Loading...
Feeser, Nadia - Annual 2015-02-25City of Pismo Beach City Clerk's Date InitiaOffice. Filing l Fili STATEMENT OF ECONOMIC INTERESTS FEB 2 ' Fill COVER PAGE Received Please type or print in ink. NAME OF FILER (LAST) (FIRST) (MIDDLE) Feeser 1. Office, Agency, or Court Nadia Khattak Agency Name (Do not use acronyms) City of Pismo Beach Division, Board, Department, District, if applicable Your Position Administrative Services Department Administrative Services Director ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: Oversight Board to the former Pismo Beach RDA 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Multi -County 0 City of Pismo Beach Position: Board Member, Designated Contact Person ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other _ 3. Type of Statement (Check at least one box) © Annual: The period covered is January 1, 2014, through ❑ Leaving Office: Date Left I_ I December 31, 2014. (Check one) -or- The period covered is —L I through December 31, 2014. ❑ Assuming Office: Date assumed I I ❑ Candidate: Election year 4. Schedule Summary Check applicable schedules or "None." [71 Schedule A-1 - Investments – schedule attached 0 Schedule A-2 - Investments – schedule attached El Schedule B - Real Property – schedule attached 5. Verification O The period covered is January 1, 2014, through the date of leaving office. O The period covered is — the date of leaving office. and office sought, if different than Part 1: ► Total number of pages including this cover page: through ❑ Schedule C - Income, Loans, & Business Positions – schedule attached ❑ Schedule D - Income – Gifts – schedule attached ❑ Schedule E - Income – Gifts – Travel Payments – schedule attached "Or. EJ None - No reportable interests on any schedule MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended - Public Document) 760 Mattie Road Pismo Beach CA 93449 ( 805 ) 773-7010 nfeeser@pismobeach.org 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 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 02/25/2015 Signature1� ` (month, day, year) (Flo the odginaNy signed stat -ed with your filing official) FPPC Form 700 (2014/2015) FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE A-1 Investments FAIR POLITICAL PRACTICES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 1006) Nadia Feeser Do not attach brokerage or financial statements. Harmonic Inc HTIL GENERAL DESCRIPTION OF THIS BUSINESS Video Delivery Infrastructure FAIR MARKET VALUE m $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT m Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: _/ /.14 11 X05/,14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Micron Technology MU GENERAL DESCRIPTION OF THIS BUSINESS build memory & semiconductor technologies 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) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on schedule C) IF APPLICABLE, LIST DATE: x.14 01 /08/14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Roundys Inc RNDY GENERAL DESCRIPTION OF THIS BUSINESS retail grocery company FAIR MARKET VALUE Z $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT m Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: x.14 03/04/.14 ACQUIRED DISPOSED Comments: ► NAME OF BUSINESS ENTITY Quinstreet Inc QNST GENERAL DESCRIPTION OF THIS BUSINESS online marketing services & technology compny 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) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: � /14 03/04/14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Echostar Corp GENERAL DESCRIPTION OF THIS BUSINESS global satellite services provider 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) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: —/ 14 02 121 / 14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Amern Eqty Invt Life Hid AEL GENERAL DESCRIPTION OF THIS BUSINESS develop & sale fixed index & fixedrate annuities 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) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 04/09/14 08/20/14 ACQUIRED DISPOSED FPPC Form 700 (2014/2015) Sch. A-1 FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE A-1 CALIFORNIA . m 700' Investments FAIR POLITICAL PRACTICES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) Nadia Feeser Do not attach brokerage or financial statements. ► NAME OF BUSINESS ENTITY Kosmos Energy LTD F KOS GENERAL DESCRIPTION OF THIS BUSINESS oil and gas exploration & production company FAIR MARKET VALUE m $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT m Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 11 X05)14 14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Kindred Healthcare Inc KND GENERAL DESCRIPTION OF THIS BUSINESS health care services company 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) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 08/20/14 14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Verizon Communications VZ GENERAL DESCRIPTION OF THIS BUSINESS communications, information & technology FAIR MARKET VALUE m $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT m Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 03 /04 1. 14 �/. 14 ACQUIRED DISPOSED Comments: ► NAME OF BUSINESS ENTITY AES Corp AES GENERAL DESCRIPTION OF THIS BUSINESS global power, generation, & distribution cmpny 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) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 01)09/.14 1. 1. ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Cardinal Health Inc GENERAL DESCRIPTION OF THIS BUSINESS health care services company FAIR MARKET VALUE W] $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT m Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 01 /09)14 14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Verizon Communications VZ GENERAL DESCRIPTION OF THIS BUSINESS communications, information & technology FAIR MARKET VALUE m $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 04)15/.14 14 ACQUIRED DISPOSED FPPC Form 700 (2014/2015) Sch. A-1 FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE A-1 CALIFORNIA FORm 700 Investments FAIR POLITICAL PRACTICES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) Nadia Feeser Do not attach brokerage or financial statements. ► NAME OF BUSINESS ENTITY Verizon Communications VZ GENERAL DESCRIPTION OF THIS BUSINESS communications, information & technology FAIR MARKET VALUE ® $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT m Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 08/20/14 14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS 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) F-1PartnershipO Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: �. 14 1 /.14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS 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) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: �. 14 /, 14 ACQUIRED DISPOSED Comments: ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS 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) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: � 1 14 14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS 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) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: �, 14—/ 14 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $10o,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: �. 14 14 ACQUIRED DISPOSED FPPC Form 700 (2014/2015) Sch. A-1 FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE A-2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) P� 1. BUSINESS ENTITY OR TRUST Mark R. Feeser, Attomey at Law Name 3940-7174 Broad St., San Luis Obispo, CA 93401 Address (Business Address Acceptable) Check one ❑ Trust, go to 2 ® Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS law practice, legal services FAIR MARKET VALUE IF APPLICABLE, LIST DATE: 7$0-$1.999 ❑ $2,000 - $10,000 .14 �� 14 ® $10,001 - $100,000 ACQUIRED DISPOSED ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Partnership m Sole Proprietorship ❑ Other YOUR BUSINESS POSITION none, spouse's business • -• •genial ❑ $0 - $499 W1 $10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,001 - $10,000 11� 3. LIST THE NAME OF -•-TABLE SINGLE SOURCE OF ❑ None or ✓� Names listed below State of California - Administrative Office of the Courts 1- 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD .- LEASED BY THE BUSINESS ENTITY . TRUST - Check one box: ❑ INVESTMENT ❑ REAL PROPERTY Name of Business Entity, if Investment, BL Assessor's Parcel Number or Street Address of Real Property Description of Business Activity PI City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 El $110.001 - $100,000 �� 14 �� 14 ❑ $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST ❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership ❑ Leasehold❑ Other Yrs. remaining ❑ Check box if additional schedules reporting investments or real property are attached CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name Nadia -- 1. BUSINESS ENTITY . TRUST - Name Address (Business Address Acceptable) Check one ❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $0 - $1,999 ❑ $2,000 - $10,000 �� 14 � /14 ❑ $10,001 - $100,000 ACQUIRED DISPOSED ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Partnership ❑ Sole Proprietorship ❑ Other YOUR BUSINESS POSITION SHARE OF -•SS INCOME TO THE ENTITYITRUST) ❑ $0 - $499 ❑ $10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,001 - $10,000 11� 3. LIST THE NAME OF ••-TABLE SINGLE SOURCE OF INCOME OF $10,000 OR MORE (Att-h . None or Names listed below 11- 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD .- LEASED BY THE BUSINESS ENTITY . TRUST - Check one box: ❑ INVESTMENT ❑ REAL PROPERTY Name of Business Entity, if Investment, Q[ Assessor's Parcel Number or Street Address of Real Property Description of Business Activity or City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 14 _j___j14 ❑ $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OFINTEREST ❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership ❑ Leasehold [:] Other Yrs. remaining ❑ Check box if additional schedules reporting investments or real property are attached FPPC Form 700 (2014/2015) Sch. A-2 Comments: FPPC Advice Email: advice@fppc.ca.gov FPPCToll-Free Helpline:866/275-3772 www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS CITY San Luis Obispo FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001- $100,000 4 © $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 Name Nadia Feeser ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS CITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 4 ❑ $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 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' I I 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: 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 (2014/2015) Sch. B FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov