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CITY OF ADELANTO
Office of the City Clerk
Candidate’s Packet for the
2020 Election Year
Brenda Lopez
City Clerk, City of Adelanto
11600 Air Expressway
Adelanto, CA 92301
Phone: (760) 246-2300 ext. 11123
Fax: (442) 249-1121
E-Mail: blopez@ci.adelanto.ca.us
www.ci.adelanto.ca.us
Regular Office Hours:
Open 7 a.m. to 6 p.m. Monday through Thursday
Closed every Friday, and
Closed daily between noon and 1:00 p.m. for
lunch
City Clerk Office Staff:
Virginia Cervantes, Executive Assistant
Table of Contents
Introduction
Disclaimer/Notice
City Clerk’s Letter to Candidates
Candidate Qualifications
Elected Officials Compensation
About City Government
Being A Member of the City Council
Adelanto’s Form of Government
Candidate Information
Questions Frequently Asked by Candidates
Summary of Forms/Documents
FPPC Campaign Statement Deadlines
Contact Information
Biographical Form
Use of Biographical Form
Information is a Public Record
Form
Nomination Process
General Notes to Candidates
Process for Filing Nomination Papers
Example of Nomination Papers
Ballot Designation
Ballot Designation Worksheet
Ballot Designation Regulations (E.C. 13107)
Ballot Designation Guide
Ballot Designation Election Code Information
Campaign Disclosure Requirements
Campaign Reporting
Campaign Disclosure Manual 2
Information for Local Candidates
Candidate/Treasurer Workshop
Getting Started (Campaign Forms)
Surplus Funds
Statement of Economic Interests Form 700 Example
Limitations and Restrictions on Gifts, Honoraria, Travel and Loans (Feb. 2019)
Table of Contents-Pg. 2
Code of Fair Campaign Practices
Code of Fair Campaign Practices Form and Information
Timing for Filing the Code
Code of Fair Campaign Practices Elections Code, Division 20, Chapter 5,
Candidate’s Statement of Qualifications – E.C. 18351
Candidate’s Statement for Official Sample Ballot
Cost of Statement
Content
Word Count
Public Viewing Period
Writ of Mandate
Confidentiality of Statements
False Statements/Fines
Candidate Statement Style Guidelines (Attachment A & B)
Candidate Statement Form
Withdrawal of Statement
Campaign Practices Regulations
Mass Mailing Requirements (G.C. 84305)
Political Sign Regulation (City of Adelanto Municipal Code, Title 17)(Attachment B)
Dept. of Transportation Political Signs
Temporary Political Signs on Commercial Property
Distribution of Notices and Handbills (City of Adelanto Municipal Code, Title 9)
Election Activities in General
Politics in City Hall
Solicitation of Political Contributions; Offense; Punishment-G.C.§3205
False or Misleading Information to Voters
Electioneering on Election Day (E.C. 18370)
Candidate Forum
Election Night Activities
Canvass
City of Adelanto
Disclaimer/Notice
OFFICE OF THE PH. (760) 246-2300 ext. 11123 or 11124
CITY CLERK FAX (442) 249-1121
THIS CANDIDATE HANDBOOK IS PROVIDED WITH THE
UNDERSTANDING THAT THE CITY CLERK IS NOT ENGAGED IN
RENDERING LEGAL, ACCOUNTING, OR OTHER PROFESSIONAL
SERVICE.
THE ENCLOSED MATERIALS ARE SUPPLIED IN AN EFFORT TO
ACCOMMODATE THOSE PARTIES INTENDING TO BECOME
CANDIDATES FOR ADELANTO MUNICIPAL OFFICE.
ALL PERSONS DESIRING TO BECOME A CANDIDATE ARE
ENCOURAGED TO REFER TO CONSITUTIONAL, STATUTORY,
REGULATORY AND CITY CODE PROVISIONS THAT MAY APPLY TO
ELECTIONS AND CANDIDATES.
City of Adelanto
Adelanto Governmental Center
11600 AIR EXPRESSWAY
ADELANTO, CALIFORNIA 92301
cherrera@ci.adelanto.ca.us
OFFICE OF THE PH. (760) 246-2300
CITY CLERK FAX (442) 249-1121
July 13, 2020
Dear Candidate:
Congratulations on your decision to run for elected public office and your desire to serve the citizens of
the City of Adelanto.
This candidate’s packet has been prepared to help guide you through the election process. In support of
GOING GREEN we have provided a Thumbdrive and have made the Candidates Handbook available on
the City Website www.ci.adelanto.ca.us. The Candidate’s Handbook contains instructions, campaign
form links from FPPC to download, statement of economic interests form, candidate statement
information, and various other information you will need as a candidate for City Council. This
handbook has been prepared to assist Candidates in the election process by providing guidance only. It
is not intended to provide legal advice. Candidates and others using this book must bear full
responsibility for making their own determinations as to legal standards, duties, and factual material.
FPPC will have a Candidate/Treasurer Workshop Webinar on their website. There is a video available
regarding Candidate Treasurer Committees by following the link
https://www.youtube.com/watch?v=sLXfEGpyExw&feature=youtu.be .This workshop helps
the candidate to avoid some of the pitfalls and problems of a campaign.
It is imperative to thoroughly review all information in order to be aware of the responsibilities of a
candidate for public office.
Your nomination paper, ballot designation worksheet, Candidate’s Statement of Qualifications, payment
of fees, Code of Fair Campaign Practices form, Political Sign Notification Sheet, and required FPPC
forms must be filed together, in my office, before the close of the filing period on Friday, August 7
2020, by 12:00 p.m., or if extension of nomination period then to August 12, 2020, by close of
business day.
If I can be of further assistance during the nomination period, please feel free to contact me at ext. 11123
or my elections staff: Executive Assistant to the City Manager, Virginia Cervantes at ext. 11124.
Sincerely,
Brenda Lopez
City Clerk, CMC
Candidate Qualifications/Compensation & About City Government
Candidate Qualifications
A person is eligible to hold office if he/she is a United States citizen, 18 years of age or
older, and is a registered voter residing within the City of Adelanto city limits and shall
have been a bona fide resident of the City for at least thirty (30) days next preceding the
date of the election. A Candidate may not have been convicted of designated crimes
specified in the Constitution and Laws of the State.
The above qualifications will be verified through San Bernardino County voter
registration files prior to the issuance of a nomination package. Elector and resident
status must be maintained during the term of office.
Elected Officials Compensation (Ord. 595)
Members receive $708.40 a month with an optional medical benefit package.
The Mayor receives $924.00 a month with an optional medical benefit package.
About City Government
The City of Adelanto was incorporated in 1970. In 1992, Adelanto City Voters adopted
a City Charter (municipal constitution) and a City Council-City Manager form of
government, which is still used today.
The City Council consists of an elected Mayor and four elected Council Members
serving four year terms. The City has no term limits. Each Council Member must
reside in the City. Elections are staggered, and held in even numbered years.
Measure U (Creating the office of an elected Mayor for a 2-yr. term) was approved by
the City voters on November 5, 2002, which provides for an elected Mayor to serve a 2
year term.
Measure D (To elect the Mayor for a 4-yr. term) was approved by the City voters on
November 2, 2004, which provides for an elected Mayor to serve a 4-year term.
Being a Member of the City Council
In General
Each City Council Member represents the City at large, there are no districts, and serve
as a liaison between the residents, businesses, and City staff. The Council meets at
least once per year to develop the City’s strategic goals. The City Council also
represents the City on the following agencies: Adelanto Public Financing Authority,
Adelanto Public Utility Authority, and Adelanto Community Benefit Corporation.
Meetings
The City Council holds “regular” public meetings every second and fourth Wednesday,
at 7:00 p.m. in the City Council Chambers on the first floor of City Hall. Preceding each
Council Meeting, there is a Closed Session held at 6:00 p.m. Special, Adjourned,
Workshops, and Emergency Meetings may be held as needed.
Special Meetings of the City Council may be called at any time by the Mayor or three
members of the City Council by written notice to each member of the City Council.
Agenda materials are in the form of an electronic agenda packet, which the City Clerk’s
Office produces for the City Council, and makes it available in a Dropbox link it is also
published on the City’s website www.ci.adelanto.ca.us for access by the public from any
internet location. A hardcopy is also provided at the reception’s counter 72 hrs. before
the meeting.
Duties
The Council establishes City policies, ordinances, and land uses; approves the City’s
annual budget, contracts, and agreements; hears appeals of decisions made by city
staff or citizen advisory groups; and appoints a representative to the Planning
Commission / Parks & Recreation Commission.
Other Activities of the City Council
Members of the City Council may also serve as the City’s representative on advisory
boards, committees, agencies, or organizations such as (not all inclusive):
SBCTA
City Select Committee
High Desert Corridor JPA
Victor Valley Transit Authority
Adelanto Community Resource Center
Adelanto Youth Accountability Board
San Bernardino County Solid Waste Mgmt. Division
Mojave Desert Air Quality Mgmt. District – Emission Reductions Committee
League of Calif. Cities Desert Mountain Division
High Desert Opportunity
Mojave Desert Air Quality Mgmt District – Governing Board
Mojave Desert and Mountain Integrated Waste JPA
VVEDA
Questions Frequently Asked by Candidates
Is there a filing fee involved in my candidacy?
There is a filing fee of twenty-five dollars ($25.00) established for processing a
candidate’s nomination papers required to run for municipal office.
What if I change my mind about being a candidate after filing nomination papers?
You may withdraw as a candidate at any time PRIOR to the close of the nomination
period, which is August 7, 2020, by close of business day, or August 12, 2020 by close
of business day if the nomination period is extended). Withdrawal must be submitted
in writing to the City Clerk’s Office. You are NOT permitted to officially withdraw after
that date, and your name will appear on the ballot.
What happens if some of the people whose signatures I obtained on my
nomination papers are not registered voters or do not live within the City?
It is important that you file your nomination papers as early as you can, because the
City Clerk must certify the signatures on nomination papers. If you wait until the last
day, and your sponsors’ signatures, for any reason, are insufficient, you will not have
qualified as a candidate. If you file early, there will be time to check the signatures
and notify you of any insufficiencies; you may have an opportunity to circulate a
supplemental nomination papers to qualify as a candidate.
How soon will a list of qualified candidates be available after the close of the
nomination period?
The nomination period closes on August 7, 2020, at 12:00 p.m. unless an incumbent
does not file and the period is extended to August 12, 2020. A list of candidates will be
prepared the next working day, and should be available for distribution by 6:00 p.m. on
Monday, August 10, 2020, or on Thursday, August 13, 2020. The list will be posted on
the City Hall’s outdoor public display board and outside the City Clerk’s Office.
When will the official results of the election be received and certified as correct?
The Registrar of Voters must canvass the election and certify the results by the fourth
Friday after the election. The City Clerk will present the results to the City Council for its
acceptance at the City Council meeting of December 9, 2020.
When will the newly-elected Council Members take office?
The oath of office will be administered on December 9, 2020 in the City Clerk’s Office,
call for an appointment between 7:00 a.m. – 6:00 p.m. The ceremonial swearing in will
take place at the City Council Meeting of December 9, 2020.
SUMMARY OF FORMS/DOCUMENTS
NOMINATION DOCUMENT
PURPOSE
1. Candidate’s Handbook & Candidate Packet
Explains rules/requirements and has hardcopy
forms, thumbdrive, etc.
2. Declaration of Candidacy (includes ballot
designation and oath of allegiance)
Form that qualifies an individual to be placed
on the official ballot. It must be completed
and filed by the filing deadline.
3. Ballot Designation Worksheet
Each candidate who submits a ballot
designation shall file a ballot designation
worksheet that supports the use of that ballot
designation by the candidate.
4. Candidate’s Statement Form
This form is used to state the education and
qualifications of the candidate. It must be
filed at the time the Declaration of Candidacy
is filed. Filing a statement is optional.
5. Code of Fair Campaign Practices
These are basic principles of decency, honesty,
and fair play, which every candidate for public
office has a moral obligation to uphold. This is
a voluntary form.
6. Campaign Disclosure Filing Forms &
Instructions
These forms are used to disclose campaign
receipts and expenditures. Appropriate forms
and instructions will be given to comply with
FPPC rules on establishing accounts, reporting
contributions and expenditures, etc.
7. Statement of Economic Interests
The Form 700 (SEI) must be filed by the close
of the nomination period
CONTACT INFORMATION
Adelanto City Clerk
11600 Air Expressway
Adelanto, CA 92301
PH: (760) 246-2300 ext. 11123
FAX: 442-249-1121
E-mail: BLopez@ci.adelanto.ca.us
City of Adelanto
Access to Adelanto City Municipal
Code and City Charter
Internet:
http://library.amlegal.com/nxt/gateway.dll/California/adelanto_ca/
San Bernardino County
Registrar of Voters
777 East Rialto Avenue
San Bernardino, CA 92415-0770
1-909-387-8300
FAX: 909-387-2022
Leslie Yeun (Exec. Sec. ) 909-387-2083
Fair Political Practice Commission
428 J Street, Ste. 450
P.O. Box 807
Sacramento, CA 95812-0807
Technical Assistance Division (916) 322-5660 or
866-ASK-FPPC (toll free)
Website: www.fppc.ca.gov
Secretary of State
1500 11
th
Street, Room 495
P.O. Box 1467
Sacramento, CA 95812-1467
Political Reform Division: (916) 653-6224
FAX: (916) 653-5045
State Attorney General
Brown Act Requirements
PH: (800) 952-5225
Internet: http://www.caag.state.ca.us
E-mail: PIU@DOJ.ca.gov
Biographical Form
Use of Biographical Form
As a courtesy to the public, news media and the City, a candidate may submit a
biographical form (in a form provided by the Clerk) disclosing personal information
about his/her background, family, education, memberships and hobbies. Alternate
formats or supplemental information will not be accepted.
