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Davison, James - Annual 2020-02-06 DagitHilgil RR63 ived CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS Cit9l`t;IgFtigt ff' ve FAIR POLITICAL PRACTICES COMMISSION FEB 0 6 2020 AMENDMENT COVER PAGE Please type or print in ink. NAME OF FILER (LAST) (FIRST) (MIDDLEF"iv'd Davison James Daniel 1. Office, Agency, or Court Agency Name (Do not use acronyms) Conference&Visitors Bureau Division, Board, Department, District, if applicable Your Position City of Pismo Beach Board Seat ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑State ❑Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction) ❑Multi-County ❑County of x❑City of Pismo Beach ❑Other 3. Type of Statement (Check at least one box) ❑x Annual: The period covered is January 1,2019, through ❑ Leaving Office: Date Left_1_1 December 31,201 (Check one circle.) -or- The period covered is_i� 2020 , through 0 The period covered is January 1,2019,through the date of December 31,2019. leaving office. -or- • Assuming Office: Date assumed_/_/ 0 The period covered is_/_/ , through the date of leaving office. ❑ Candidate: Date of Election and office sought, if different than Part 1: 4. Schedule Summary (must complete) ► Total number of pages including this cover page: Schedules attached ❑ Schedule A-1 -Investments—schedule attached x❑ Schedule C-Income, Loans, &Business Positions—schedule attached ❑ 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- ❑ None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended-Public Document) 100 Stimson Ave Pismo Beach CA 93449 DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS ( 805 ) 234-4863 gm@sandcastlehotelonthebeach.com I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the .-.t-of miry knu edge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public docum I certify under penalty of perjury under the laws of the State of California that the foreg 6 D is true and correct. Date Signed 2/6/2020 Signature ----- (month,day,year) (File the originally signed paper statement with your filing official.) FPPC Form 700 (2019/2020) advice@fppc.ca.gov•866-275-3772•www.fppc.ca.gov SCHEDULE C CALIFORNIA FORM 700 Income, Loans, & Business FAIR POLITICAL PRACTICES COMMISSION Positions AMENDMENT (Other than Gifts and Travel Payments) ► 1. INCOME RECEIVED ► 1. INCOME RECEIVED NAME OF SOURCE OF INCOME NAME OF SOURCE OF INCOME Pacifica Hotels ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable) 100 Stimson Ave, Pismo Beach, CA 93449 BUSINESS ACTIVITY, IF ANY,OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION YOUR BUSINESS POSITION General Manager GROSS INCOME RECEIVED ❑ No Income-Business Position Only GROSS INCOME RECEIVED ❑ No Income-Business Position Only 0$500-$1,000 0$1,001 -$10,000 0$500-$1,000 ❑$1,001-$10,000 ❑$10,001-$100,000 j OVER$100,000 ❑$10,001 -$100,000 ❑OVER$100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑X Salary ❑Spouse's or registered domestic partner's income ❑Salary ❑Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) (For self-employed use Schedule A-2.) 0 Partnership(Less than 10%ownership.For 10%or greater use 0 Partnership(Less than 10%ownership. For 10%or greater use Schedule A-2.) Schedule A-2.) ❑Sale of ❑Sale of • (Real property,car,boat,etc.) (Real property,car,boat,etc.) ❑ Loan repayment ❑ Loan repayment ❑ Commission or ❑ Rental Income,list each source of$10,000 or more ❑ Commission or ❑ Rental Income,list each source of$10,000 or more (Describe) (Describe) • ❑ Other ❑Other (Describe) (Describe) Comments: ► 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD * You are not required to report loans from a commercial lending institution,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(Business Address Acceptable) SECURITY FOR LOAN BUSINESS ACTIVITY, IF ANY,OF LENDER ❑ None ❑ Personal residence ❑ Real Property Street address HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500-$1,000 City ❑$1,001 -$10,000 ❑Guarantor 0$10,001 -$100,000 ❑OVER$100,000 Other (Describe) Filer's Verification Print Name - Office,Agency or Court Statement Type ❑2019/2020 Annual ❑ Annual ❑Assuming ❑Leaving ❑Candidate (yr) 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. Date Signed Filer's Signature (month,day,year) FPPC Form 700-Schedule C(2019/2020) advice@fppc.ca.gov•866-275-3772•www.fppc.ca.gov