Schedule A-1, Investments: Stocks, Bonds, and Other Interests (Ownership Interest is Less than 10 Percent)

Do not attach brokerage or financial statements.

California Form 700 (2016/2017) Fair Political Practices Commission
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Name:

Name of Business Entity:

General Description of this Business Activity:

Fair Market Value:

$2,000-$10,000

$10,001-$100,000

$100,001-$1,000,000

Over $1,000,000

Nature of Investment

Stock

Other - Describe Other:

Partnership

  • Income Received of $0 - $499
    or
  • Income Received of $500 or More (Report on Schedule C)

If Applicable, List Date in 2016.
Acquired: month/day:
Disposed: month/day:

Name of Business Entity:

General Description of this Business Activity

Fair Market Value:

$2,000-$10,000

$10,001-$100,000

$100,001-$1,000,000

Over $1,000,000

Nature of Investment

Stock

Other - Describe Other:

Partnership

  • Income Received of $0 - $499
    or
  • Income Received of $500 or More (Report on Schedule C)

If Applicable, List Date in 2016.
Acquired: month/day:  
Disposed: month/day:

Name of Business Entity:

General Description of Business Activity:

Fair Market Value:

$2,000-$10,000

$10,001-$100,000

$100,001-$1,000,000

Over $1,000,000

Nature of Investment

Stock

Other - Describe Other:

Partnership

  • Income Received of $0 - $499
    or
  • Income Received of $500 or More (Report on Schedule C)

If Applicable, List Date in 2016.
Acquired: month/day:
Disposed: month/day:

Name of Business Entity:

General Description of Business Activity:

Fair Market Value

$2,000-$10,000

$10,001-$100,000

$100,001-$1,000,000

Over $1,000,000

Nature of Investment

Stock

Other - Describe Other:

Partnership

  • Income Received of $0 - $499
    or
  • Income Received of $500 or More (Report on Schedule C)

If Applicable, List Date in 2016.
Acquired: month/day:  
Disposed: month/day:

Name of Business Entity:

General Description of Business Activity

Fair Market Value

$2,000-$10,000

$10,001-$100,000

$100,001-$1,000,000

Over $1,000,000

Nature of Investment

Stock

Other - Describe Other:

Partnership

  • Income Received of $0 - $499
    or
  • Income Received of $500 or More (Report on Schedule C)

If Applicable, List Date in 2016.
Acquired: month/day:  
Disposed: month/day:

Name of Business Entity:

General Description of Business Activity:

Fair Market Value:

$2,000-$10,000

$10,001-$100,000

$100,001-$1,000,000

Over $1,000,000

Nature of Investment

Stock

Other - Describe Other:

Partnership

  • Income Received of $0 - $499
    or
  • Income Received of $500 or More (Report on Schedule C)

If Applicable, List Date in 2016.
Acquired: month/day:  
Disposed: month/day:

Comments:

[End of Schedule A-1 Investments: Stocks, Bonds, and Other Investments]