If the candidate elects to submit this form, it must be filed on the filing deadline for
nomination documents. Submission of this form is optional. (Enclosed is biographical
form)
Information is a Public Record
If you choose to submit the Biographical Form, it will be used to provide information
over the phone and will be posted on the Internet. As this information is a public record
and will be duplicated at the request of any interested party, candidates are encouraged
to provide legible, accurate and verifiable information.
Biographical Form
Name:________________________________________________________________
Address:_______________________________________________________________
Date of Place of Name of
Birth:_______________ Birth:__________________ Spouse:______________
Names and Ages of Children:_____________________________________________
_____________________________________________________________________
Years of Residency in City:________________ Formerly of:_____________________
Occupation:____________________________
Education & Training:____________________________________________________
______________________________________________________________________
Service Record:_________________________________________________________
______________________________________________________________________
Membership and Offices Held in Civic, Religious, Fraternal or Technical Associations:
______________________________________________________________________
______________________________________________________________________
Hobbies:______________________________________________________________
______________________________________________________________________
Campaign Manager/Treasurer Name:
Campaign Phone #:__________________ E-mail Address:
Home Phone #:____________________ Business Phone #:_____________________
Cell Phone #:
I authorize the City to post the information above on the Internet and release it to the public in
connection with my candidacy:
Date:__________________ _____________________________________
Signature
- THIS DOCUMENT IS PUBLIC INFORMATION -
General Notes to Candidates
CANDIDATES MUST PERSONALLY FILE THEIR PAPERS FOR THE FOLLOWING
REASONS:
a. The candidate must take the Oath of Affirmation, administered by the City Clerk
or her Deputy.
b. The candidate’s signature is required on many documents involved in the
election process.
c. If through an oversight the nomination papers are incomplete, the problem can
easily be rectified when the candidate files in person.
Since there are a number of instructions to review and documents to complete, it is
strongly recommended that candidates make appointments with the City Clerk (760)
246-2300 ext. 11123 to file paperwork at the Office of the City Clerk, City Hall, 11600 Air
Expressway, Adelanto. Please allow a minimum of 45 minutes to 1 hour to file
nomination papers.
You are considered a candidate when your nomination documents have been filed and
verified.
Ballot order of Candidates
The drawing of the letters of the alphabet for order of candidates’ names on the ballot
will be done by the Secretary of State on August 13, 2020. We will notify the
candidates of the ballot order.
Withdrawal of Candidacy/Candidate Statement
Candidates may withdraw their Nomination until the close of the nomination period
August 7, 2020, by close of business day, or if extension of nomination period then to
August 10, 2020, by close of business day. The $25 filing fee is not refundable.
Candidates may withdraw their candidate statements August 10, 2020, by close of
business day, unless there is an extension of the nomination period then August 13,
2020, by close of business day. Withdrawal of candidate statements must be in writing
to the City Clerk. A refund of the estimated cost for printing the statement will be made
within 30 days of the election.
NOTE: Once a statement is withdrawn, it cannot be filed again.
The fee paid for the estimated cost of printing the Candidate’s Statement will be
reimbursed if the candidate withdraws no later than the above date and time.
A candidate is not permitted to withdraw his/her nomination after close of business on
August 10, 2020, or if extension of nomination period then August 13, 2020 by close of
business day and the candidate’s name will appear on the ballot.
Process for Filing Nomination Papers
Nomination Period
The nomination period for obtaining and submitting candidacy documents for Two City
Council positions is Monday, July 13, 2020, through Friday, August 7, 2020 by 12:00
p.m.
Time extension: If an incumbent fails to file then the candidates shall have from 7:00
a.m. until close of business day on Wednesday, August 12, 2020
Nomination Papers
Pick up the candidate packet from the City Clerk’s office it will have your nomination
petition paper and other documents.
It is recommended that you submit your nomination petition paper to the City Clerk’s
Office well in advance of the deadline in case it is determined that you do not have the
required minimum valid signatures, thus allowing you sufficient time to remedy the
situation before the filing deadline. (See attached example of Nomination Petition
document.)
A candidate for a City Council position shall obtain the valid signatures of not less
than 20 nor more than 30 registered voters of the City.
Only the signatures of persons registered to vote within the City of Adelanto will be valid
to sign or circulate City Council nomination papers. A person registered to vote within
the City of Adelanto may sign up to two nomination papers of City Council candidates,
one for each of the two seats to be filled. Only one person may circulate the
nomination paper. A candidate may either circulate his/her own nomination paper or
may appoint another person to act as a circulator. The Declaration of Circulator and
Affidavit of Nominee must be completed before submitting the nomination paper to the
City Clerk’s Office.
Circulators are required to execute a sworn statement that all the signatures they
obtained in the nomination paper were made in their presence. After the circulator
signs the sworn statement (on last page of nomination paper) as to the validity of the
signatures, the candidate should complete and file the nomination paper along with the
other required documents with the City Clerk.
Once a nomination paper is filed with the City Clerk’s Office, the nomination paper may
not be returned to the candidate to obtain additional signatures. If the nomination paper
is determined to be insufficient or the candidate fails to obtain the correct number of
valid signatures on his or her nomination paper, the election official shall retain the
original nomination paper, provide a copy of the nomination paper to the candidate with
an indication of which signatures are valid, and issue one supplemental petition to the
Process for Filing Nomination Papers – Pg. 2
candidate on which the candidate may collect additional signatures. The supplemental
petition shall be filed not later than the last day for filing for City Council. The form of
the supplemental petition shall be the same as the nomination paper, except that the
word “Supplemental” shall be inserted above the phrase “Nomination Paper.”
There are two vacancies for Member of the City Council, therefore, a registered
voter may nominate up to two individuals for the City Council office.
Once the minimum requisite number of signatures has been verified, the verification
process ceases. The City Clerk will notify the candidate of the verification results.
List of Candidates
A list of qualified candidates will be available the next working day after the close of the
nomination period on August 8, 2020, or if there is an extension then August 13, 2020,
for distribution by close of business day.
Ballot Designation Worksheet
General Municipal Election
November 3, 2020
Name of candidate:
First
Middle
Last
Office sought:
Office Name
Office Term
Current residence address:
Street
City
Zip
Mailing address (if different):
Street/PO BOX
City
Zip
Contact information:
Residence Phone
Business Phone
Cell Phone
E-mail:
Authorized Contact:
Name
Authorization Level
Contact information:
Home Phone
Business Phone
E-mail:
A ballot designation appears under the candidate’s name on the ballot and describes that candidate’s principal profession, vocation or
occupation. The Ballot Designation Worksheet is a form that candidates use to request a ballot designation and to justify the reason for
requesting that designation. There are specific rules regarding selecting a ballot designation, and these rules are outlined in Cal. Code of
Regulations Code §20710-20719 and Cal. Elec. Code. §13107. Ballot designation requirements include but are not limited to the
following:
A ballot designation represents a candidate’s true principal profession, vocation or occupation
A ballot designation may not be more than three words
An elected official may use “Incumbent” or his/her full official title as the ballot designation. Official elected titles are not subject
to the three word limit
An appointed official may use “Appointed Incumbent” or his/her full official title, accompanied with the word “appointed,” as the
ballot designation. Official titles are not subject to the three word limit
A ballot designation is limited to approximately 48 characters including spaces and punctuation
Proposed Ballot Designation:
1st alternative:
2nd alternative
Occupation justifying Ballot Designation:
Employer name or business:
Job Title:
Dates in position: From:
To:
Person(s) who can verify this information:
Name:
Phone Number:
Name:
Phone Number:
Name:
Phone Number:
There are specific laws and regulations that govern whether or not a ballot designation is acceptable or unacceptable for printing on the
ballot. These rules are outlined in California Elections Code sections §13107, §13107.3, §13107.5 and California Code of Regulations
sections §20710-20719. The laws and regulations on ballot designations are complex, and may be challenging to navigate. Please refer to
the Candidate Filing Guide for assistance with navigating these laws and regulations.
Supporting Documentation Justifying Proposed Ballot Designations:
California Code of Regulations §20717(c) dictates that the candidate shall have the burden of establishing that the proposed ballot
designation is accurate and complies with all provisions of Elections Code and California Code of Regulations.
California Code of Regulations §20717(a) dictates that time is of the essence regarding all matters pertaining to the review of ballot
designations submitted by candidates. Failure to promptly submit requested supporting documentation will preclude consideration of such
materials in and the rendering of a final decision on the candidate’s proposed ballot designation.
The Registrar of Voters requires candidates to provide documentation to support their principal profession(s), vocation(s), or
occupation(s). Candidate are encouraged to provide supporting documentation at the time they file the Ballot Designation Worksheet. If a
candidate is not able to provide documentation at the time of filing, the Registrar of Voters allows candidates to provide supporting
documentation within three business days from filing the Ballot Designation Worksheet. If a candidate fails to provide supporting
documentation, the Registrar of Voters may not approve the candidate’s designation for printing on the ballot.
In the space below, please describe your principal profession(s), vocation(s), or occupation(s). Also, please submit substantial
documentation that demonstrates that your profession(s), vocation(s), or occupation(s) meet the definition for principal. In the space
below, please itemize the documentation you are submitting.
I understand that my ballot designation will be translated and printed in Spanish. When translating my ballot designation in Spanish, I
request that the Registrar of Voter (check only one option below):
Translate my statement using female nouns and pronouns, or
Translate my statement using male nouns and pronouns.
To the best of my knowledge and belief, the above-requested ballot designation(s) represent my true principal profession(s), vocations(s),
or occupation(s). Furthermore, I understand that the Elections Office will not accept any ballot designation that violates any rules outlined
in either the California Code of Regulations §20710-20719, or the Cal. Elec. Code §13107.
Executed on ____________________ at San Bernardino, California.
Signature of Candidate
ISSUED
FILED
By: _______________________________________
Date: _____________________________________
Ballot Designations (E.C. 13107)
BALLOT DESIGNATION WORKSHEET
Each candidate who submits a ballot designation shall file a ballot designation
worksheet that supports the use of that ballot designation by the candidate. The
candidate’s ballot designation is the designation that will be printed next to your name
on the ballot. (See enclosed ballot worksheet).
A ballot designation is a brief description, generally not more than three words, that
candidates provide to describe themselves on the ballot. The ballot designation is
found on page 4 of the Nomination Paper (petition). You will need to decide this
designation when the nomination papers are filed.
Ballot designations must strictly adhere to the provisions of the California Elections
Code. After the filing of nomination documents, the City Clerk will review and verify that
each designation is in compliance. If a ballot designation does not adhere to the
Elections Code, the candidate will be notified that the designation must be changed.
The Clerk will notify the candidate by registered mail or certified mail, e-mail, return
receipt requested, addressed to the mailing address appearing on the candidate’s
nomination documents. If the candidate does not respond within three days of the
notification, the clerk will withdraw the designation. No ballot designation given by a
candidate shall be changed by the candidate after the final date for filing
nomination documents.
A candidate may submit a proposed ballot designation pursuant to any one of the four
provisions specified in Elections Code. The candidate shall be free to select from one
of the applicable four sections. The designation shall be submitted by completing a
“Ballot Designation Worksheet” and attaching verifying materials.
BALLOT DESIGNATION REGULATIONS
The four types of ballot designations as outlined in Elections Code are:
1. The name of the candidate’s elective office;
2. The term “incumbent” as it refers to the current holder of the office;
3. The principal profession, vocation, or occupation of the candidate; or
4. The term “appointed incumbent” as it refers to appointed officers.
Name of Candidate’s Elective Office
In the case of candidates holding elective office, or a judicial officer, the designation
shall be the elective office the candidate holds at the time of filing nomination
documents. There is no word limit for designations under this category. A copy of the
candidate’s official “certificate of election” shall be attached to the Ballot
Designation Worksheet as proof of elective office. Or, if a judicial officer, a copy of the
“certificate of appointment”.
Ballot Designations – Pg. 2
Term “Incumbent”
The term “incumbent” must be used as a noun. It shall not be used in conjunction with
any other words, including any accompanying adjectives or modifiers. It must stand
alone, and may not be used as an adjective in any other ballot designation. A copy of
the candidate’s official “certificate of election” shall be attached to the Ballot
Designation Worksheet as proof of elective office.
Principal Profession, Vocation, or Occupation
The term “principal” as used by the Elections Code means a substantial involvement of
time and effort such that the activity is one of the primary, main or leading professional,
vocational or occupational endeavors of the candidate. The term precludes any activity
which does not entail a significant involvement on the part of the candidate.
Involvement which is only nominal, pro forma, or titular in character does not meet the
requirements of the statute. For more information, refer to “unacceptable ballot
designations” below. The term “profession” means a field of employment requiring
special education or skill and requiring specific knowledge of a particular discipline of
learning or science. The labor and skill involved in a profession is predominantly mental
or intellectual, rather than physical or manual. Recognized professions generally
include, but are not limited to, law, medicine, education, engineering, accountancy, and
journalism. Examples of an acceptable designation of a “profession,” as defined in
Elections Code, include, but are not limited to, “attorney,” “physician,” “architect,” and
“teacher.”
The term “vocation” means a trade, a religious calling, or the work upon which a person,
in most but not all cases, relies for his or her livelihood and spends a major portion of
his or her time. As defined, vocations may include, but are not limited to, religious
ministry, child rearing, homemaking, elderly and dependent care, and engaging in
trades such as carpentry, cabinetmaking, plumbing, and the like. Examples of an
acceptable designation of a “vocation,” as defined in Election Code, include, but are not
limited to, “minister,” “priest,” “mother,” “father,” “homemaker,” “dependent care
provider,” “carpenter,” “plumber,” “electrician,” and “cabinetmaker”.
