schedule D • Income - Gifts - schedule allached

o Schedule E • Income - Gifts - Travel Peyman/s - schedule allached

o None· No reportable in/eresls on eny schedule

5. Verification

⁄⁁⁾※†

helein and in any altached schedules is lrue and complele, I acknowledge Ihis is a piJb~c documenl

I certify under penelly 01 pe~ury under the laws 01 the Stale 01 Cellfom

Date Signed __ -,5,,---,1_-_1,-,30~ ____ _ ImootiJ dII)( rear1

S ⁾›››⁛⁾‡⁹⁐⁴‡⁉†‽‽‽‽‽‽⁴⁽‧†‧ ⁾⁴⁴⁗⁏‧•†⁊⁴‶⁊⁴

FPPC Advice Email: ed~ce@/ppc.ce.gov

FPPC ToHlee Helpline: 8661275-3772 www./ppc.ca.gov

(d)(5)

(d)(5)

.K.J::CCElVED

- -

CAUFORNIAFORM 700 STATEMENT OF ECONOMIC INTERESTS "AIR POLl'nCAt PRACTICES COM!.I'S~!0t4

A PUBLIC DOCUMENT COVER PAGE BY: (00?, ..-Please type or print In ink,

,- . ,,'I "

flAME OF FILER (lASD ~a13 l.F':? 2 3 P:i 2: ~I~SD (MJOOLE)

Alien


CA State Assembly

Division. Soald. Departmenl. Dislncl. ff applicable

... It filing tal multiple posilions, lisl below or on an attachmenl

Travis

YOUI Position

Agency __________________ _ Posilion: ________________ _

2. Jurisdiction of Office (Check., leasl one box)

III Siale

o Multi-Counly _______________ _

o City 01 _______________ _

3. Type of Statement (Check alleasl one box)

III Annual:

-or·

The period ccvered ~ January 1. 2012. Ihrough Decembel 31. 2012.

The period ccvered is ~~ 2013 Decembel 31. 2012.

Ihrough

o Assuming OffIce: Dale assumed ----1----1, ___ _

o Judge or Court Commissionel (Statewide Jurlsdidion)

o Counly 01 _______________ _

OOthei ______________ _

o Leaving OffIce: Date Left ----1----1 ___ _ (Check one)

o The period ccveled is January 1. 2012. through the dale 01 leaving office.

o The period ccvsred is ----1----1 ____ IhlOugh the dale 01 leaving office.

o Candldete: Beclion ye., _____ _ and office soughl. 1/ diflelenl Ihan Part 1: _______________ _

4. Schedule Summary Check applicable schedules or "None."

III Schedule A·1 • Inveslments - schedule attached

III Schedule A·2 • Inveslments - schedule al!ached

o Schedule B • Real Pi operty - schedule attached

-or·

~ Total number of pages including this cover page: __ 1..l..._ o Schedule C • Income. Loans. & Busmess Posilions - schedule afteched

III Schedule D • Income - Gifls - schedule attached

o Schedule E • Income - Gifts - Travel Paymenls - schedule afteched

o None· No reportable inleresls on any schedule

5. Verification ⁁⁾⁸›⁹†

helein and in any attached schedules is lrue and compJele, I acknOVJfedge Ihis is a publfc doaJmenl

I certify undel penelty 01 p.~ury under the laws 01 Ihe State 01 California thel I

Dele Signed 04/19/2013 ⁾†Signature  ‷‽⁾‱ †‽‽‽‽‧‴‡‰⁊‽‹‹

FPPC Focm 700 (2012/2013) FPPC Advice Email: [email protected]

FPPC Toll-Flee Helpline: 8661275-3772 www.lppc.ca.gov

(d)(5)

(d)(5)


of Business EntitieslTrusts (Ownership Interest is 10% or Greater)

CALIFORNIA FORM 700 E'MR POtnlcAL PRACTiCES COMM~S!t;lr,.

