Shadwell, Dan - Candidate 2020-08-09STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A PUBLIC DOCUMENT
Please type or print in ink.
NAME OF FILER (LAST) (FIRST)
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
Division, Board, Department, District, if applicable Your Position
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction Of Office (Check at least one box)
❑ State
❑ Multi -County
City of<-}-
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2019, through
December 31, 2019.
-or-
The period covered is through
December 31, 2019.
❑ Assuming office: Date assumed ----J---J- —
City of Pismo Beach
City Clerk's Office
:if F I,l,g
F,'"fG 07 2020
Received
(MIDDLE)
C—
Position: M 0 `? ` ZA— Fes" 1& t hAfr_
❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of
❑� Other
❑ Leaving Office: Date Left I I
(Check one circle.)
O The period covered is January 1, 2019, through the date of
leaving office.
.or-
0 The period covered is I I through
the date of leaving office.
Candidate: Date of Election/ ivr�a°and office sought, if different than Part 1
Schedule Summary (must complete)
Schedules attached
► Total number of pages including this cover page:
❑ Schedule A-1 - Investments - schedule attached
❑ Schedule A-2 - Investments - schedule attached
5�*fchedule B - Real Property - schedule attached
-or- ❑ None - No reportable interests on any schedule
5. Verification
Z
❑ Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
(, _ Pfs ..o _Q- CA-- `33
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS /
(
1 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 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 SignedI 1z.,c7" Signature
(month, day, year) �97., ent with your filing official.)
FPPC Form 700 - Cover Page (2019/2020)
advice@fppc.ca.gov • 866-275-3772 - www.fppc.ca.gov
Page - 5
SCHEDULE 6
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 -/s / 12
F2<100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
7ow
RE OF INTEREST
nership/Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
510,001 - $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
❑ None
hbMIWA =1f�1_�'
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
d-9- -J-/-1-9-
❑ $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 - $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
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
❑ None
* You are not required to report loans from a commercial lending institution 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 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
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 - Schedule B (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page -11