The term “occupation” means the employment in which one regularly engages or
follows as the means of making a livelihood. Examples of an acceptable designation of
an “occupation”, as defined in Elections Code, but are not limited to, “rancher,”
“restaurateur,” “retail salesperson,” “manual labor,” “construction worker,” “computer
manufacturing executive,” “military pilot,” “secretary,” and “police officer.”
If a candidate is licensed by the State of California to engage in a profession, vocation
or occupation, the candidate is entitled to consider it his/her “principal” profession,
vocation or occupation if: 1) the candidate has a current license as of the date of filing
nomination documents and has complied with all applicable requirements respective of
the licensure, such as payment of licensing fees; and 2) a status of the license is active
at the time of filing nomination documents. A candidate may not use a ballot
designation based on a license that is inactive, suspended or revoked by the issuing
agency.
Ballot Designations – Pg. 3
A candidate may engage in multiple principal professions, vocations or occupations.
Accordingly, the candidate may designate multiple principal professions, vocations or
occupations. If a candidate proposes a designation of this type, the designation must
be limited to three words and be separated by a slash “/”. Each principal profession,
vocation or occupation must independently qualify as a principal profession, vocation or
occupation. An example of an acceptable designation would be
“Legislator/Rancher/Physician.”
A designation shall be limited to three words. Punctuation shall be limited to the use of
a comma “,” or a slash “/”. A hyphen may be used if, and only if, the use of the hyphen
is called for in the spelling of the word as it appears in a standard reference dictionary of
the English language. An acronym shall be counted as one word.
All California geographical names shall be considered to be one word and shall be
limited to the names of cities, counties, and states. The names of special districts and
political subdivisions are not “geographical names,” as the term is used in Election
Code. If the candidate desires, the geographical name may be used in the form of “City
of ….,” “County of ….,” or “City and County of ….” Examples of geographical names
considered to be one word include Tehama County, Los Angeles County and County of
Sacramento.
In the event the candidate does not have a current principal profession, vocation or
occupation at the time of filing nomination documents, the candidate may use a ballot
designation consisting of principal profession, vocation or occupation which the
candidate was principally engaged in during the calendar year immediately preceding
the filing of nomination documents.
Term “Appointed Incumbent” or “Appointed”
A candidate may propose a ballot designation consisting of the phrase “appointed
incumbent” if the candidate holds an office, other than a judicial office, by virtue of
appointment, and the candidate is a candidate for election to the same office. The
candidate may not use the unmodified word “incumbent” or any words designating the
office unmodified by the word “appointed.”
A candidate may propose a ballot designation consisting of the word “appointed” in
conjunction with the elective office, if the candidate is a candidate for election to the
same office or to some other office. The candidate may not use any words designating
the office unmodified by the word “appointed.”
There shall be no word count limitation applicable to ballot designations under this
category.
For candidates proposing the designation of “appointed incumbent”, the candidates
shall indicate the date on which he/she was appointed. This may be confirmed by
submitting a copy of the “certificate of appointment” with the Ballot Designation
Worksheet.
Ballot Designations – Pg. 4
UNACCEPTABLE BALLOT DESIGNATION
Any ballot designation that is prohibited by Elections Code, is misleading, or otherwise
improper will be rejected as unacceptable.
The following types of activities are distinguished from professions, vocations or
occupations and are not acceptable as designations:
1. Avocations: An avocation is a casual or occasional activity, diversion or hobby
pursued principally for enjoyment and in addition to the candidate’s principal
profession, vocation or occupation. Avocations may include, but are not limited
to, hobbies, social activities, volunteer work, and matters pursued as an amateur.
2. Pro Forma Professions, Vocations and Occupations: Pro forma professions,
vocations or occupations are positions held by the candidate which consume little
or none of the candidate’s time and which, by their nature, are voluntary or for
which the candidate is not compensated. Pro forma professions, vocations and
occupations may include, but are not limited to, such pursuits as honorary peace
officer, volunteer firefighter, honorary chairperson, honorary professor, goodwill
ambassador, official host or hostess and the like.
3. Statuses: A status is a state, condition, social position or legal relation of the
candidate to another person, persons or the community as a whole. A status is
generic in nature and generally fails to identify with any particular specificity the
manner by which the candidate earns his or her livelihood or spends the
substantial majority of his or her time. Examples of a status include, but are not
limited to, philanthropist, activist, patriot, taxpayer, concerned citizen, husband,
wife, and the like.
A ballot designation shall not:
1. Be comprised of or include commercial identification information, such as a
trademark, service mark, trade name, or the specific name of a business,
partnership, corporation, company, foundation, or organization. Examples of an
improper use of commercial identification information include, but are not limited
to, “Acme Company President,” “Universal Widget Inventor,” “Director, Smith
Foundation,” “UCLA Professor,” and the like.
2. Suggest an evaluation of the candidate’s qualifications, honesty, integrity,
leadership abilities or character. Any laudatory or derogatory adjectives which
would suggest an evaluation of the candidate’s qualifications shall not be
permitted. Such impermissible adjectives include, but are not limited to,
“outstanding,” “leading,” “expert,” “virtuous,” “eminent,” “best,” “exalted,”
“prominent,” “famous,” “respected,” “honored,” “honest,” “dishonest,” “corrupt,”
“lazy,” and the like.
Ballot Designations – Pg. 5
3. Abbreviate the word “retired” or place it following any word or words which it
modifies. Examples of impermissible designations include “Ret. Army General,”
“Major USAF, Retired” and “City Attorney, Retired.”
The use of the word “retired” in a ballot designation is generally limited for use by
individuals who have permanently given up their chosen principal profession,
vocation or occupation. The following will be considered by the Clerk for any
designation including the word retired:
a. Prior to retiring from his or her principal profession, vocation or
occupation, the candidate worked in such profession, vocation or
occupation for more than 5 years;
b. The candidate is collecting, or eligible to collect, retirement benefits or
other type of vested pension;
c. The candidate has reached at least the age of 55 years;
d. The candidate voluntarily left his or her last professional, vocational or
occupational position;
e. If the candidate is requesting a ballot designation indicating that he or she
is a retired public official, the candidate must have previously voluntarily
retired from public office, not have been involuntarily removed from office,
not have been recalled by voters, and not have surrendered the office to
seek another office or failed to win reelection to the office;
f. The candidate has not had another more recent, intervening principal
profession, vocation or occupation; and,
g. The candidate’s retirement benefits are providing him or her with a
principal source of income.
4. Use a word or prefix to indicate a prior profession, vocation, occupation or
elected, appointed or judicial office previously held by the candidate. Such
impermissible words or prefixes include, but are not limited to, “Ex-,” “former,”
“past,” and “erstwhile.” Examples of impermissible designations include “Former
Congressman,” “Ex-Senator,” and “Former Educator.”
5. Include the name of any political party.
6. Include a word(s) referring to a racial, religious, or ethnic group.
7. Expressly contains or implies any ethnic or racial slurs or ethnically or racially
derogatory language.
8. If the candidate is a member of the clergy, the candidate may not make reference
to his/her specific denomination. However, the candidate may use his or her
clerical title as a ballot designation (e.g. “Rabbi,” “Pastor,” “Minister,” “Priest,”
“Bishop,” “Deacon,” “Monk,” “Nun,” “Imam,” etc.)
9. Refers to any activity prohibited by law. Unlawful activity includes any activities,
conduct, professions, vocations, or occupations prohibited by state or federal
law.
Revised 6/22/2020
Ballot Designation
Worksheet Guide
November 3, 2020
This Page Was Left Blank Intentionally
2
1.
Has the candidate filed a Declaration of Candidacy?
YES ☐
Continue to #2
NO ☐
Candidate must
complete a
Declaration of
Candidacy.
Continue to #2
2.
Has the candidate indicated on the Declaration of Candidacy that
they want a ballot designation to appear on the ballot?
YES ☐
Continue to #3
NO ☐
A Ballot Designation
Worksheet is optional
and the candidate is not
required to complete.
3.
Has the candidate, or a person authorized to act on the
candidate’s behalf, provided their name, office, residence
address, and telephone numbers on the Ballot Designation
Worksheet? (E-mail, business address, and mailing address are
to be provided only if applicable)
YES ☐
Continue to #4
NO ☐
The candidate, or
person authorized to act
on candidates’ behalf,
must provide the listed
information on the
Ballot Designation
Worksheet. When
completed
continue to #4
4.
Has the candidate proposed a ballot designation and alternate
ballot designations?
YES ☐
Continue to #5
NO ☐
Alternate ballot
designations are
optional, but highly
advised. Continue to #5
ELECTIVE OFFICE TITLE
5.
Does the candidate’s proposed ballot designation refer to a
currently held elective office?
YES ☐
Continue to #6
NO ☐
Continue to #13
6.
Has the candidate presented a Certificate of Election or a
Certificate In-Lieu of Election?
YES ☐
Continue to #9
NO ☐
Election Official must
verify status as
officeholder, then
continue to #7
7.
Was the candidate appointed to their current term?
YES ☐
Continue to #8
NO ☐
Candidate must provide
Certificate of Election,
then continue to #9
8.
Does the proposed ballot designation contain the word
“appointed?”
YES ☐
Continue to #9
NO ☐
Candidate must use the
word “appointed” in their
proposed Ballot
Designation, then
continue to #9
9.
Does the proposed ballot designation contain the candidate’s full
elective office title?
YES ☐
Continue to #12
NO ☐
Continue to #10
10.
Does the proposed ballot designation contain the word
“incumbent?”
YES ☐
Continue to #11
NO ☐
Candidate’s ballot
designation must be full
elective office title,
“incumbent” or
“appointed incumbent.”
Select a different ballot
designation, then
return to #5.
3
11.
In addition to “incumbent” or “appointed incumbent,” has the
candidate designated any other professions, vocations or
occupations?
YES ☐
Candidate may not
designate any other
professions, vocations or
occupations with
“incumbent” or
“appointed incumbent.”
NO ☐
Continue to #36
REFERENCE - 2 CA ADC § 20713(b) reads as follows:
The term “incumbent” must be used as a noun. It shall not be used in conjunction with any other words, including any accompanying
adjectives or modifiers, and must stand alone.
REFERENCE – 2 CA ADC § 20715(a)(b) reads as follows:
(a) Pursuant to Elections Code § 13107, subdivision (a)(4), a candidate may propose a ballot designation consisting of the phrase “appointed
incumbent” if the candidate holds an office, other than a judicial office, by virtue of appointment, and the candidate is a candidate for election
to the same office. The candidate may not use the unmodified word “incumbent” or any words designating the office unmodified by the word
“appointed.”
(b) Pursuant to Elections Code § 13107, subdivision (a)(4), a candidate may propose a ballot designation consisting of the word “appointed” in
conjunction with the elective office, if the candidate is a candidate for election to the same office or to some other office. The candidate may
not use any words designating the office unmodified by the word “appointed.”
12.
In addition to their elective office title, has the candidate
designated any other professions, vocations or occupations?
YES ☐
Continue to #13
NO ☐
Continue to #36
REFERENCE – 2 CA ADC § 20714(g) reads as follows:
A candidate who chooses to include the name of his or her elective office with another profession, vocation, or occupation may do so.
Examples of acceptable designations under this section include:
“State Senator/Rancher,” “California Assemblywoman/Attorney,” “County Supervisor/Teacher,” and “State Controller/Businessman.”
Examples of unacceptable designations under this section include “Assemblyman, 57th District/Educator,” “California State
Senator/Architect,” “Placer County Supervisor/Business Owner,” and “Member, Board of Equalization/Banker.”
PRINCIPAL PROFESSION, VOCATION, OR OCCUPATION
13.
Has the candidate designated multiple principal professions,
vocations or occupations?
YES ☐
Continue to #14
NO ☐
Continue to #15
14.
Has the candidate separated the multiple principal
professions, vocations or occupations with a “/”?
YES ☐
Continue to #15
NO ☐
Candidate must
separate principal
professions, vocations or
occupations with a “/”,
then Continue to #15
REFERENCE – 2 CA ADC § 20714(e) reads as follows:
A candidate may engage in multiple principal professions, vocations or occupations. Accordingly, the candidate may designate multiple
principal professions, vocations or occupations. If a candidate proposes a ballot designation including multiple principal professions, vocations
or occupations, the proposed ballot designation must comply with the following provisions:
…(3) When multiple professions, vocations or occupations are proposed as a ballot designation, they shall be separated
by a slash (“/”). An example of an acceptable designation would be “Legislator/Rancher/Physician.”
15.
Is the proposed ballot designation grammatically correct,
generic, and are all words spelled correctly?
YES ☐
Continue to #16
NO ☐
Candidate must re-write
ballot designation then
Continue to #16
16.
Does the proposed ballot designation use any punctuation
other than a comma (e.g., District Attorney, Los Angeles
County), a slash (e.g., Legislator/Rancher/Physician), or a
hyphen as called for in the spelling of a word?
YES ☐
Candidate must
re-write ballot
designation.
Continue to #17
NO ☐
Continue to #17
REFERENCE – 2 CA ADC § 20714(f)(2) reads as follows:
Punctuation shall be limited to the use of a comma (e.g., District Attorney, Los Angeles County) and a slash (e.g.,
legislator/Rancher/Physician)... A hyphen may be used if, and only if, the use of a hyphen is called for in the spelling of a word as it appears in
a standard reference dictionary of the English language which was published in the United States at any time within the 10 calendar years
immediately preceding the election…
4
17.
Does the proposed ballot designation contain more than three
words designating the current principal profession, vocation,
or occupation of the candidate?
YES ☐
Continue to #18
NO ☐
Continue to #20
18.