Name

.. 1. BUSINESS ENTITY OR TRUST

W~B!:=C\ ~""G\"'-:;;z ~q2 Nmoo

~~~-r "lIS ~'?TA c::2~ (a: tZ~2"'" AddrC!55 IBu3IneS5 Address Acceplable)

Check one

~USlnC!S5 Enlily, cemp/sls Ihe bO)l, lhen go to 2 o Trusl, go 10 2


FAIR MARKET VALUE IF APPLICABLE. LIST DATE: o $0 - $1,sg9

§.i"OOO - $10,000 ---1---1..R. ---1---1..R. $10,001 . $100,000 ACQUIRED DISPOSED

$l00,{Xn • 51,000,000 o Over $1,000,000


~ 6-eo/l-P o Psnncrship o Sole Proprietorship 0i/iC,

YOUR BUSINESS POSITION

-- ----to 2. IDENTlfV tHE GR'OSS INCrn.1{ RECEIVED {lNCLUDE YOUR PRO RATA

SHM!:: OF tHe: GROSS INCOME :m THE Ef'Ulf'!ftrnuSn

o '0 - $499 "P-O '500 - $1,000 o 51,001 - 510,000

~,{m - $100,000 o OVER $100,000

-- ---I>- '* U'<!VESjME~nS.MllO mj£RES"TS IN REAL PROPERTV HHD 00

lEAS£D I.ri THE BUSllifESS ENTITY OR TRUST Chsck one 00)1:

o INVESTMENT ~EAL PROPERTY

'15:> 5:.....r11 ~ irrl:J CoS,,, mg.>,"", LA CJz..v,z.t,p Name 01 BusrllC!ss Entity, il Invcs.tmenL Jll. Assessor's Parwl Number or Slmol Addwss 01 Resl Propcmy

Description of Business ActMty D[

Cily or Olher Precl5e Locnlion of Real PropC!fty

FAIR fMRKET VALUE

D 52.000 . 510.000 @""fl0,001 - 5100.000

B 5100,001 ·51.000.000 OvC!f 51,000,000

NATURE OF INTEREST o Propeny ONoershtplOeC!d 01 Trusl


---1---1..R. ---1---1..R. ACQUIRED DISPOSED

o Siock o PanllC!rsh,p

[3'ka,ohold ¥( 0 01"'" _________ _ V's. 'cmainlng

o ChC!Ck box if addlrlonal schedules mponing Inveslments or msl propeny em attached

... 1. BUS1N[SS ENTITY OR TRUST

Name

Address (Busin8~ Address Acceplabls)

Check ons

o Trusl, go 10 2 o Buslness EnlUy. comp/a18 Ihe bO)l, then flO 10 2


FAIR MARKET VALUE IF APPUCABLE. LIST DATE: B SO - $1,999 $2,000 . 51D.000 ---1---1..R. ---1---1..R. B 510,001 . $100.000 ACQUIRED DISPOSED

$100,001 . $1,000,000

DOver 51,000,000

NATURE OF INVESTMENT o Ps"""',hlp o Sole Proprlelorshlp 0 1lihiii


to.2 tnENnF¥ THE GROSS l"l{;:O.!!flE RECEiVED tn .. CUU:fE 'tOOR PRO RATA SHM£: OF tHE GROSS INCOME TIl THE Ef'·fiUV!fRUSl1

0'0 -$499 o 510,{m • $100,000

o '500 - $1,000 o aVE R 51 00,000

o ",001 - $10,000

.. .1 U~T 11ft NA,~E m:·-EACH RE~ORTAB!J: SINGl~ SOURCE Of mCOME: OF S1tl,'oOO OR MOR:£' ::'-'illi.l;<h ... ~ ..... _ If """"~ __ :fl

•

Ii>- .Il, INVEStMENfS A~-t:LI! INf{RESiS IN REAL PROFERT'-( HnD QR lEASED fri THE BU$I"NESS ENTITY OR TRUST

Chsck ons box

o INVESTMENT o REAL PROPERTY

NaffiC! 01 Business EnHty. If InveslmenL Jll. Assessor's Psrcel NumbCf or Slr(!-C!1 Addmss 01 Real Propeny

Ocscrlplion 01 Business AcUvUy D[

City or Other PrecrS(! Localion 01 Resl Propony

FAIR MARKET VALUE

B 52,000 • 510,000 510,001 • $100,000 o 5100,001 ·51,000,000

Dover 51,000.000

NATURE OF INTEREST o Propeny OwnorshlplDeed 01 Trusl


---1---1..R. ---1---1..R. ACQUIRED DISPOSED

o Siock o PannC!fship

o Leasehold -::::-:::== V's. 'cmai .... n.g

001"'" _______ _

o ChC!Ck box II addiHonill schC!du1C!s reporting invoslmcnts or msl propC!fty 8m aHached

camments: ______________________ _ FPPC Foon700 (201212013) Sch, A-2 FPPC Advice Email: [email protected]

FPPC Toll-Flee Helpline: 8661275·3772 www.lppc.ca.gov

. . -

SCHEDULE A-' Investments

CALIFORNIAI'ORM 700 fA:~ POln:I~AL PI'tACftl;;.!;;S C(mMISStaN

Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10%)

Name

Do not attach brokerage or financial statements,


-':::1 J rfA,AJ/>~I"CC:: GENERAL DESCRIPTION OF BUSINESS ACTIVITY

FAIR foAARKET VALUE o $2.000 - 510.000 o 5100,001 - $1,000,000

~oo, . $100,000

Dover $1,000,000

!'0TYFE OF INVESTMENT IB"Slock 0 Oth", ____ -:;== ____ _

1D~1bc1 o Panncrsl.ip o Income! RC!((!,ved of SO - $499 o Incume Roceived 01 $500 or MOre! jRep(ll1 on Sc/1edtJIB Cr

IF APPt.ICABLE, LIST DATE:

----.l----.l.JL 05 I 06 1.1L ACQUIRED DISPOSED


,c::;qc....., .. B..ffiG.':> ~t: Ie A GENERAL DESCRIPTION OF BUSINESS ACTIVITY

FAIR foAARKET VALUE

o $2.000 - $10,000 o SlOO,C()1 • $1,000,000

g11"o 001 - $100,000 o O..,(!f $l,OO<U)OO

!'0TYFE OF INVESTMENT lB"Slock 0 OHler _____ ::::---:--;-____ _

IDC"SGlool o Pnnner5hip 0 lI)ComC! RC!coivod of SO - $499 o Income! Received 01 5500 or More! jR9porl on SdleduhJ CI


----f----.l.JL ACQUIRED

----.l----.l.JL DISPOSED



FAIR MARKET VALUE

o $2.000 - $10,000 o $10,001 - 5100,000

o 5100.001 - $1,000,000 o OV(!f $1,()((),ooo

NATURE OF INVESTMENT o Siock 0 Othc< ____ ==-:-___ _ 1[)(N;r,hcl o Psnncrship 0 Incomo Ro(C!lvod 01 $0 - $499

o lI)Como Roceivod 01 5500 01' MOI'o IReport on Schedule Cr