Based on the three word count rule, does the proposed ballot
designation include words that are considered one word, such
as California geographical names or acronyms?
(e.g. Tehama County, Los Angeles County and County of
Sacramento)
YES ☐
Continue to #19
NO ☐
Candidate must re-write
ballot designation.
Return to #5
REFERENCE - 2 CA ADC § 20714(f)(3)(4) reads as follows:
(f)…The following rules shall govern the application of the three word limitation:
(3) All California geographical names shall be considered to be one word and shall be limited to the names of cities, counties and states. The
names of special districts and political subdivisions are not “geographical names”… If the candidate desires, the geographical name may be
used in the form of “City of . . . ,” “County of . . . ,” or “City and County of . . .” Examples of geographical names considered to be one word
include Tehama County, Los Angeles County and County of Sacramento…
(4)An acronym shall be counted as one word.
19.
Does the proposed ballot designation contain more than three
words that is not the elected title after applying the three word
count rule?
YES ☐
Candidate must
re-write ballot
designation.
Return to #5
NO ☐
Continue to #20
20.
Is the candidate currently engaged in the principal
professions, vocations, or occupations selected as the ballot
designation?
YES ☐
Continue to #22
NO ☐
Candidate must use
current principal
professions, vocations
or occupations. If none,
continue to #21
21.
Was the candidate engaged in the principal professions,
vocations, or occupations selected as the ballot designation
during the calendar year immediately preceding this filing?
YES ☐
Continue to #22
NO ☐
Candidate must re-write
ballot designation.
Return to #5
REFERENCE - 2 CA ADC § 20714(d) reads as follows:
If the candidate is engaged in a profession, vocation or occupation at the time he or she files his or her nomination documents, the
candidate's proposed ballot designation is entitled to consist of the candidate's current principal professions, vocations and occupations. In
the event the candidate does not have a current principal profession, vocation or occupation at the time he or she files his or her nomination
documents, the candidate may use a ballot designation consisting of his or her principal professions, vocations or occupations, which the
candidate was principally engaged in during the calendar year immediately preceding the filing of the candidate's nomination papers.
22.
Is the proposed ballot designation factually accurate,
descriptive of the candidate's principal profession, vocation or
occupation?
YES ☐
Continue to #23
NO ☐
Candidate must re-write
ballot designation.
Return #5
REFERENCE – 2 CA ADC § 20714(a)(b) reads as follows:
(a)The terms “profession,” “vocation,” or “occupation,” as those terms are used in Elections Code § 13107, subdivision (a)(3), are defined as
follows:
(1) “Profession” means a field of employment requiring special education or skill and requiring knowledge of a particular discipline. The labor
and skill involved in a profession is predominantly mental or intellectual, rather than physical or manual. Recognized professions generally
include, but are not limited to, law, medicine, education, engineering, accountancy, and journalism. Examples of an acceptable designation of
a “profession,” as defined in Elections Code § 13107, subdivision (a)(3), include, but are not limited to, “attorney,” “physician,” “accountant,”
“architect,” and “teacher.”
(2) “Vocation” means a trade, a religious calling, or the work upon which a person, in most but not all cases, relies for his or her livelihood and
spends a major portion of his or her time. As defined, vocations may include, but are not limited to, religious ministry, child rearing,
homemaking, elderly and dependent care, and engaging in trades such as carpentry, cabinetmaking, plumbing, and the like. Examples of an
acceptable designation of a “vocation,” as defined in Elections Code § 13107, subdivision (a)(3), include, but are not limited to, “minister,”
“priest,” “mother,” “father,” “homemaker,” “dependent care provider,” “carpenter,” “plumber,” “electrician,” and “cabinetmaker.”
(3) “Occupation” means the employment in which one regularly engages or follows as the means of making a livelihood. Examples of an
acceptable designation of an “occupation,” as defined in Elections Code § 13107, subdivision (a)(3), include, but are not limited to, “rancher,”
“restaurateur,” “retail salesperson,” “manual laborer,” “construction worker,” “computer manufacturing executive,” “military pilot,” “secretary,”
and “police officer.”
5
(b) “Principal,” as that term is used in Elections Code § 13107, subdivision (a)(3), means a substantial involvement of time and effort such that
the activity is one of the primary, main or leading professional, vocational or occupational endeavors of the candidate. The term “principal”
precludes any activity which does not entail a significant involvement on the part of the candidate. Involvement which is only nominal, pro
forma, or titular in character does not meet the requirements of the statute.
(1) If a candidate is licensed by the State of California to engage in a profession, vocation or occupation, the candidate is entitled to consider it
one of his or her “principal” professions, vocations or occupations if (i) the candidate has maintained his or her license current as of the date
he or she filed his or nomination documents by complying with all applicable requirements of the respective licensure, including the payment
of all applicable license fees and (ii) the status of the candidate's license is active at the time he or she filed his or her nomination documents.
(2) A candidate who holds a professional, vocational or occupational license issued by the State of California may not claim such profession,
vocation or occupation as one of his or her “principal” professions, vocations or occupations if (i) the candidate's licensure status is “inactive”
at the time the candidate files his or her nomination document, or (ii) the candidate's license has been suspended or revoked by the agency
issuing the license at the time the candidate files his or her nomination documents.
23.
Is the proposed ballot designation confusing or misleading?
YES ☐
Candidate must re-write
ballot designation.
Return to #5
NO ☐
Continue to #24
REFERENCE - 2 CA ADC§ 20716(c) reads as follows:
….. In making this determination, the Secretary of State shall determine whether there is a substantial likelihood that a reasonably prudent
voter would be misled as to the candidate's principal profession, vocation or occupation by the candidate's proposed ballot designation. The
determination shall take into account the plain meaning of the words constituting the proposed ballot designation and the factual accuracy of
the proposed ballot designation based upon supporting documents or other evidence submitted by the candidate in support of the proposed
ballot designation….
24.
Does the proposed ballot designation contain the words
“Community Volunteer”?
YES ☐
Continue to #25
NO ☐
Continue to #27
25.
Is the candidate a person who engages in an activity or
performs a service for or on behalf of, without profiting
monetarily, one or more of the following?
A charitable, educational, or religious organization as defined
by the United States Internal Revenue Code section
501(c)(3);
A governmental agency; or
An educational institution.
YES ☐
Continue to #26
NO ☐
Candidate may not use
the words “Community
Volunteer” as the
proposed ballot
designation.
Return to #5
26.
Does the candidate’s activity or service constitute substantial
involvement of the candidate’s time and effort such that the
activity or service is the sole, primary, main or leading
professional, vocational, or occupational endeavor of the
candidate?
YES ☐
Continue to #27
NO ☐
Candidate may not use
the words “Community
Volunteer” as the
proposed ballot
designation.
Return to #5
REFERENCE – 2 CA ADC § 20714.5(b) reads as follows:
The activity or service must constitute substantial involvement of the candidate’s time and effort such that the activity or service is the sole,
primary, main or leading professional, vocational, or occupational endeavor of the candidate.
RETIRED
27.
Does the proposed ballot designation contain the word “Retired”?
YES ☐
Continue to #28
NO ☐
Continue to #31
28.
Does the candidate possess another more recent, intervening
principal profession, vocation, or occupation?
YES ☐
Candidate may not use
the word “Retired” as the
proposed ballot
designation.
Return to #5
NO ☐
Continue to #29
29.
Does the proposed ballot designation abbreviate the word
“Retired”?
YES ☐
Candidate must correct
abbreviation, then
Continue to #30
NO ☐
Continue to #30
6
30.
Does the proposed ballot designation place “retired” following any
word or words which it modifies?
YES ☐
“Retired” must be placed
before any word or
words which it modifies,
then Continue to #31
NO ☐
Continue to #31
REFERENCE – 2 CA ADC § 20716(h)(1) reads as follows:
Subject to the provisions of Elections Code § 13107, subdivision (b)(4), use of the word “retired” in a ballot designation is generally limited for
use by individuals who have permanently given up their chosen principal profession, vocation or occupation.
(2) In evaluating a proposed ballot designation including the word “retired,” the Secretary of State will consider the following factors in making
a determination as to the propriety of the use of the term “retired”:
(A) Prior to retiring from his or her principal profession, vocation or occupation, the candidate worked in such profession, vocation or
occupation for more than 5 years;
(B) The candidate is collecting, or eligible to collect, retirement benefits or other type of vested pension;
(C) The candidate has reached at least the age of 55 years;
(D) The candidate voluntarily left his or her last professional, vocational or occupational position; and
(E) The candidate’s retirement benefits are providing him or her with a principal source of income.
(3) If the candidate is requesting a ballot designation that he or she is a retired public official, the candidate must have previously voluntarily
retired from public office, not have been involuntarily removed from office, not have been recalled by voters, and not have surrendered the
office to seek another office or failed to win reelection to the office. If such a candidate did not voluntarily retire from public office, he or she
may not use the word “retired” in this or her ballot designation.
(4) A candidate may not use the word “retired” in his or her ballot designation if that candidate possesses another more recent, intervening
principal profession, vocation, or occupation.
REFERENCE - CA EC § 13107 (e) 3 reads as follows:
(e) Neither the Secretary of State nor any other elections official shall accept a designation of which any of the following would be true:
(3) It abbreviates the word “retired” or places it following any word or words which it modifies.
UNACCEPTABLE BALLOT DESIGNATIONS
31.
Is the proposed ballot designation an avocation, pro forma
profession, vocation or occupation, or a status?
YES ☐
Candidate must re-write
ballot designation.
Return to #5
NO ☐
Continue to #32
REFERENCE – 2 CA ADC § 20716(b) reads as follows:
The following types of activities are distinguished from professions, vocations and occupations and are not acceptable as ballot
designations…
(1)Avocations: An avocation is a casual or occasional activity, diversion or hobby pursued principally for enjoyment and in addition to the
candidate’s principal profession, vocation or occupation. Avocations may include, but are not limited to, hobbies, social activities, volunteer
work (except as set forth in Section 20714.5 of this Chapter), and matters pursued as an amateur.
(2) Pro Forma Professions, Vocations and Occupations: Pro forma professions, vocations or occupations are positions held by the candidate
which consume little or none of the candidate’s time and which, by their nature, are voluntary or for which the candidate is not compensated,
except as set forth in Section 20714.5 of this Chapter. Pro forma professions, vocations and occupations may include, but are not limited to,
such pursuits as honorary peace officer, honorary chairperson, honorary professor, goodwill ambassador, official host or hostess and the like.
(3)Statuses: A status is a state, condition, social position or legal relation of the candidate to another person, persons or the community as a
whole. A status is generic in nature and generally fails to identify with any particular specificity the manner by which the candidate earns his or
her livelihood or spends the substantial majority of his or her time. Examples of a status include, but are not limited to, veteran, proponent,
reformer, scholar, founder, philosopher, philanthropist, activist, patriot, taxpayer, concerned citizen, husband, wife, and the like.
32.
Does the proposed ballot designation include commercial
identification information, such as a trademark, service mark,
trade name, or the specific name of a business, partnership,
corporation, company, foundation, or organization?
YES ☐
Candidate must re-write
ballot designation.
Return #5
NO ☐
Continue #33
33.
Does the proposed ballot designation suggest an evaluation of
the candidate’s qualifications, honesty, integrity, leadership
abilities or character?
YES ☐
Candidate must re-write
ballot designation.
Return to #5
NO ☐
Continue to #34
REFERENCE – 2 CA ADC§ 20716(e) reads as follows:
…Such impermissible adjectives include, but are not limited to, “senior,” “emeritus,” “specialist,” “magnate,” “outstanding,” “leading,” “expert,”
“virtuous,” “eminent,” “best,” “exalted,” “prominent,” “famous,” “respected,” “honored,” “honest,” “dishonest,” “corrupt,” “lazy,” and the like.
7
34.
Does the proposed ballot designation:
Use a word or prefix such as “former”?
Use the name of any political party, qualified or
unqualified?
Use a word or words referring to a racial, religious, or
ethnic group?
Refer to any activity prohibited by law?
YES ☐
Candidate must re-write
ballot designation.
Return to #5
NO ☐
Continue to #35
REFERENCE - CA EC § 13107(e) 3-7 reads as follows:
(e) Neither the Secretary of State nor any other elections official shall accept a designation of which any of the following would be true:
(3) It abbreviates the word “retired” or places it following any word or words which it modifies.
(4) It uses a word or prefix, such as “former” or “ex-,” which means a prior status. The only exception is the use of the word “retired.”
(5) It uses the name of any political party, whether or not it has qualified for the ballot.
(6) It uses a word or words referring to a racial, religious, or ethnic group.
(7) It refers to any activity prohibited by law.
2 CA ADC § 20716 reads as follows:
Pursuant to Elections Code § 13107, subdivision (e)(5), the Secretary of State shall reject as unacceptable any proposed ballot designation
which uses the name of any political party, whether or not it has qualified for recognized ballot status.
Pursuant to Elections Code § 13107, subdivision (e)(6), the Secretary of State shall reject as unacceptable any proposed ballot designation
which uses a word or words referring to a racial, religious, or ethnic group.
The Secretary of State shall reject as unacceptable any ballot designation which expressly contains or implies any ethnic or racial slurs or
ethnically or racially derogatory language.
If the candidate is a member of the clergy, the candidate may not make reference to his or her specific denomination. However, the candidate
may use his or her clerical title as a ballot designation (e.g., “Rabbi,” “Pastor,” “Minister,” “Priest,” “Bishop,” “Deacon,” “Monk,” “Nun,”
“Imam,” etc.)
35.
Does the proposed ballot designation use a word or prefix to
indicate a prior profession, vocation, occupation or elected,
appointed or judicial office previously held by the candidate?
YES ☐
Candidate must re-write
ballot designation.
Return to #5
NO ☐
Continue to #36
REFERENCE – 2 CA ADC § 20716(g) reads as follows:
Such impermissible words or prefixes include, but are not limited to, “Ex-,” “former,” “past,” and “erstwhile.” Examples of impermissible
designations include “Former Congressman,” “Ex-Senator,” and “Former Educator.”
Supporting Documentation
36.
Has the candidate supplied the following information?
The title of the current occupation which he or she claims
supports the proposed ballot designation
the name of the candidate’s business or employer
The dates during which the candidate held such position
The name and telephone numbers of persons who could
verify such information
YES ☐
Continue to #37
NO ☐
Candidate should
provide information to
support the use of
proposed ballot
designation
37.
Has the candidate submitted a brief statement identifying the
factual basis upon which the candidate claims the proposed
ballot designation?
YES ☐
Continue to #38
NO ☐
Candidate should
provide information to
support the use of
proposed ballot
designation
38.
Has the candidate submitted proof of chosen ballot designation
status information such as a business card or a notice from the
organization or business on official company letterhead?
YES ☐
Continue to #39
NO ☐
Candidate should
provide information to
support the use of
proposed ballot
designation
39.
Has the candidate signed and dated the Ballot Designation
Worksheet?
YES ☐
File with San Bernardino
County Elections Office
NO ☐
Candidate must sign
and date the Ballot
Designation Worksheet,
then File with the San
Bernardino County
Elections Office
8
Campaign Disclosure Requirements
CAMPAIGN REPORTING
The Act requires that all state and local elected officeholders, candidates for state and
local elected offices, and their controlled committees file campaign disclosure
statements at specified intervals. Failure to file appropriate statements and reports in
compliance with the Act can result in substantial criminal, civil and administrative
penalties. Failure to file within the prescribed deadlines can lead to late filing penalties
of $10 for each day the statement is late. Except for deadlines that fall on a Saturday,
Sunday, or official state holiday, the law does not allow for extensions of filing
deadlines.
Anyone may act as a committee treasurer. A candidate may serve as his or her own
committee treasurer.
Candidates may start soliciting and receiving contributions for campaign expenses as
soon as the candidate has filed a Form 501 and a Form 410, Statement of Organization
(establishes committee). Candidate does not have to wait until the nomination period
opens on July 13, 2020 to file these statements to start soliciting/receiving campaign
contributions.
CAMPAIGN DISCLOSURE MANUAL 2 – INFORMATION FOR LOCAL CANDIDATES
All candidates are required to file some level of campaign disclosure documents and/or
reports. These documents are required by Government Code and provide the public
with details on who contributes money or items to a candidate’s campaign, and how the
candidate spends that money. Disclosure requirements are very complicated. These
instructions provide only basic guidelines on which forms to file and when. How to
complete the various forms, establish a campaign committee, manage a campaign
account, and what the Government Code requires of a candidate is fully detailed in
“Campaign Disclosure Manual 2 – Information for Local Candidates”. This manual is
prepared by the California Fair Political Practices Commission, and is provide by
accessing the FPPC website at: http://www.fppc.ca.gov/content/dam/fppc/NS-
Documents/TAD/Campaign%20Manuals/Manual_2/Final_Manual_2_Entire_Manual.pdf.
Candidates are encouraged to thoroughly read the Campaign Disclosure Manual 2.
FORM 700 –STATEMENT OF ECONOMIC INTERESTS – G.C. 87200 et. seq.
Form 700 is available from the FPPC website: www.fppc.ca.gov
Each candidate shall submit a Statement of Economic Interests, Form 700,
(2019/2020), at the time the candidate’s nomination papers are submitted to the City
Clerk’s Office. The Statement of Economic Interests is a public record. It may be
inspected, and copies of it may be purchased, by anyone.
Candidates are required to report investments, interests in real property, and business
positions held on the date of filing their declaration of candidacy. In addition, income
received during the 12 months prior to the date of filing the declaration of candidacy is
reportable income (including loans, gifts and travel payments). This statement is
entirely separate from campaign disclosure statements. (See attached example of
Statement of Economic Interest Form 700.)
Campaign Disclosure Requirements – Pg. 2
The Technical Assistance Division of the Fair Political Practices Commission (FPPC) is
available to answer questions at 1-866-275-3772 or at http://www.fppc.ca.gov.
Completing and Filing the Statement
Fill out the cover sheet and each schedule in which information is disclosed. The
information in Sections 1, 2 and 3 of the Cover Sheet is static data, and has been filled
in for you. Make sure that you’ve checked the appropriate boxes in Section 4, noted the
number of pages attached (if applicable), and dated and signed in Section 5. Discard
schedules that you did not complete. Only return the Cover Sheet and completed
schedules.
Enclosed is an example of the Cover Sheet from the Statement of Economic Interest
Form.
Once received, the City Clerk will make and retain a copy of the statement and forward
the original to the State Fair Political Practices Commission (FPPC), which is the official
filing officer.
Future Statement Filings
If a non-incumbent is successful, that individual will be required to file an
“assuming” Statement of Economic Interests Form within thirty (30) days of being
sworn into office.
In addition, all office holders file new statements on an “annual” basis. These
statements are due on April 1
st
of each year.
Office holders who are appointed to joint power authorities who have conflict of interest
codes, will also be required to file “assuming” and “annual” statements with those
agency filing officers.
Office holders who leave office must file a “leaving” Statement of Economic Interests
Form within thirty (30) days of leaving office.
Candidate/Treasurer Workshop Video
There is a Candidate Treasurer Workshop Webinar provided on the FPPC Website for
all candidates and their treasurers can download the powerpoint presentation. Please
follow the link if you would like to register http://www.fppc.ca.gov/learn/training-and-
outreach/candidates-treasurers-committees.html.
Getting Started
Establishing the Bank Account
Candidates who anticipate soliciting or receiving contributions from others, or who
anticipate spending over $2,000 or more of personal funds in connection with the
Campaign Disclosure Requirements – Pg. 3
election must open a campaign bank account. A candidate’s personal funds used to
pay for the candidate’s statement does not count toward the $2,000 threshold.
Campaign contributions may not be commingled with any individual’s personal funds.
All contributions must be deposited in, and expenditures made from, the campaign bank
account. Candidate’s may not re-use (or re-designate) a prior account for a future
election. A new and separate bank account is required for each election. Specific
information relative to establishing Bank Accounts are found in Campaign Disclosure
Manual 2, Chapter 4 and Chapter 9 for restrictions on the use of campaign funds.
Campaign Forms
Candidate Intention Statement (Form 501)
Form 501 is available from the FPPC website: www.fppc.ca.gov
All candidates must file a Form 501 prior to soliciting or receiving contributions, and
before any campaign expenditure is made from personal funds. The only exception is
when a candidate spends personal funds to pay for a candidate’s statement that is
submitted with the nomination documents. An example of how to complete the form is
on page 4-2 of the “Campaign Disclosure Manual 2 – Information for Local Candidates.”
Statement of Organization (Form 410)
Form 410 is available from the FPPC website: www.fppc.ca.gov
All candidates that receive $2,000 or more in contributions in a calendar year qualify as
a recipient committee and must file a Form 410. The Form 410 identifies the name of
the committee, the treasurer and officers, and the purpose of the committee.
Candidates may not re-use (or re-designate) a prior committee for a future election. A
new and separate committee is required for each election.
Within 10 days of receiving $2,000 or more, the candidate must file an original and one
copy of the Form 410 with the Secretary of State, Political Reform Division, 1500 11
th
Street, Room 495, Sacramento, CA 95814. The Secretary of State will issue a
committee ID Number. A copy of the Form 410 must be filed with the Office of the City
Clerk. An example of how to complete the form is in the Campaign Disclosure Manual
2 – Information for Local Candidates.
Exceptions: The Statement of Organization (Form 410) is not required if the candidate
will not be receiving contributions from others and will spend less than $2000 in a
calendar year from personal funds to support his or her candidacy. Payment of a
Candidate’s Filing Fee or Candidate’s Statement is not counted toward the $2000
expenditure threshold. Note: If the candidate finds later that he/she will be spending
more than $2000 from personal funds, a campaign bank account must be opened.
Campaign Disclosure Requirements – Pg. 4
Statement of Termination (Form 410)
Form 410 is available from the FPPC website: www.fppc.ca.gov
When all financial obligations are met, the committee’s account has been spent or
distributed, and a candidate ceases to raise or spend funds, the committee should be
terminated. An original and one copy of the Form 410 must be filed with the Secretary
of State, and a copy of the Form 410 must also be filed with the Office of the City Clerk.
An example of how to complete the form is in the Campaign Disclosure Manual 2 –
Information for Local Candidates.
In addition, a termination Form 460 must also be filed with the Office of the City Clerk to
report the committee’s activity since the close of the filing period of the previously filed
statement.
Recipient Committee Campaign Statement (Form 460)
Form 460 is available from the FPPC website: www.fppc.ca.gov
Used by a candidate or officeholder who has a controlled committee, or who has raised
or spent or will raise or spend $2,000 or more during a calendar year in connection with
election to office or holding office. Also, use the Form 460 to file a pre-election
statement, semi-annual statement, quarterly statement, special odd-year report,
supplemental pre-election statement. File this form with the City Clerk in accordance
with the deadlines established by the FPPC. See FPPC Campaign Statement
Deadlines listed under Candidate Information in this handbook.
Candidate Campaign Statement Short Form (Form 470)
Form 470 is available from the FPPC website: www.fppc.ca.gov
If a candidate does not anticipate raising or spending $2,000 or more in a calendar year,
the candidate may file a Form 470. Payments from the candidate’s personal funds used
to pay for the candidate’s statement that is submitted with the nomination documents
does not count toward the $2,000 threshold. This form shall be filed with the
candidate’s nomination documents. An example of how to complete the form is in the
Campaign Disclosure Manual 2 – Information for Local Candidates. Note: Candidates
who file the Form 470 (Short Form) do not need to fill out termination forms.
Candidate Campaign Statement Form 470 Supplement
Form 470 is available from the FPPC website: www.fppc.ca.gov
If a Form 470 is filed and later in the calendar year $2,000 or more is raised or spent,
the candidate’s filing obligations and deadlines will change. If this occurs, a Form 470-
Supplement must be filed with the City Clerk within 48 hours of reaching this threshold,
and notification must also be sent to all candidates seeking the same office. The notice
must be sent by guaranteed, overnight delivery, personal delivery or fax.
In addition, a Form 410 must be filed, and the candidate must begin filing detailed
campaign statements using the Form 460. Refer to the Campaign Disclosure Manual 2
– Information for Local Candidates for more details.
Campaign Disclosure Requirements – Pg. 5
Surplus Funds
Campaign Funds held by a non-incumbent defeated candidate or a candidate who
withdraws from an election become “surplus” and the end of the semi-annual reporting
period following the election. For candidates involved in the November election the end
of the reporting period would be December 31, 2020.
For an elected officeholder, funds become “surplus” at the end of the semi-annual
reporting period following the date the officeholder leaves office. If an incumbent is not
successful in the 2020 election process, the end of the reporting period would be
December 31, 2020.
After these dates, the use of the funds is restricted. To ensure the proper disposition of
campaign funds individuals who fall into the noted categories must take action before
the end of the applicable reporting period. Refer to the Campaign Disclosure Manual 2
– Information for Local Candidates for more details.
December 2019
2019-2020
Statement of
Economic Interests
Form 700
California Fair Political Practices Commission
1102 Q Street, Suite 3000 • Sacramento, CA 95811
Email Advice: advice@fppc.ca.gov
Toll-free advice line: 1 (866) ASK-FPPC • 1 (866) 275-3772
Telephone: (916) 322-5660 • Website: www.fppc.ca.gov
A Public Document
Table of Contents
Quick Start Guide .................................................... p.2
Who? Where? How? When? .................................... p.3
Types of Statements ................................................. p.4
Cover Page and Schedules
Cover Page ........................................................ p.5
Schedule A-1 (Investments) ............................... p.7
Schedule A-2 (Business Entities/Trusts) ............ p.9
Schedule B (Real Property) ...............................p.11
Schedule C (Income) .........................................p.13
Schedule D (Gifts) ..............................................p.15
Schedule E (Travel Payments) ...........................p.17
Restrictions and Prohibitions ....................................p.19
Q & A ........................................................................p.20
Helpful Resources
• Video Tutorials
• Reference Pamphlet
• Excel Version
• FAQs
• Gift and Travel Fact
Sheet for State and
Local Ocials
Quick Start Guide
Detailed instructions begin on page 3.
WHEN IS THE ANNUAL STATEMENT DUE?
• March 2 – Elected State Ocers, Judges and Court Commissioners, State Board and Commission
members listed in Government Code Section 87200
• April 1 – Most other lers
WHERE DO I FILE?
Most people le the Form 700 with their agency. If you’re not sure where to le your Form 700, contact your
ling ocer or the person who asked you to complete it.
ITEMS TO NOTE!
• The Form 700 is a public document.
• Only lers serving in active military duty may receive an extension on the ling deadline.
• You must also report interests held by your spouse or registered domestic partner.
• Your agency’s conict of interest code will help you to complete the Form 700. You are encouraged to get
your conict of interest code from the person who asked you to complete the Form 700.
NOTHING TO REPORT?
Mark the “No reportable interests” box on Part 4 of the Cover Page, and submit only the signed Cover Page.
Please review each schedule carefully!
Schedule
Common
Reportable Interests
Common
Non-Reportable Interests
A-1:
Investments
Stocks, including those held in an IRA
or 401K. Each stock must be listed.
Insurance policies, government bonds, diversied
mutual funds, funds similar to diversied mutual
funds.
A-2:
Business
Entitites/Trusts
Business entities, sole proprietorships,
partnerships, LLCs, corporations and
trusts. (e.g., Form 1099 lers).