----f----.l.JL ACQUIRED




FAIR MARKET VALUE o $2,000 - $10,000 o 5100,001 - 51,000,000


o 510,001 - 5100,000

DOver 51,000,000

o Siock 0 Otho' - ___ -:;:-:-=,--___ _ I "'="bel o Pannorship 0 Incomo RC!CONOd 01 50 - $499

o lI)Como Ro(C!ivod 01 5500 or Mot(! IRepon on Sch~ule C)


----.l----.l.JL ACQUIRED



GENERAL DESCRIPTION OF BUSINESS ACTIVlTY

FAIR fMRKET VALUE

o $2.000 - $10,000 o 510,001 - 5100,000

o $100,001 - S1.ooo,ooo o OV(!f $1,000,()(()


o Siock 0 Olh'" -----;::-=,-----IDc-;uibel o Pantlef!:ihip 0 lI)Como Receivod 01 50 - $499

o lI)Come Ret:C!ivcd 01 5500 Of Moro IR~ on Schedule C)






FAIR MARKET VALUE

o $2,000 - $10.000 o 510,001 - 5100,000 o 5100,001 - $1,000,000 o Ovor 51,000,000


o Sioek 0 Olh'" -----;;;:=c::----I 0 """"" o Pann(!fsh/p 0 Incomo Roccivod 01 50 - $499

o Incomo RC!Coivod 01 $500 or MOI'o IRepon on Schedule Cr




Commen~: _____________________________________________________________________ _

FPPC Form 700 (2012/2013) Sch. A-1 FPPC Advice Email: [email protected]

FPPCToll-Ftee Helpline: 8661275-3772 www.lppc.ca.gov

1'\,),)t.Mt1LfI4I\H IIi .... V!1::o I\LLt.H tm VU,J/ UU;:J ..... ,-"', ....... , ... , .... v"" .n ..

~ 008/014 ~ .. .

•

.' ~~U"ORNIA ~()RM 700 SCHEDULE D Income - Gifts

l-&llR Ji'Ol mf'JU. filliP !eu c:rtm.tts~~urt

Namo

=-:-c::;;..... A..« \ I;, .J

... N.A.MI: of SOURer: (NOt.an Acrw1,m)

.~.,..t4 A.~[l,..-:)?= F3?ft. AetCMP-\....ol ?Q,1 ~ODRF!ig, (B~u AddJe:t. Atuptabht)

13-3' $.6s;ast=¢!tC!lt .... T -'1c6:l Le#J c9r:Jb •• p, fA 90etT aUSINESS ACTIVITY. tf ANV, OF SOURCe J

~ IQ,( •• ',a ~ P"'~"> ... kcc:!. DII.TF Imm/ddt)y) VALUF Dr S~If'lTIO"l OF Glnl~)

a .. '...2.....! IL • U . .l!o

..Ll:J..J..!iJ.J1.... ' ..... '2 z..

... NAME OF SOI.iRCE (Ncllm Ar1IW1Yf1l)

"UHrt OUSINESS "CTMTY, Ir ANY. OF SOIIRCF.:

~ 4!~tf#:a ~ DAT, (mmId"'111 V.LUE

---1---1_ LI __ _

d .... '.;\1 DrSCI"tIPTI(lN OF qIFT(S)

... N~~£ OF S~! rNollf" Aerenym)

1'" '" ". Il....-, p ~ ... " Co """ l)to· v'h.l

DATr. (_ddlyyl VALUE nFSCRlPTJON OF OIFTlS)

lL..bJJJ-. \ Q'" 10 '\ --=:L;:.::J:!.!.{lO=\').l-__

---1---1_ ~S ___ _

... NAMl! OF SOURCE (NOI All A~1"')

I&).."t;;'ru-

fiaf?c> el. I .,..,!,.},,", FS::=¥ I ):zlY 'ow Lorr= A..lJ1:!&. C1",\o!l2.1.. BUSINCSS ACTIVlTV, IF ~Y. OF SOURer.

LlATC (mmlddlyy) v"',lIC DI!SCRIPTION 0' Qlrr(s)

... NfIME Of 'OU~C[ (NO( an A~l1'ymJ

r .... /tN<:[r I\OORF ~;5 (Bw:fneu Add,. .. ku~tt)

,fir"Cb e; C<'Mr~p ''''.A<.. I ftO'\ ,Cu.. W., ACl1j:fa .. "1'i~:tL BUSlNFSS ACTlVlTif.IF "NY. OF SOURCE

OAT, I.mhld!yy) VAlUE bF.SCRIPnON OF GlfT(')

-... NAMe Of SOURCft INol .n ~"rgnrmJ

ACCRCSS (QUIInsM Adm ... McepIBbIt)

gUS1NESS Ar:nVl rf. Ir I\NY. OF SOUIo\CC

CESCRIP110N or GlrT(S)

---1---1_ " ___ _

camrnonts: _________________________________________________________________________ _

FPPC Farm 100 (2012120131 SCh. 0 F PPC AtMco E:mslil: ad ... leQQlpp'.~a.gou

Fp"'CTou·Flce Holpl,ne: 866121S-3'112 ...-.w.v.1ppC.co,911V

" , .. . . CAl~ORNtAI'ORM 700 STATEMEN'f'PfEGON.OMIC INTERESTSRECg.fV'~L> i'AH? PGtJT1t:IU~ V:il!ACTlCES COMM!s'SmN

A PUBLIC DOCUMENT MAR 01 2013

Plees" type or pn'nl in ink. ! - I

NAME OF FILER

1. Office, Agency, or Court

Agency Name

(LAST)

ALuZj

Di'iision, Boald, Dapartmenl Dislricl ff applicable

~ 1/ filing 101 multiple posliions, I~I below 01 on an aHachmenl,

- U I:'::'

IMIO<JI.£) By: ___ -/!.:'-"

Yow Position

~ency: __________________________________ ___ Pos'ion ________________________________ _

2. Jurisdiction of Office (Check alleasl One box)

0'&a1e

o Mulli-Counly _____________________________ ___

o City r:l _______________ _

3. Typ~f Statement (Check al leasl one box)

[i("Annu.': The period ccveled Is January 1, 2012, thlough December 31, 2012,

The period covered is ____ -*--i thlough Derembel 3 I, 2012,

-1'~AssUmlng OffIce: Dale assumed ~~ ......,

o Judge or Ccurt Commissionel (SIa1ewide JurisdIction)

o Ccunty 01 ____________________________ _

o Othel _____________________ _

o leaving OffIce: Dale LeIl----1----1 ______ _ (Check one)

o The period cove,ed ~ January 1, 2012, Ihlough the dale of Iea~ng office,

o The period coveled is ----1----1' ______ 'hlough Ihe dale o/lea~ng office,

o Candldale: Election yeal __________ __ and office soughl, ff diffelenllhan Part 1: _____________________________ _

4. Schedule Summary Check applicable schedules or "None."

o Jchedule A·l • Inveslmenls - schedule attached