Savings and checking accounts, and annuities.
B:
Real Property
Rental property in ler’s jurisdiction, or
within two miles of the boundaries of
the jurisdiction.
A residence used exclusively as a personal
residence (such as a home or vacation property).
C:
Income
Non-governmental salaries. Note that
lers are required to report only half of
their spouse’s or partner’s salary.
Governmental salary (from school district, for
example).
D:
Gifts
Gifts from businesses, vendors, or
other contractors (meals, tickets, etc.).
Gifts from family members.
E:
Travel
Payments
Travel payments from third parties (not
your employer).
Travel paid by your government agency.
Note: Like reportable interests, non-reportable interests may also create conicts of
interest and could be grounds for disqualication from certain decisions.
QUESTIONS?
• advice@fppc.ca.gov
• (866) 275-3772 Mon-Thurs, 9-11:30 a.m.
E-FILING ISSUES?
• If using your agency’s system, please contact technical support at your agency.
• If using FPPC’s e-ling system, write to form700@fppc.ca.gov.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www. .ca.gov
Page - 2
What’s New
Gift Limit Increase
The gift limit increased to $500 for calendar years 2019
and 2020.
Who must le:
• Elected and appointed ocials and candidates listed in
Government Code Section 87200
• Employees, appointed ocials, and consultants ling
pursuant to a conict of interest code (“code lers”).
Obtain your disclosure categories, which describe
the interests you must report, from your agency;
they are not part of the Form 700
• Candidates running for local elective oces that are
designated in a conict of interest code (e.g., county
sheris, city clerks, school board trustees, and water
board members)
Exception:
• Candidates for a county central committee are not
required to le the Form 700.
• Members of newly created boards and
commissions not yet covered under a conict of
interest code
• Employees in newly created positions of existing
agencies
For more information, see Reference Pamphlet, page 3, at
www.fppc.ca.gov.
Where to le:
87200 Filers
State oces Your agency
Judicial oces The clerk of your court
Retired Judges Directly with FPPC
County oces Your county ling ocial
City oces Your city clerk
Multi-County oces Your agency
Code Filers — State and Local Ocials, Employees,
and Consultants Designated in a Conict of Interest
Code: File with your agency, board, or commission unless
otherwise specied in your agency’s code (e.g., Legislative
sta les directly with FPPC). In most cases, the agency,
board, or commission will retain the statements.
Members of Boards and Commissions of Newly
Created Agencies: File with your newly created agency
or with your agency’s code reviewing body.
Employees in Newly Created Positions of Existing
Agencies: File with your agency or with your agency’s
code reviewing body. (See Reference Pamphlet, page 3.)
Candidates: File with your local elections oce.
How to le:
The Form 700 is available at www.fppc.ca.gov. Form
700 schedules are also available in Excel format. All
statements must have an original “wet” signature or be
duly authorized by your ling ocer to le electronically
under Government Code Section 87500.2.
When to le:
Annual Statements
March 2, 2020
- Elected State Ocers
- Judges and Court Commissioners
- State Board and State Commission Members listed
in Government Code Section 87200
April 1, 2020
- Most other lers
Individuals ling under conict of interest codes in city and
county jurisdictions should verify the annual ling date with
their local ling ocers.
Statements postmarked by the ling deadline are
considered led on time.
Statements of 30 pages or less may be emailed or faxed by
the deadline as long as the originally signed paper version is
sent by rst class mail to the ling ocial within 24 hours.
Assuming Oce and Leaving Oce Statements
Most lers le within 30 days of assuming or leaving oce
or within 30 days of the eective date of a newly adopted
or amended conict of interest code.
Exception:
If you assumed oce between October 1, 2019, and
December 31, 2019, and led an assuming oce
statement, you are not required to le an annual
statement until March 2, 2, 2021, or April 1, 2021,
whichever is applicable. The annual statement will cover
the day after you assumed oce through December 31,
2020. (See Reference Pamphlet, page 6, for additional
exceptions.
Candidate Statements
File no later than the nal ling date for the declaration
of candidacy or nomination documents. A candidate
statement is not required if you led an assuming oce or
annual statement for the same jurisdiction within 60 days
before ling a declaration of candidacy or other nomination
documents.
Late Statements
There is no provision for ling deadline extensions unless
the ler is serving in active military duty. (See page 19 for
information on penalties and nes.)
Amendments
Statements may be amended at any time. You are only
required to amend the schedule that needs to be revised.
It is not necessary to amend the entire led form. Obtain
amendment schedules at www.fppc.ca.gov.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 3
Types of Statements
Assuming Oce Statement:
If you are a newly appointed ocial or are newly employed
in a position designated, or that will be designated, in
a state or local agency’s conict of interest code, your
assuming oce date is the date you were sworn in or
otherwise authorized to serve in the position. If you are a
newly elected ocial, your assuming oce date is the date
you were sworn in.
• Report: Investments, interests in real property, and
business positions held on the date you assumed the
oce or position must be reported. In addition, income
(including loans, gifts, and travel payments) received
during the 12 months prior to the date you assumed the
oce or position.
For positions subject to conrmation by the State Senate
or the Commission on Judicial Appointments, your
assuming oce date is the date you were appointed or
nominated to the position.
• Example: Maria Lopez was nominated by the Governor
to serve on a state agency board that is subject to state
Senate conrmation. The assuming oce date is the
date Maria’s nomination is submitted to the Senate.
Maria must report investments, interests in real
property, and business positions she holds on that date,
and income (including loans, gifts, and travel payments)
received during the 12 months prior to that date.
If your oce or position has been added to a newly
adopted or newly amended conict of interest code, use
the eective date of the code or amendment, whichever is
applicable.
• Report: Investments, interests in real property, and
business positions held on the eective date of the
code or amendment must be reported. In addition,
income (including loans, gifts, and travel payments)
received during the 12 months prior to the eective date
of the code or amendment.
Annual Statement:
Generally, the period covered is January 1, 2019,
through December 31, 2019. If the period covered by
the statement is dierent than January 1, 2019, through
December 31, 2019, (for example, you assumed oce
between October 1, 2018, and December 31, 2018 or you
are combining statements), you must specify the period
covered.
• Investments, interests in real property, business
positions held, and income (including loans, gifts, and
travel payments) received during the period covered
by the statement must be reported. Do not change the
preprinted dates on Schedules A-1, A-2, and B unless
you are required to report the acquisition or disposition
of an interest that did not occur in 2019.
• If your disclosure category changes during a reporting
period, disclose under the old category until the
eective date of the conict of interest code amendment
and disclose under the new disclosure category through
the end of the reporting period.
Leaving Oce Statement:
Generally, the period covered is January 1, 2019,
through the date you stopped performing the duties of
your position. If the period covered diers from January
1, 2019, through the date you stopped performing the
duties of your position (for example, you assumed oce
between October 1, 2018, and December 31, 2018, or
you are combining statements), the period covered must
be specied. The reporting period can cover parts of two
calendar years.
• Report: Investments, interests in real property, business
positions held, and income (including loans, gifts, and
travel payments) received during the period covered by
the statement. Do not change the preprinted dates on
Schedules A-1, A-2, and B unless you are required to
report the acquisition or disposition of an interest that
did not occur in 2019.
Candidate Statement:
If you are ling a statement in connection with your
candidacy for state or local oce, investments, interests
in real property, and business positions held on the date
of ling your declaration of candidacy must be reported.
In addition, income (including loans, gifts, and travel
payments) received during the 12 months prior to the date
of ling your declaration of candidacy is reportable. Do not
change the preprinted dates on Schedules A-1, A-2, and B.
Candidates running for local elective oces (e.g., county
sheris, city clerks, school board trustees, or water
district board members) must le candidate statements,
as required by the conict of interest code for the elected
position. The code may be obtained from the agency of
the elected position.
Amendments:
If you discover errors or omissions on any statement, le
an amendment as soon as possible. You are only required
to amend the schedule that needs to be revised; it is not
necessary to rele the entire form. Obtain amendment
schedules from the FPPC website at www.fppc.ca.gov.
Note: Once you le your statement, you may not withdraw
it. All changes must be noted on amendment schedules.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 4
Schedule C - Income, Loans, & Business Positions – schedule attached
Schedule D - Income – Gifts – schedule attached
Schedule E - Income – Gifts – Travel Payments – schedule attached
Leaving Ofce: Date Left / /
(Check one circle.)
The period covered is January 1, 2019, through the date of
leaving ofce.
The period covered is / / , through
the date of leaving ofce.
Annual: The period covered is January 1, 2019, through
December 31, 2019.
The period covered is / / , through
December 31, 2019.
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A PUBLIC DOCUMENT
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
(month, day, year)
3. Type of Statement (Check at least one box)
State
Judge, Retired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction) (Statewide Jurisdiction)
Multi-County
County of
City of
Other
2. Jurisdiction of Ofce (Check at least one box)
Candidate: Date of Election and ofce sought, if different than Part 1:
Assuming Ofce: Date assumed / /
Date Initial Filing Received
Filing Ocial Use Only
Please type or print in ink.
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
Agency Name (Do not use acronyms)
Division, Board, Department, District, if applicable Your Position
1. Ofce, Agency, or Court
NAME OF FILER (LAST) (FIRST) (MIDDLE)
MAILING ADDRESS STREET CITY STATE ZIP CODE
( )
DAYTIME TELEPHONE NUMBER
EMAIL ADDRESS
(Business or Agency Address Recommended - Public Document)
Signature
(File the originally signed paper statement with your ling ofcial.)
5. Verication
► If ling for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency: Position:
-or-
-or-
None - No reportable interests on any schedule
4. Schedule Summary (must complete)
Schedules attached
Schedule A-1 - Investments – schedule attached
Schedule A-2 - Investments – schedule attached
Schedule B - Real Property – schedule attached
► Total number of pages including this cover page:
-or-
FPPC Form 700 - Cover Page (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 5
• If your agency is a multi-county oce, list each county in
which your agency has jurisdiction.
• If your agency is not a state oce, court, county oce, city
oce, or multi-county oce (e.g., school districts, special
districts and JPAs), check the “other” box and enter the
county or city in which the agency has jurisdiction.
Example:
This ler is a member of a water district board with jurisdiction
in portions of Yuba and Sutter Counties.
Part 3. Type of Statement
Check at least one box. The period covered by a statement
is determined by the type of statement you are ling. If you
are completing a 2019 annual statement, do not change the
pre-printed dates to reect 2020. Your annual statement is
used for reporting the previous year’s economic interests.
Economic interests for your annual ling covering January 1,
2020, through December 31, 2020, will be disclosed on your
statement led in 2021. See Reference Pamphlet, page 4.
Combining Statements: Certain types of statements may be
combined. For example, if you leave oce after January 1,
but before the deadline for ling your annual statement, you
may combine your annual and leaving oce statements. File
by the earliest deadline. Consult your ling ocer or the
FPPC.
Part 4. Schedule Summary
• Complete the Schedule Summary after you have reviewed
each schedule to determine if you have reportable
interests.
• Enter the total number of completed pages including the
cover page and either check the box for each schedule you
use to disclose interests; or if you have nothing to disclose
on any schedule, check the “No reportable interests” box.
Please do not attach any blank schedules.
Part 5. Verication
Complete the verication by signing the statement and
entering the date signed. All statements must have an original
“wet” signature or be duly authorized by your ling ocer to
le electronically under Government Code Section 87500.2.
When you sign your statement, you are stating, under
penalty of perjury, that it is true and correct. Only the ler
has authority to sign the statement. An unsigned statement
is not considered led and you may be subject to late ling
penalties.
Instructions
Cover Page
Enter your name, mailing address, and daytime telephone
number in the spaces provided. Because the Form 700 is
a public document, you may list your business/oce
address instead of your home address.
Part 1. Oce, Agency, or Court
• Enter the name of the oce sought or held, or the agency
or court. Consultants must enter the public agency name
rather than their private rm’s name. (Examples: State
Assembly; Board of Supervisors; Oce of the Mayor;
Department of Finance; Hope County Superior Court)
• Indicate the name of your division, board, or district, if
applicable. (Examples: Division of Waste Management;
Board of Accountancy; District 45). Do not use acronyms.
• Enter your position title. (Examples: Director; Chief
Counsel; City Council Member; Sta Services Analyst)
• If you hold multiple positions (i.e., a city council member
who also is a member of a county board or commission),
you may be required to le statements with each agency.
To simplify your ling obligations, you may complete an
expanded statement.
• To do this, enter the name of the other agency(ies)
with which you are required to le and your position
title(s) in the space provided. Do not use acronyms.
Attach an additional sheet if necessary. Complete
one statement covering the disclosure requirements
for all positions. Each copy must contain an original
signature. Therefore, before signing the statement,
make a copy for each agency. Sign each copy with an
original signature and le with each agency.
If you assume or leave a position after a ling deadline,
you must complete a separate statement. For example, a
city council member who assumes a position with a county
special district after the April annual ling deadline must le
a separate assuming oce statement. In subsequent years,
the city council member may expand his or her annual ling to
include both positions.
Example:
Brian Bourne is a city council member for the City of Lincoln
and a board member for the Camp Far West Irrigation
District – a multi-county agency that covers Placer and
Yuba counties. Brian will complete one Form 700 using full
disclosure (as required for the city position) and covering
interests in both Placer and Yuba counties (as required for
the multi-county position) and list both positions on the Cover
Page. Before signing the statement, Brian will make a copy
and sign both statements. One statement will be led with
City of Lincoln and the other will be led with Camp Far West
Irrigation District. Both will contain an original signature.