0" Schedule A·2 • Inves/melllS - schedule aHached

o Schedule B • Real Property - schedule attached

-or·

<I" ~ Total number of pages including this cover page: ''1 ·WT...L.,

(f",,"" ........ ) o Schedule C • Jncome. Loans, & BUSiness Positions - schedLJe attached

~Schedule D • Income - Giffs - schedule attached

o Schedule E • Income - Giffs - Travel Paymenls - schedule allached

o None· No wportabJe intelesis on any schedule

5. Verification MAIUNG ADERESS STREET CITY STA1E liP CODE ⁒⁾†

herein and in any attached schedules is lrue and complele. I acknOVJfedge this is a public doaJmenl.

I certify under penalty 01 pe~ury under the (aws 01 the Stale 01 Cellfornla tha

⁾†Signat •⁾•⁊⁾ ›⁊† ‽‹‹‹‹‹‹⁊⁊

FPpe Form 7DD (2012/2013) FPPC Advice Email: [email protected]

FPPC Toll· Free Helpline: 8661275-3772 wwwJppc.ca.gov

(d)(5)

(d)(5)

• ---

SCHEDULE A-' Investments

CALIFORNIA FORM 700 FA;1<l POUTICAL PRACnC;:ES COMMts:5Hm

Stocks, Bonds, and Other Interests (Ownership Inieresl is Less Than 10%)

Name

~"'" 4ttHJ Do not attach brokerage or financial statements.



FAIR MARKET VALUE

D $2,000 - 510,000

D 5100,001 - $1,000,000


D 510,001 - $100,000

DOver $1,000,000

D S10ck DOli"" - ___ -:::--,,-:-___ _ IOc5(;fil>c1

D Penncr~hjp o IllComc Received of SO - 5499 o IllComc Rcccivod or $500 or MDfC rReport on Schedule CJ


---1---1..JL ACQUIRED

---1---1..JL DISPOSED



FAIR MARKET VALUE

D $2,000· $10,000

D $100,001 - $1,000,000


D $10,001 - 5100,000

DOver $1,000,000

D Srock D Othe, - ___ -:::--,---, ____ _ (D=tIel

D Pannership 0 Incomo Roce-lved of $0 - $499 o Income RccC!'ivcd 01 $500 or More rReport on SChedule cr

IF APPliCABLE, LIST DATE

---1---1..1L ACQUIRED

---1---1..1L DISPOSED


GENERAL DE"SCRIPTION OF BUSINESS ACTIVITY

FAIR MARKET VALUE

D $2,000 - $10000

D $100,001 . $1,000,000


D $10,001 . $100,000

DOver $1,000,000

D Srock D Or"", - ___ -:::--::-:-___ _ IOc~lbcl

D Pennership 0 Income Rc-ceivod 01 $0 . $499 o Income Receiv{!{j 01 $500 01 More (RepOf1 on Sct100uie CI






FAIR MARKET VALUE

D $2,000 - $10,000

D $100,001 - $1,000,000


D $10,001 . $100,000

DOver $1,000,000

D Srock D Other ____ ---:::--,-: ____ _ IOc.',C/!bo1

D Pannership 0 Income Received 01 $0 - $499 o Incomo Receiv{!{j 01 $500 or More IRf!port on Schedule CJ






FAIR MARKET VALUE

D $2,000 - $10,000

D $100,001 - $1,000,000


D $10,001 - $100,000

DOver $1,000,000

D Srock D Orh", - ___ -----:::---,-:-___ _ (Dt:rwTbl!1

D Panncrsl1ip 0 Incomo Received 01 $0 . $499 o Incomt! Received 01 $500 or More IReport on Schedule CJ






FAIR MARKET VALUE

D $2,000· $10.000

D $ 100,001 - $1,000,000

D $10,001 . $100.000

DOver $1,000,000

NATURE OF INVESTMENT D Srock D Other - ___ ---=-----:---,---___ _

IOcswbcl

D PilnnershlP 0 Income Receiv{!{j 01 $0 - $499 o IncotTl{) Receivod 01 $500 or More IRepOf1 on Schedule CI




Commems: _______________________________________________________________ _

F ppe Form 700 (201212013) 5ch_ A-1 FPPC Advice Email: [email protected]

FPPC TolI.Free Helpline: B66/275·3772 WWlNJppc.ca,gov

, SCHEDULE A-2 Investments, Income, and Assets

of Business EntitieslTrusts (Ownership Inlerest is 10% or Greater)

CAUI'ORNIA FORM 700 FA!R POLITleAl ~At:Tlefi:~ CCMMt5SmN

to- 1 nUSINESS ENTITY OR TRUST

Name sI\\~

'ISO 5. CO""" t>B,. C¢XA. r-\?;,,, CA '1l&lk Address (Busmess Address Acceptable' I

Check. one o TrUsr, go to 2 o Buslncs~ Entity. complete rhe box, then go to 2


FAIR MARKET VALUE

D SO - $1,999


D $2,000 . $10.000

~.OO1 . 5100,000

$100,001 - $1,000,000

Over $1,000,000


---1---1..1L ACQUIRED

---1---1..1L DISPOSED

D Pannershlp D Sole PropriorDfsl1lp D -----.,.,:;:;------1 OIflCf


Ii> 2. UlE~nu:'Y THE' G"ROSS INCOM~ RECEWED (INClUDE YOUI'l PRO RATA SHAR'E: OF fH~ GHQSS mCOM[ IQ THE E~'TtT'!(iTRUSn

D '0 ~ $499

D $500 ~ 51 ,000 D $1,001 ~ $10,000

~.OO1 - 5100,000 DOVER 51 00,000

.. JUST THE' NAME OF EACH 9[P01HABlE SINGLE SOIJRCE OE' INCOME ot S10.0CHl OR MORE Mi5h"~M~~'-lg"'''''''''''l'

D None

... "", il'..'\IESTMENi5 AND lNTE:tU':SfS IN RtAt PROPEJ!1'V ~EU) OR lEASEI} In: THEe BUS!N;£'S5 ENTITV OR mUS"T

Check one box:

D INVESTMENT D REAL PROPERTY

Namo or BlI5iness EnrHy, II Il1\IesrmC!l1L Q[ Assossor's Pmcel Number or Srreer Addmss or Real Property

DcsctlpHon or Business Activity ill Chy or OrllL'!' Precl5c Loc;lIion of Real Propcny

FAIR MARKET VALUE D $2,000 • $10,000

B $10,001 . $100,000

$100,001 . $1,000,000

D Ovor $1,000,000

NATURE OF INTEREST

D Propcny OwnershipiDcod or Trusr


---1---1.J1. ---1---1..1L ACQUIRED DISPOSED

D srock

D Lensehold D Olhc' ________ _ YIS Icmalning

D Check bOle H" eddlUonel schedules reporting invcsrmenrs or real properry nre eneched

.. 1. BUSINESS ENTITV OR TRUST

Name

Address (Business Address Acceptabre,

Check one

o Trust go to 2 o Busrness EnUry, complfJre rhe box, then go ro 2

FAJR ~,"AUKH VALUf o ~G· ~U~88 D S:VDOO ~ smJJOO o $1G,001 ' SiOO,COQ D $lIJO,r::'1}~ - $1 )}j}O O[~

D O~W SHIDiiJJOO

~1---1..lZ... ACQ"·dlRED

~ __ J 12 DISPOSED

"':2 ID~NfWY THE cm:Q5.S 1~":C.oME R[C£l\fED tlJilCLUDE YOUR PRO RATA SHARE Qf: TH! GROSS E~-!C:OMr ill THE ENTITymmSn

D '0 ~ $499

D '500 ~ $1,000 D $1.001 - $10,000

D $10,001 • $100,000

DOVER $100,000

.. J LIST 114£ NAME OF EACH REPORTABLE SINGLE SQU'RCE OJ' 11ilCOME Q!, S1Ci,0G0 OR MORE. [tlu".;, "' .... f"'<~1" ",=,..f!l i;l """""'"""'~~

•

'" 4 tNVE.ST".JIt:1oJT5 AND !N'f'E;RESTS IN REAL PROPERTY HElD 00 lEASED Sl THE BUSINESS ENTITY 00 TRUST

Check one box

D INVESTMENT D REAL PROPERTY

N1:lme or Business Enrtty, II Invesrmenr. ill Assessor's Parcel Number or Srreer Addre~s 01 Real Propeny

DescripUoo or Business AcrMry JJ! Ciry or OthL'!' Preci~e Locarlon of Re<ll Propc-rty

FAIR MARKET VALUE

B $2.000 - $10,000 $10,001 . $100,000

D $100.001 - $1,000,000

DOver $1,000,000

NATURE OF INTEREST

D Propeny Ownership/Deed of Trust


---1---1..1L ---1---1..1L ACQUIRED DISPOSED

D srock D Pannership

D Leasehold D orhc, ________ _

D Chc-ck bOK ir eddrtional schedules repottJng investments or reel properry are artached

Com me nts: ______________________ _ FPpe Form 700 (2012/2013) 5ch. A~2 FPPC AdvIce Email: [email protected]

FPPC Toll-Free Helpline: B66/275-3772 WWlNJppc.ca.goy

CAUFOI<NIA FORM 700 SCHEDULE D Income - Gifts

FAlR POliTICAL PHA-C'nC!;S C~US:!MON

Name

~v,. A. •• e ,j

... NAME OF SOURCE (Nor en Acronym'

.3;"IlN A. ?e<>?1'; FbI<. llc:pe.Ki'uI ?P'"L ADDRESS (Business Address Acr;eprebleJ

TH' 5·6uu.e ..... ",To "~c6? ","8,"<><:,,<;, (A '@?ti BUSINESS ACTIVITY, IF ANY, OF SOURCE i

~ 1Q{e;'/,a. ~ ~=_lJ ~ 402..

DATE Imrnlddlyyl VALUE DESCRIPTION OF GIFTIS,

~J:...J /2- • '1'1.«0 .ee ...... r.bJ

/2- I-.LJ.J..!::. • tS.&> G<-+bS &-'L.

..il1_!.:f.U..z.... • 38'72- L u." <..tt"6., ,J

... NAME OF SOURCE (Nor an Acronym'

BUSINESS ACTIVITY, IF ANY, OF SOURCE •

-'t' ItiWJ!:f.t'6 ~ DATE Immlddlyy) VALUE

---1---1__ ,>-__ _

• ... NAME OF SOURCE (Nor en Acronym'

ADDRESS (BUSIness Add~ AcceprebleJ

dJd:&1IU;t( DESCRIPTION OF GIFTIS,

BUSINESS ACTIVITY, IF ANY, OF SOURCE

DATE Immrddlyyl VALUE DESCRIPTION OF GIFTISI

---1---1__ ,-, ___ _

---1---1_ .' ___ _

---1---1_ ., ___ _

... NAME OF SOURCE (Nor en Acronym'

tqut::E:r ADDRESS (Busmess Address AcceprebleJ

DATE Immlddlyyl VALUE DESCRIPTION OF GIFTISI

iZ..JilL.!.L • /16. M

.. NAME OF SOURCE (Nor an Acronym,

ADDRESS (Business Address Acceprebre,

6?& .e;.. 1jA1'-l1,o.lO LH...-L. ~ 'tHp w~Ag§ I .,"i 6 Z1... BUSINESS ACTIVITY. IF ANY. OF SOURCE

DATE Immfddryyl VALUE DESCRIPTION OF GIFTISI

• .. NAME OF SOURCE (Nor en Acronym)

ADDRESS fBusmess Address Acceprabre,

BUSINESS ACTIVITY, IF ANY. OF SOURCE

DATE Imrnlddlyyl VALUE DESCRIPTION OF GIFTIS,

---1---1_ • ___ _

---1---1_ • ___ _

Commen~: __________________________________________________________________________________ __

FPpe Form 700 (2012/2013) 5ch. 0 FPPC AdvIce Email: [email protected]

FPPC ToU-Free Helpline: B66/275-3772 WWlNJppc.ca.gov

CJtLlFORNIA FORM 700 CbVERPAGE

FAfR POt.lTlCAl. PRACllC£S cmJjM!~St(j!l'J

A PUI'IUC DOCUMENT

Pleese type or print fn Ink.

NAME OF FIlER ILAST)

I" '1-'" J' ....

".~ r" b' 'lit'" ? (IIODlE)

Allen Travis


CA State Assembly

Divisioo, Board, Deparbnenl Drslricl n appiK:able

~ II filing lor multiple positions, I~I below or on an altachmenl

Your Position

Assemblyman

Agency· ______________________________________ _ Position: ________________________________ _

2, Jurisdiction of Office (Check BI teasl one box)

III Siale

o Mulli-Counly ________________________________ _

DCllyo/ _______________ _

3, Type of Statement (Check al teasl one box)

III Annual:

-or-

The period ccvered is January 1, 2012, through December 31, 2012.

The period covered ~ ~~ 2012 December 31, 2012.

Ihrough

o Assuming Office: Dale assumed ----1----1, ____ _