Part 2. Jurisdiction of Oce
• Check the box indicating the jurisdiction of your agency
and, if applicable, identify the jurisdiction. Judges, judicial
candidates, and court commissioners have statewide
jurisdiction. All other lers should review the Reference
Pamphlet, page 13, to determine their jurisdiction.
State
Judge or Court Commissioner (Statewide Jurisdiction)
Multi-County
County of
City of
Other
2. Jurisdiction of Ofce (Check at least one box)
Agency Name (Do not use acronyms)
Division, Board, Department, District, if applicable Your Position
1. Ofce, Agency, or Court
► If ling for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency: Position:
Yuba & Sutter Counties
Board MemberN/A
N/A
Feather River Irrigation District
FPPC Form 700 - Cover Page (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 6
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
19 19
19
19
19
19
19
1919
Name
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
Comments:
SCHEDULE A-1
Investments
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10%)
Investments must be itemized.
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
19
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership
Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership
Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership
Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership
Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership
Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership
Income Received of $0 - $499
Income Received of $500 or More (Report on Schedule C)
19
19
FPPC Form 700 - Schedule A-1 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 7
Instructions – Schedules A-1 and A-2
Investments
“Investment” means a nancial interest in any business
entity (including a consulting business or other independent
contracting business) that is located in, doing business in,
planning to do business in, or that has done business during
the previous two years in your agency’s jurisdiction in which
you, your spouse or registered domestic partner, or your
dependent children had a direct, indirect, or benecial interest
totaling $2,000 or more at any time during the reporting
period. (See Reference Pamphlet, page 13.)
Reportable investments include:
• Stocks, bonds, warrants, and options, including those held
in margin or brokerage accounts and managed investment
funds (See Reference Pamphlet, page 13.)
• Sole proprietorships
• Your own business or your spouse’s or registered
domestic partner’s business (See Reference Pamphlet,
page 8, for the denition of “business entity.”)
• Your spouse’s or registered domestic partner’s
investments even if they are legally separate property
• Partnerships (e.g., a law rm or family farm)
• Investments in reportable business entities held in a
retirement account (See Reference Pamphlet, page 15.)
• If you, your spouse or registered domestic partner,
and dependent children together had a 10% or greater
ownership interest in a business entity or trust (including
a living trust), you must disclose investments held by the
business entity or trust. (See Reference Pamphlet, page
16, for more information on disclosing trusts.)
• Business trusts
You are not required to disclose:
• Government bonds, diversied mutual funds, certain
funds similar to diversied mutual funds (such as
exchange traded funds) and investments held in certain
retirement accounts. (See Reference Pamphlet, page 13.)
(Regulation 18237)
• Bank accounts, savings accounts, money market accounts
and certicates of deposits
• Insurance policies
• Annuities
• Commodities
• Shares in a credit union
• Government bonds (including municipal bonds)
• Retirement accounts invested in non-reportable interests
(e.g., insurance policies, mutual funds, or government
bonds) (See Reference Pamphlet, page 15.)
• Government dened-benet pension plans (such as
CalPERS and CalSTRS plans)
• Certain interests held in a blind trust (See Reference
Pamphlet, page 16.)
Use Schedule A-1 to report ownership of less than 10%
(e.g., stock). Schedule C (Income) may also be required if
the investment is not a stock or corporate bond. (See second
example below.)
Use Schedule A-2 to report ownership of 10% or greater
(e.g., a sole proprietorship).
To Complete Schedule A-1:
Do not attach brokerage or nancial statements.
• Disclose the name of the business entity.
• Provide a general description of the business activity of
the entity (e.g., pharmaceuticals, computers, automobile
manufacturing, or communications).
• Check the box indicating the highest fair market value of
your investment during the reporting period. If you are
ling a candidate or an assuming oce statement, indicate
the fair market value on the ling date or the date you took
oce, respectively. (See page 20 for more information.)
• Identify the nature of your investment (e.g., stocks,
warrants, options, or bonds).
• An acquired or disposed of date is only required if you
initially acquired or entirely disposed of the investment
interest during the reporting period. The date of a stock
dividend reinvestment or partial disposal is not required.
Generally, these dates will not apply if you are ling a
candidate or an assuming oce statement.
Examples:
Frank Byrd holds a state agency position. His conict of
interest code requires full disclosure of investments. Frank
must disclose his stock holdings of $2,000 or more in any
company that is located in or does business in California,
as well as those stocks held by his spouse or registered
domestic partner and dependent children.
Alice Lance is a city council member. She has a 4% interest,
worth $5,000, in a limited partnership located in the city. Alice
must disclose the partnership on Schedule A-1 and income of
$500 or more received from the partnership on Schedule C.
Reminders
• Do you know your agency’s jurisdiction?
• Did you hold investments at any time during the period
covered by this statement?
• Code lers – your disclosure categories may only
require disclosure of specic investments.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 8
NATURE OF INTEREST
Property Ownership/Deed of Trust Stock Partnership
Leasehold Other
Check box if additional schedules reporting investments or real property
are attached
Yrs. remaining
Other
NATURE OF INVESTMENT
Partnership Sole Proprietorship
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
19 19
19 19
19 19
SCHEDULE A-2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
Comments:
Name
Address (Business Address Acceptable)
Name
Address (Business Address Acceptable)
FAIR MARKET VALUE
$0 - $1,999
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
FAIR MARKET VALUE
$0 - $1,999
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
GENERAL DESCRIPTION OF THIS BUSINESS
GENERAL DESCRIPTION OF THIS BUSINESS
INVESTMENT REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor’s Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
INVESTMENT REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor’s Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
►4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR
LEASED BY THE BUSINESS ENTITY OR TRUST
►4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR
LEASED BY THE BUSINESS ENTITY OR TRUST
Check one
Trust, go to 2 Business Entity, complete the box, then go to 2
Check one
Trust, go to 2 Business Entity, complete the box, then go to 2
►2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST)
►2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST)
Name
700
Check one box: Check one box:
YOUR BUSINESS POSITION
YOUR BUSINESS POSITION
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
$0 - $499
$500 - $1,000
$1,001 - $10,000
$0 - $499
$500 - $1,000
$1,001 - $10,000
$10,001 - $100,000
OVER $100,000
$10,001 - $100,000
OVER $100,000
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
►1. BUSINESS ENTITY OR TRUST
►1. BUSINESS ENTITY OR TRUST
NATURE OF INTEREST
Property Ownership/Deed of Trust Stock Partnership
Leasehold Other
Check box if additional schedules reporting investments or real property
are attached
Yrs. remaining
19 19
Other
NATURE OF INVESTMENT
Partnership Sole Proprietorship
or
►3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.)
►3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.)
FPPC Form 700 - Schedule A-2 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 9
None
Names listed below
None
or
Names listed below
Instructions – Schedule A-2
Investments, Income, and Assets of Business Entities/Trusts
Use Schedule A-2 to report investments in a business
entity (including a consulting business or other independent
contracting business) or trust (including a living trust) in
which you, your spouse or registered domestic partner,
and your dependent children, together or separately, had a
10% or greater interest, totaling $2,000 or more, during the
reporting period and which is located in, doing business in,
planning to do business in, or which has done business during
the previous two years in your agency’s jurisdiction. (See
Reference Pamphlet, page 13.) A trust located outside your
agency’s jurisdiction is reportable if it holds assets that are
located in or doing business in the jurisdiction. Do not report
a trust that contains non-reportable interests. For example,
a trust containing only your personal residence not used in
whole or in part as a business, your savings account, and
some municipal bonds, is not reportable.
Also report on Schedule A-2 investments and real property
held by that entity or trust if your pro rata share of the
investment or real property interest was $2,000 or more
during the reporting period.
To Complete Schedule A-2:
Part 1. Disclose the name and address of the business entity
or trust. If you are reporting an interest in a business entity,
check “Business Entity” and complete the box as follows:
• Provide a general description of the business activity of the
entity.
• Check the box indicating the highest fair market value of
your investment during the reporting period.
• If you initially acquired or entirely disposed of this interest
during the reporting period, enter the date acquired or
disposed.
• Identify the nature of your investment.
• Disclose the job title or business position you held with the
entity, if any (i.e., if you were a director, ocer, partner,
trustee, employee, or held any position of management). A
business position held by your spouse is not reportable.
Part 2. Check the box indicating your pro rata share of the
gross income received by the business entity or trust. This
amount includes your pro rata share of the gross income
from the business entity or trust, as well as your community
property interest in your spouse’s or registered domestic
partner’s share. Gross income is the total amount of income
before deducting expenses, losses, or taxes.
Part 3. Disclose the name of each source of income that is
located in, doing business in, planning to do business in, or
that has done business during the previous two years in your
agency’s jurisdiction, as follows:
• Disclose each source of income and outstanding loan
to the business entity or trust identied in Part 1 if
your pro rata share of the gross income (including your
community property interest in your spouse’s or registered
domestic partner’s share) to the business entity or trust
from that source was $10,000 or more during the reporting
period. (See Reference Pamphlet, page 11, for examples.)
Income from governmental sources may be reportable
if not considered salary. See Regulation 18232. 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 ocial status are not
reportable.
• Disclose each individual or entity that was a source
of commission income of $10,000 or more during the
reporting period through the business entity identied in
Part 1. (See Reference Pamphlet, page 8.)
You may be required to disclose sources of income located
outside your jurisdiction. For example, you may have a client
who resides outside your jurisdiction who does business on a
regular basis with you. Such a client, if a reportable source of
$10,000 or more, must be disclosed.
Mark “None” if you do not have any reportable $10,000
sources of income to disclose. Phrases such as “various
clients” or “not disclosing sources pursuant to attorney-client
privilege” are not adequate disclosure. (See Reference
Pamphlet, page 14, for information on procedures to request
an exemption from disclosing privileged information.)
Part 4. Report any investments or interests in real property
held or leased by the entity or trust identied in Part 1 if your
pro rata share of the interest held was $2,000 or more during
the reporting period. Attach additional schedules or use
FPPC’s Form 700 Excel spreadsheet if needed.
• Check the applicable box identifying the interest held as
real property or an investment.
• If investment, provide the name and description of the
business entity.
• If real property, report the precise location (e.g., an
assessor’s parcel number or address).
• Check the box indicating the highest fair market value
of your interest in the real property or investment during
the reporting period. (Report the fair market value of the
portion of your residence claimed as a tax deduction if you
are utilizing your residence for business purposes.)
• Identify the nature of your interest.
• Enter the date acquired or disposed only if you initially
acquired or entirely disposed of your interest in the
property or investment during the reporting period.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 10
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ / / /
ACQUIRED DISPOSED
19 1919 19
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR’S PARCEL NUMBER OR STREET ADDRESS
► ASSESSOR’S PARCEL NUMBER OR STREET ADDRESS
CITY CITY
INTEREST RATE TERM (Months/Years)
% None
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.
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.
NATURE OF INTEREST
Ownership/Deed of Trust Easement
Leasehold
Yrs. remaining
Other
NATURE OF INTEREST
Ownership/Deed of Trust Easement
Leasehold
Yrs. remaining
Other
Comments:
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $0 - $499 $1,001 - $10,000
$10,001 - $100,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $0 - $499 $1,001 - $10,000
$10,001 - $100,000
HIGHEST BALANCE DURING REPORTING PERIOD
Guarantor, if applicable
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Years)
% None
Guarantor, if applicable
HIGHEST BALANCE DURING REPORTING PERIOD
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
* 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 ocial status. Personal loans and
loans received not in a lender’s regular course of business must be disclosed as follows:
None
None
FPPC Form 700 - Schedule B (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 11
Name
disclose the number of years remaining on the lease.
• If you received rental income, check the box indicating the
gross amount you received.
• If you had a 10% or greater interest in real property and
received rental income, list the name of the source(s) if
your pro rata share of the gross income from any single
tenant was $10,000 or more during the reporting period. If
you received a total of $10,000 or more from two or more
tenants acting in concert (in most cases, this will apply
to married couples), disclose the name of each tenant.
Otherwise, mark “None.”
• Loans from a private lender that total $500 or more and
are secured by real property may be reportable. 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 ocial
status are not reportable.
When reporting a loan:
- Provide the name and address of the lender.
- Describe the lender’s business activity.
- Disclose the interest rate and term of the loan. For
variable interest rate loans, disclose the conditions
of the loan (e.g., Prime + 2) or the average interest
rate paid during the reporting period. The term of
a loan is the total number of months or years given
for repayment of the loan at the time the loan was
established.
- Check the box indicating the highest balance of the
loan during the reporting period.
- Identify a guarantor, if
applicable.
If you have more than one
reportable loan on a single
piece of real property, report
the additional loan(s) on
Schedule C.
Example:
Allison Gande is a city
planning commissioner.
During the reporting period,
she received rental income of
$12,000, from a single tenant
who rented property she
owned in the city’s jurisdiction.
If Allison received $6,000
each from two tenants, the
tenants’ names would not be
required because no single
tenant paid her $10,000 or
more. A married couple is
considered a single tenant.
Instructions – Schedule B
Interests in Real Property
Reminders
• Income and loans already reported on Schedule B are
not also required to be reported on Schedule C.
• Real property already reported on Schedule A-2, Part 4
is not also required to be reported on Schedule B.
• Code lers – do your disclosure categories require
disclosure of real property?
Report interests in real property located in your agency’s
jurisdiction in which you, your spouse or registered domestic
partner, or your dependent children had a direct, indirect, or
benecial interest totaling $2,000 or more any time during
the reporting period. Real property is also considered to be
“within the jurisdiction” of a local government agency if the
property or any part of it is located within two miles outside
the boundaries of the jurisdiction or within two miles of any
land owned or used by the local government agency. (See
Reference Pamphlet, page 13.)
Interests in real property include:
• An ownership interest (including a benecial ownership
interest)
• A deed of trust, easement, or option to acquire property
• A leasehold interest (See Reference Pamphlet, page 14.)