o Judge or Court Commissioner (Slalewde Jurisdiction)

o Counly 0/ __________________ _

o Other ______________ _

o Leaving OffIce: Date Left ----1----1 ___ _ (Check one)

o The period covered ~ January 1, 2012, thfO\ljJh the dale 01 leaving office,

o The period covered is ----1----1 ____ Ihrough the date of leav'rng office.

o Candlde'e: EleeDon year __________ _ and office soughl, if cfrfferenl than Pari 1: ______________________________ _

4, Schedule Summary Check applicable schedules or "None,"

o Schedule A-' - Inveslmenfs - schedule attached

III Schedule A-2 - Inveslmenls - schedule attached

o Schedule B - Real Property - schedule atlached

-01-

~ Total number of pages including this cover page: __ 4,--_ o Schedule e - Income, Loans, & Business Posffions - schedule attached

III Schedule 0 - Income - Gifts - schedule attached

o Schedule E - Income - Gins - Travel Paymenls - schedule attached

o None - No reportable inleresls on any schedule

5, Verification MAIUNG ADDRESS STREET CITY STATE ZIP CODE

⁾† herein and in any attached schedules is 1rue and comple1e. I acknD'NIedge this is a public document.

I certJfy under penafty of perjury under1he laws of the State of Callfornla tha

DOle Signed 04/19/2013 Signatu ‽⁊‽‽‽‽‽‽⁵⁽⁊

FPpe Form 700 (2012/2013) FPPC Advice EmaU: [email protected]

FPPC ToU-Free Helpline: 866/275-3772 www.fppc.ca.gov

(d)(5)

(d)(5)

", , .... , ....... ,.. tt'tU'tUUo.JI;J IltJ 002/009

~007/0'4 '\J.:JI ~v, "V I.:J I::J.VO r .... 1\ -~,

.' . , . ' ,. SCHEDULE A-2

Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest Is 10% Of' Gre.tor)

.. 1 FJII!iilr>.lES,S [l'-JIII '/ CD TRUS.T

, A )eE.u, .. 'I:b f-~~",,~~ ~::::''1!.1iZ::a10112 N_ .. ".-j~ ~. '~l'\,to3: ¥f!. ~ 1~'.Ia. ~31 ~B jZJ.u,

MC'lrDlii ISf.I:NUnC'k1rt.i' Cr:.ptI&'e) ,

C/'O<k """ o 1r~lI, ~ ~ 2 o 8.u:tln~'$ Enwy, compl.,. lI'I. bcut. Ihen Ql' ~ ~

C;FNERAL OESCRfPnON OF ar.JSJHiSS hCTtvlTV

rAIR MARK", V~LU[ Ir I\PPUC"BLP'.l.I!i OI\TE:

~ 51,'" ---1---1S ---1---1.i?.. 52,000 • 51 O,COJ I .D01· $'100.000 .t\COUIRro UI~FoOSI:O 5100.001. S1,o.x.,000 OVer S1.Clc'lQ,OOQ

NATUR£ OF lNVC5TMEI\I1 Co o p.oomliP 0 Solo p<o~ Oia(P .OUR BU .. N<oS posiTION eC ~ 'I J.~!1l f

'" ~ lITJt,Nhn' WI:. GhQ'Ss IrtU;I;M[ RECf'l\Ibu !If!lCl tj~ YOUR 1'.1:1:1 l:'llUI!o ~HAaf: OF tJolJ:: GROSS 1l'~otJ:V .!!! THi! ~;lYvfl~»sn

§ 50, , .. US 5liOD • 51,000 51,001 • 510,000

[3-!1o,001 . ., 00,000 o O"rR J1oo,000

~ It4Vi!:SruU4 tl,i; ~Nfi Iftll !::.IU s,n. tt"* rflF AlL PHDf"J'qu t-tElO Ctll LE1L~ro I1i T1EL.lilJ~Ii\lF!ilS U·HUY ft~ fl.i'UST

Chtdt' DlJt bo;;(:

o IN"'~STMr'NT o REM. PROI"["R1"Y

~lp4lOn gf DUIilnt.~ N:itlvltt r;r. CIty 01' 0\:hDf p~ Lac:mC)f1 01 ADoJI Propany

rl\lI~ MARICET VALUr IF I\PPUCI\I1l of, WiT DATE:

$10.001·1100,000 ---1---1.Jl.. --'---12L ~ 5Z.DOO· 11O,oal

.s1t'Cl.001 ,,$1,000.000 I\CQur~~C. DISPOS£O 0v0r'1,000.aoo

HA ruKE. or ItfT£RF5T D I-ItnptRV Q\.omtrslup/tk'll10 Ql Tf'\.ISl o Sig ....

o L' ...... """d """""',..,...'tit IItIhMlnJ

0o""" _______ _

o Chi!:. 1)Or: IT iddltJOnol 6d'U.Wfl' rvpQ1\1!10 Il'wO\WIUpll't Dr rqnI ptgpef1J lit.:! MIIIC;h~

... f. lJLl5J"'r'~5 Ef'JTlTY tlH. lI:lJ'';T

Nemel

l\daI'eu l~h/QllJO.n MdlWIJ kC'.gl"~' CJt.d OM

o Tn~ 90 to I o t'US1I'1C'>'" Cntlly, ~I' the bo.t. III." DO IV 2

CENCRAL CESCRIPTION OF BUSINESS ~C;TIVITY

rAIA M/'.R1C1"1 VAlUE: iF ArPI ICf\8Lr. LIST OAT~.

~ '0. '1,no, --'--'.J:L ---1---1.:Jl.. $1,000· $10,000 $10,001 ,$100.000 ACOUIRFO OISI"OSFO

J1oo,001 • t1.ooo,COJ Ovof S 1 000,000

HMUR£ or INVESTMtNT o Ponn~'h!p o SOlo ~ID""""""'" D 0ii0i

yOUR GUSlNF.SS P(j:lolTlON

III> :. InENlu'v 1HE t,';RO§S IN~.YMf nr:CEI1Jl'll tlNt:l,UUL YOU"- p~O fl'A1A StlARr OF 'I! If' r.uQ5S mcQM,£ 1J,l: 11 tt: FNTITYlfRiJ:n~

LI so' 1m o 51 0,001 . 51 00,_ o 1500 • ~1,DC(l o overt "00,000 o S1.oo1 '110,000

.. A. I~ESlfM"P~f!< ltND j~TEf,1F:!~I~ IN F::IE:At, PIU'Jjl~hV HclD OR J ~A!Jr t! alt luI" t-lUSU¥T. 50S OHfTY U.H T;:'US1"

OREAL pAOPil,"V

Dt<»ctlpttm of 0\I51nt'b Mrl'l1ry til: Clay CK' (JI1\Il( I"roc;natl LDCUOOIl 01 RUIlJ .. rg~'1

rAI~ M,A,/.{KH V"~UC Ir APPWCAGLC. LtST DATF·

$10,001 . >100.0011 ---1~..:rL ---1---1.1l.. ~ SZ.OClI • '10,DI.XJ

\100.001 • 11,QM.ooa ACQUIREU DISPOSED tlYtt' J1,oooOOO

NfI,1 I IkF or INTIERE:S' o PtnOt"n'l Qwnftr.'J1ip/C1.lM ftf TrufJ o Stogl.

o LU.l'wl\Okf """-;::== 'tl't rell'ltlrllWlloJ

0001«--_____ _

o CMdi 1;\1 .. II ildl:I'tW/'I." .. c.uutluIQa rvpontng irf."ow.,Iments til ,.oJ pUIIlClty ~ C1'b.C:hL'<I

Commllnts: ________________________ _ FPPC; fOml 700 120121<0,.1 Sell, A.2 fPPC ArlYlce Enwc (UlV1CO~tlppC,Co.gov

FPPC To,·F,.. H~ 8&61275·3172 w.vw.fpp<'c •. O"'

. " ...... --' .'.. " . •• 'tu'tuuu • ..J .... o.Jo.)t.ITIOL.TITlt'lrl Int'lV.L':::' I'ILLt.li ~ 0001 OO~

G!i 008/014 . -. ....... ....... .... . ... . ...... . .... " •

-.' , CAUfORNIA~ORM 700 SCHEDULE D Income - Gifts

liljlR pc.w,mCtLL P.IllOthC;t!; oo~M!SS!UU

NamD

::r;:)"6 '" I L f5 Y

... NAME" of SOURCC (Nor ." A~""'J

I'.ODRFSS (Sw.Imu AdiJreu.ACC.ptableJ

13=3: $. 6&",g~ bT .... "tree Uk AeJb;· n· 'A ?ppt-1 ~USINESS ACTIVrTY. IF ~Y, OF SOURCC J

~ ff!.r,?' Ira ~~ P., t>'" tLQ. O"TF tmm/ddln1 VALUF orSCRIfITIO"4 OF Glnl~l

..JJ:./..kJ21,:. , -t 'I. '(0

1~1...2wJ.b I $,?.!Io

.. NAME OF SOUACE (Nol lit! AMtWlymJ

CA 1?E~P< '&"1'( t:I~

ClUSINESS AcnvrTV. rr ANY, OF' snrrRL.:F.

4'" ""M~ ~ DATe:- ImrnldlilY1J VALUE

..iJ....J~.!..!::... .• (,1. 1'1

----1----1__ .. , ___ _

----1----1 •

oATt. (mm1ddlyyl VALUE

----1----1__ So' ____ _

----1-1_

dId .:9 Dr!5C~IPTI(.N OF GIFT(SI

nFSCRIPTl'::>N OF OIFTIS)

... HAM!! OF SOURCE (NOI.an A~rmJ

't&u~\:ll:

6c:£;Q yl '*t"-\Hc '4;=¥-, DiY" lOLa Lort= ~ "1"'\~2.z. ISUSINCss ACTIVITY. IF ANY, or SOURer.

UATC ImmlddlnJ V.t,luC DESCRIPTIO" O' eler(SI

1<6. ':'1

.. NAME OF SOU~C[ (UOf M AMlr!j1'I1l

rcrutNer

6:t"'r9 e& tAM·#-lP 'If#« , f;fI"t lAc.. BUSlNFSS ACTIVITY. IF ANY, OF SOUAC!

DATt I nmlddlyyl VALUE oF.SCRI?nON OF GltllS)

..l.!!J..i.tz.J..J.b. , 't B' • " 'f

.4CoRL:SS (QuJlneu AddrN. McepID~J

BUSINESS Ar.nVlrf. Ir I\NY, OF SOUli\ct

OE'SCRIPllrlN or GlrTIS)

--...1-1__ ,-, ____ _

Co~.n~: ___________________________________ . _______________________________________ ___

FPPC For'" 100 (2012l2O131 Soh. 0 FPPC Altvlco e:r-nail: .,qvlt:c~/pp'.rIl.gov

FP~C TofI·r:/08 Holplm~ 8661l1S·3712 www1ppc.eo.gov

SCHEDULE A-1 Investments

Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10%)

Do not attach brokerage or financial statements .


FT J Fundchoice GENERAL DESCRIPTION OF BUSINESS ACTIVITY

Investment

FAIR MARKET VALUE

D $2,000 - $10,000

D $100,001 • $1,000,000

~ 510,001 ·5100,000

DOver $1.000,000

NAT4 OF INVESTMENT ifs;;k DOth., ____ ---;;==:-___ _

IDesolbel D Partnership o Income Received of $0 - $499

o Income Ret::eived of $500 or More rReport on Scflffiu/e CJ

IF APPLICABLE, UST DATE:

---1---1-1L ACQUIRED

~~-1L


Securities America

DISPOSED


Investment

FAIR MARKET VALUE

D $2,000· $10,000

D $100,001 - 51,000,000

~ $10,001 • $100,000

DOver $1,000,000

NLeE OF INVESTMENT i!j" ~~ D Ott,., ____ ---;;::--,:-:-___ _ IDesoiool

D Partnership 0 Income Receivad 01 $0 - $4BB o Income Received Dr $500 or More rReport on Scflfldule CJ

IF APPLICABLE, LIST DATE;

---1---1-1L ACOUIRED

~~-1L DISPOSED

... NAME OF BUSINESS ENnTY


FAIR MARKET VALUE

D $2,000 • $10,000

D $100,001 • $1,000,000


D $10,001 - $100,000

DOver $1,000,000

D Slocl< D Othe, -----::0=---:-___ _ rDero1ber

D Partnership 0 Income Received or $0 - $499 o Income Received or $500 or More rReport on Schedule CJ



---1---1-1L DISPOSED

Comments: _________________ _



FAIR MARKET VALUE

D $2,000 • S10,000

D $100,001 - $1,000,000


D $10,001 • $100,000

DOver $1,000,000

D Stock D Olh., ____ --::::--:-:---:-___ _

,'''''''''' I D Pertnershlp 0 Income Received or $0 • ~9S

o Income Receivad of $500 or More rReport all Schedule CJ






FAIR MARKET VALUE

D $2,000· $10,000

D $100,001 • $1,000,000


D $10,001 • $100,000

DOver $1.000,000

D Stock DOth .. ____ -=---,-,-___ _ (DuctJool

D Pertnerehlp 0 Income Recetv&d of $0 • ~S9 o Income Received of $500 or More rR~porI an Schedule CJ





Prim Name fgJ\\J Is' ~:1~e~~gency (fJ ¢;i<1fe ItsrerrJb{y SIl"emen1Type D 201212013 Annual D Assuming D Leevlng

~ __ Annual DCendldale

'''' I have used all reasonable diligence In preparing thIs slalement. I have reviewed thIs slalemenl end 10 the besl of my knowledge the Informallon conlained herein and In any attached sdledules Is true end complele,

I certIfy under penelty of perjury Under 1he laws of the Sta1e of Californle 1ha1 1he foregoIng 1& Hue and correct.

O.'e Signed ____ =S'---::'::::-;;:',-'3o:::c=:-_____ _

FlIer's Slgna1U ⁾‧‧‽⁾† ‧›‧‧ ‧⁾‽‽‽‽‾

FPPC Form 700 Amendmenl (201212013) FPPCAdvice Email: [email protected]

FPPC TolI·Free Helpline: B66/275·3n2 W'M'I.fppc.ca.gov

(d)(5)


of Business EntitieslTrusts (Ownership Interest is 10% or Greater)

.... 1. BUSINESS ENTIlY OR TRUST

Wealth Strategies Group Name

950 South Coast #115, Costa Mesa, CA 92626 Address (Busfness Address AcceprabreJ

Ch&ek one _ /' o Trusr, go ro 2 [If Business En1ity, camp/are rhe box, rhen go to 2


Investment

FAIR MARKET VALUE

D $0 - $1,99'

IF APPLICABLE, LIST DATE

B $2,000 • $10,000

$10,001 - $100,000

~ $100,001 ·511,000,000

DOver Sl,OOO,OOO

---1---1..li. ACOUIRED

---1---1..li. DISPOSED

NATURE OF INVESTMENT D Sole Proprielorshlp D Partnership ~ .cS-'--'C"O"rp"'---= ____ _

00-

YOUR BUSINESS POSITION President


--- ---

... A. INVESTMENTS ANt) INTERESTS IN REAL PROPERTY HELD- OR tEASEO frl mE 8U5IN~SS ~NTITY OR TRUST

Check one box:

D INVESTMENT IRl REAl PROPERTY

950 South Coast #115, Costa Mesa, CA 92626 Name of Business Entity, if InvestmenL Q[

Assessor's Percel Number or Street Address of Reel Property

\ nveMment Descriphon 01 Business Acttvity m City or Other Precise Location of Reel Property

FAIR MARKET VALUE

§ $2,000 • 510,000 $10,001 • $100,000 $100,001 - $1,000,000

DOver $1,000,000

NATURE OF INTEREST

D Property OwnMBhiplDeed of Trusl


---1---1..li. ---1---1..li. ACQUIRED DISPOSED

D Srock D Pertnershlp

~ Leesehold 0 Yl5 mrTI<lJtl109

D O1he, --______ _

D Check bOK if eddltional schedules reporting investmenrs or reel property ere attached

Comments: _________________ _

prtn1 Nama ---'\12.f-WJ'-'-'--''-''~_:cAucLke~')J''___ _ ____:_._------------Offiea, Agancy or Court _-=C-""-!-f't.=--S>,.l.:\1!u,oJlV-=---'{\-'!f: ... S...,,;(m"-'-L!XJ""¥f ______________ _

S1a1emen1 Type D 201212013 Annual if' _ Annual D Assuming (1'1,

D Laavlng D Candida Ie

I have used an reasonable diligence In prepering thIs slalemenll have revle'NeCllhls stalemenl and 10 Ihe besl of my knowledge the Information conlained hereIn and In eny attached schedules is lrue and complele.

I certIfy under penalty of perjury under 1he laws of the Sta1e of CaUfornla

Oa1a Slgnad ----"S~-__c/':-=I":.!>;;;;-=,-----rmonrfl day.,.ea.;

FPPC Form 700 Amendmanl (201212013) FPPC Advice Email: [email protected]

FPPC Toll-Free HelplIne: B661275-3772 W'NWJppc.ca.gov

(d)(5)

•

SCHEDULE D Income - Gifts

... NAME OF SQURCE (Not en Acronym'

JmO ?etE.i!. fir /\'tf5m\'d.y '2.0 \ ?. ADDRESS (Business Address AcceprabJeJ

~S.\1~llerc:\g .st --!JOW. /..Os f'II19G/Or,lII "1001" BUSINESS ACTIVITY. IF ANY, OF SOURCE

kt~J$la/1J( DATE mmldd1yy1 VALUE DESCRIPTION OF GIFTISI

~..1:..J n.. I '"i 'Plo

~..!::..J-.!J::. s gS". tD

!:!::.J..!:i.J I z.. $ 35. S"2..

... NAME OF SOURCE (Nor en Acronym,

CA DeoolYXa.tiG P.a~ ADDRESS (Bus/nBSl Addrcs$ Accepreb!eJ

It..! p]. 2nd <)±#'UJIlJ'~ I CA 1M /I BUSINESS ACTIVITY, IF ANY, OF SOURCE

'PGlibC:<L{ ?et,.-1,tj DATE Imm1tidlyYJ VALUE DESCRIPTION OF GIFT(SI

---1---1_ S ___ _

---1---1 ,

DATE ImmJddiYi VALUE DESCRIPTION OF GIFTISI

---1---1_ $, ___ _

---1---1_ $ ___ _

... NAME OF SOURCE (Nat art At1'OIlymJ

\~cn~et AnDRESS (Bu.Jiness Address Acceptable,

'5I:SD et CArnll\.O J2La,l,1,o3 f}!/pt, a<I "t'fotZ-BUSINESS ACTIVITY, IF ANY, OF SOURCE

Mfl~I~'J~ DATE Imrnlddfyy) VALUE DESCRIPTION OF GIFTISI

oJ

J:bJ/1- 1 /2. $ I~ 0t

..J.!.11- I 1'2- , I K 51

Jl::.J /2,- I 11- s 51 . en. I2tup t7nt I ty!e gfj~ I

... NAME OF SOURCE (Nor en Acron}7l1J

'\(c.klkt ADDRESS (BusiT1{llS ADdress AcceptBbleJ

50/;)) Gt Umftl:O tZt"f./, US Al11s, &l '1'/D1.'2--BUSINESS ACTIVITY, IF ANY, OF SOURCE

'Ud1Yl010~ D.<:y'dol~ DATE Immldd1yy1 AWE DESCRIPTION OF GIFTIS)

..t1J~ Iz,.. $ '"If '$(

n- I~ f1... ,I(C.OI.{

---1---1_ $ ___ _


Prtn1 Name -fggvjS A-[Cly

~~~:.;~gency CA Statv ~m th~

Sta1emen1 Type D201212013Annual DAssumlng DLeevlng

S-:::::lYri Annuel D Condltlele

I have used aU reasonable diligence in preparing thIs statement I have reviewed this sta1emenl end.lo the best afmy kr'IDwledge the information contained herein and In any attadled scheduleS Is true end complete.

I certify under penalty of perjury under the faws of 1he S1a1e of California 1ha11he foregoIng Is true and correct.

D"e 51 gned ---s.‽••‧››⁃‧››•›››‧‧‧‧•‧•⁽‡‹⁌‾※  ⁉‽‽⁾⁾⁾† Flier's Slgna1ure ⁾†

Commen~: _______________________________________________________________________ _

FPPC Fo,m 700 Amendmenl (201212013) FPPC AdvIce EmeU', [email protected]

F'PPC Toll-Free Helpline: 868/275-3772 wwwfppc.ca.gov

(d)(5)

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