• A mining lease
• An interest in real property held in a retirement account
(See Reference Pamphlet, page 15.)
• An interest in real property held by a business entity or
trust in which you, your spouse or registered domestic
partner, and your dependent children together had a 10%
or greater ownership interest (Report on Schedule A-2.)
• Your spouse’s or registered domestic partner’s interests in
real property that are legally held separately by him or her
You are not required to report:
• A residence, such as a home or vacation cabin, used
exclusively as a personal residence (However, a residence
in which you rent out a room or for which you claim a
business deduction may be reportable. If reportable,
report the fair market value of the portion claimed as a tax
deduction.)
• Some interests in real property held through a blind trust
(See Reference Pamphlet, page 16.)
• Please note: A non-reportable property can still
be grounds for a conict of interest and may be
disqualifying.
To Complete Schedule B:
• Report the precise location (e.g., an assessor’s parcel
number or address) of the real property.
• Check the box indicating the fair market value of your
interest in the property (regardless of what you owe on the
property).
• Enter the date acquired or disposed only if you initially
acquired or entirely disposed of your interest in the
property during the reporting period.
• Identify the nature of your interest. If it is a leasehold,
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 12
NAME OF LENDER
*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
IF APPLICABLE, LIST DATE:
/ /
/ /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ /
/ /
ACQUIRED DISPOSED
18 1818 18
SCHEDULE B
Interests in Real Property
(Including Rental Income)
Name
► ASSESSOR’S PARCEL NUMBER OR STREET ADDRESS
► ASSESSOR’S PARCEL NUMBER OR STREET ADDRESS
CITY CITY
INTEREST RATE TERM (Months/Years)
%
None
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.
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.
NATURE OF INTEREST
Ownership/Deed of Trust
Easement
Leasehold
Yrs. remaining
Other
NATURE OF INTEREST
Ownership/Deed of Trust
Easement
Leasehold
Yrs. remaining
Other
Comments:
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000
$0 - $499
$1,001 - $10,000
$10,001 - $100,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000
$0 - $499
$1,001 - $10,000
$10,001 - $100,000
HIGHEST BALANCE DURING REPORTING PERIOD
Guarantor, if applicable
OVER $100,000
$500 - $1,000
$1,001 - $10,000
$10,001 - $100,000
FPPC Form 700 (2017/2018) Sch. B
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
NAME OF LENDER
*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Years)
%
None
Guarantor, if applicable
HIGHEST BALANCE DURING REPORTING PERIOD
OVER $100,000
$500 - $1,000
$1,001 - $10,000
$10,001 - $100,000
*
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 ofcial status. Personal loans and
loans received not in a lender’s regular course of business must be disclosed as follows:
None
None
4600 24th Street
Sacramento
Henry Wells
Sophia Petroillo
2121 Blue Sky Parkway, Sacramento
Restaurant Owner
8
15 Years
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
IF APPLICABLE, LIST DATE:
/ /
/ /
ACQUIRED DISPOSED
IF APPLICABLE, LIST DATE:
/ /
/ /
ACQUIRED DISPOSED
18 1818 18
SCHEDULE B
Interests in Real Property
(Including Rental Income)
Name
► ASSESSOR’S PARCEL NUMBER OR STREET ADDRESS
► ASSESSOR’S PARCEL NUMBER OR STREET ADDRESS
CITY CITY
INTEREST RATE TERM (Months/Years)
% None
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.
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.
NATURE OF INTEREST
Ownership/Deed of Trust Easement
Leasehold
Yrs. remaining
Other
NATURE OF INTEREST
Ownership/Deed of Trust Easement
Leasehold
Yrs. remaining
Other
Comments:
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $0 - $499 $1,001 - $10,000
$10,001 - $100,000
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
OVER $100,000
$500 - $1,000 $0 - $499 $1,001 - $10,000
$10,001 - $100,000
HIGHEST BALANCE DURING REPORTING PERIOD
Guarantor, if applicable
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
FPPC Form 700 (2017/2018) Sch. B
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Years)
% None
Guarantor, if applicable
HIGHEST BALANCE DURING REPORTING PERIOD
OVER $100,000
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000
*
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 ofcial status. Personal loans and
loans received not in a lender’s regular course of business must be disclosed as follows:
None
None
4600 24th Street
Sacramento
Henry Wells
Sophia Petroillo
2121 Blue Sky Parkway, Sacramento
Restaurant Owner
8
15 Years
(Real property, car, boat, etc.) (Real property, car, boat, etc.)
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
GROSS INCOME RECEIVED
No Income - Business Position Only
No Income - Business Position Only
GROSS INCOME RECEIVED
Name
OVER $100,000 OVER $100,000
$500 - $1,000 $500 - $1,000
$1,001 - $10,000 $1,001 - $10,000
$10,001 - $100,000 $10,001 - $100,000
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
► 1. INCOME RECEIVED
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
► 1. INCOME RECEIVED
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
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
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 ocial status. Personal loans and loans received not in a lender’s
regular course of business must be disclosed as follows:
SECURITY FOR LOAN
None Personal residence
Real Property
Guarantor
Other
Street address
City
(Describe)
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse’s or registered domestic partner’s income
(For self-employed use Schedule A-2.)
Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
Sale of
Other
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse’s or registered domestic partner’s income
(For self-employed use Schedule A-2.)
Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
Sale of
Other
(Describe) (Describe)
(Describe) (Describe)
Rental Income, list each source of $10,000 or more Rental Income, list each source of $10,000 or moreCommission or Commission or
Loan repayment Loan repayment
FPPC Form 700 - Schedule C (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 13
Instructions – Schedule C
Income, Loans, & Business Positions
(Income Other Than Gifts and Travel Payments)
Reporting Income:
Report the source and amount of gross income of $500 or
more you received during the reporting period. Gross income
is the total amount of income before deducting expenses,
losses, or taxes and includes loans other than loans from a
commercial lending institution. (See Reference Pamphlet,
page 11.) You must also report the source of income to your
spouse or registered domestic partner if your community
property share was $500 or more during the reporting period.
The source and income must be reported only if the source
is located in, doing business in, planning to do business in,
or has done business during the previous two years in your
agency’s jurisdiction. (See Reference Pamphlet, page 13.)
Reportable sources of income may be further limited by
your disclosure category located in your agency’s conict of
interest code.
Reporting Business Positions:
You must report your job title with each reportable business
entity even if you received no income during the reporting
period. Use the comments section to indicate that no income
was received.
Commonly reportable income and loans include:
• Salary/wages, per diem, and reimbursement for expenses
including travel payments provided by your employer
• Community property interest (50%) in your spouse’s
or registered domestic partner’s income - report the
employer’s name and all other required information
• Income from investment interests, such as partnerships,
reported on Schedule A-1
• Commission income not required to be reported on
Schedule A-2 (See Reference Pamphlet, page 8.)
• Gross income from any sale, including the sale of a house
or car (Report your pro rata share of the total sale price.)
• Rental income not required to be reported on Schedule B
• Prizes or awards not disclosed as gifts
• Payments received on loans you made to others
• An honorarium received prior to becoming a public ocial
(See Reference Pamphlet, page 10.)
• Incentive compensation (See Reference Pamphlet, page
12.)
You are not required to report:
• Salary, reimbursement for expenses or per diem, or
social security, disability, or other similar benet payments
received by you or your spouse or registered domestic
partner from a federal, state, or local government agency.
• Stock dividends and income from the sale of stock unless
the source can be identied.
• Income from a PERS retirement account.
(See Reference Pamphlet, page 12.)
To Complete Schedule C:
Part 1. Income Received/Business Position Disclosure
• Disclose the name and address of each source of income
or each business entity with which you held a business
position.
• Provide a general description of the business activity if the
source is a business entity.
• Check the box indicating the amount of gross income
received.
• Identify the consideration for which the income was
received.
• For income from commission sales, check the box
indicating the gross income received and list the name of
each source of commission income of $10,000 or more.
(See Reference Pamphlet, page 8.) Note: If you receive
commission income on a regular basis or have an
ownership interest of 10% or more, you must disclose
the business entity and the income on Schedule A-2.
• Disclose the job title or business position, if any, that you
held with the business entity, even if you did not receive
income during the reporting period.
Part 2. Loans Received or Outstanding During the
Reporting Period
• Provide the name and address of the lender.
• Provide a general description of the business activity if the
lender is a business entity.
• Check the box indicating the highest balance of the loan
during the reporting period.
• Disclose the interest rate and the term of the loan.
- For variable interest rate loans, disclose the conditions
of the loan (e.g., Prime + 2) or the average interest rate
paid during the reporting period.
- The term of the loan is the total number of months or
years given for repayment of the loan at the time the
loan was entered into.
• Identify the security, if any, for the loan.
Reminders
• Code lers – your disclosure categories may not require
disclosure of all sources of income.
• If you or your spouse or registered domestic partner are
self-employed, report the business entity on Schedule A-2.
• Do not disclose on Schedule C income, loans, or business
positions already reported on Schedules A-2 or B.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 14
SCHEDULE D
Income – Gifts
Comments:
Name
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
/ / $
/ / $
/ / $
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
/ / $
/ / $
/ / $
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
/ / $
/ / $
/ / $
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
/ / $
/ / $
/ / $
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
/ / $
/ / $
/ / $
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
/ / $
/ / $
/ / $
FPPC Form 700 - Schedule D (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 15
Instructions – Schedule D
Income – Gifts
Reminders
• Gifts from a single source are subject to a $500 limit in
2019. (See Reference Pamphlet, page 10.)
• Code lers – you only need to report gifts from
reportable sources.
Gift Tracking Mobile Application
• FPPC has created a gift tracking app for mobile
devices that helps lers track gifts and provides a quick
and easy way to upload the information to the Form
700. Visit FPPC’s website to download the app.
A gift is anything of value for which you have not provided
equal or greater consideration to the donor. A gift is
reportable if its fair market value is $50 or more. In addition,
multiple gifts totaling $50 or more received during the
reporting period from a single source must be reported.
It is the acceptance of a gift, not the ultimate use to which it is
put, that imposes your reporting obligation. Except as noted
below, you must report a gift even if you never used it or if you
gave it away to another person.
If the exact amount of a gift is unknown, you must make a
good faith estimate of the item’s fair market value. Listing
the value of a gift as “over $50” or “value unknown” is not
adequate disclosure. In addition, if you received a gift through
an intermediary, you must disclose the name, address, and
business activity of both the donor and the intermediary. You
may indicate an intermediary either in the “source” eld
after the name or in the “comments” section at the bottom
of Schedule D.
Commonly reportable gifts include:
• Tickets/passes to sporting or entertainment events
• Tickets/passes to amusement parks
• Parking passes not used for ocial agency business
• Food, beverages, and accommodations, including those
provided in direct connection with your attendance at a
convention, conference, meeting, social event, meal, or like
gathering
• Rebates/discounts not made in the regular course of
business to members of the public without regard to ocial
status
• Wedding gifts (See Reference Pamphlet, page 16)
• An honorarium received prior to assuming oce (You may
report an honorarium as income on Schedule C, rather
than as a gift on Schedule D, if you provided services of
equal or greater value than the payment received. See
Reference Pamphlet, page 10.)
• Transportation and lodging (See Schedule E.)
• Forgiveness of a loan received by you
You are not required to disclose:
• Gifts that were not used and that, within 30 days after
receipt, were returned to the donor or delivered to a
charitable organization or government agency without
being claimed by you as a charitable contribution for tax
purposes
• Gifts from your spouse or registered domestic partner,
child, parent, grandparent, grandchild, brother, sister, and
certain other family members (See Regulation 18942 for a
complete list.). The exception does not apply if the donor
was acting as an agent or intermediary for a reportable
source who was the true donor.
• Gifts of similar value exchanged between you and an
individual, other than a lobbyist registered to lobby your
state agency, on holidays, birthdays, or similar occasions
• Gifts of informational material provided to assist you in the
performance of your ocial duties (e.g., books, pamphlets,
reports, calendars, periodicals, or educational seminars)
• A monetary bequest or inheritance (However, inherited
investments or real property may be reportable on other
schedules.)
• Personalized plaques or trophies with an individual value of
less than $250
• Campaign contributions
• Up to two tickets, for your own use, to attend a fundraiser
for a campaign committee or candidate, or to a fundraiser
for an organization exempt from taxation under Section
501(c)(3) of the Internal Revenue Code. The ticket must
be received from the organization or committee holding the
fundraiser.
• Gifts given to members of your immediate family if the
source has an established relationship with the family
member and there is no evidence to suggest the donor had
a purpose to inuence you. (See Regulation 18943.)
• Free admission, food, and nominal items (such as a pen,
pencil, mouse pad, note pad or similar item) available to
all attendees, at the event at which the ocial makes a
speech (as dened in Regulation 18950(b)(2)), so long as
the admission is provided by the person who organizes the
event.
• Any other payment not identied above, that would
otherwise meet the denition of gift, where the payment is
made by an individual who is not a lobbyist registered to
lobby the ocial’s state agency, where it is clear that the
gift was made because of an existing personal or business
relationship unrelated to the ocial’s position and there
is no evidence whatsoever at the time the gift is made to
suggest the donor had a purpose to inuence you.
To Complete Schedule D:
• Disclose the full name (not an acronym), address, and, if a
business entity, the business activity of the source.
• Provide the date (month, day, and year) of receipt, and
disclose the fair market value and description of the gift.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 16
SCHEDULE E
Income – Gifts
Travel Payments, Advances,
and Reimbursements
Name
Comments:
700
FAIR POLITICAL PRACTICES COMMISSION
CALIFORNIA FORM
• Mark either the gift or income box.
• Mark the “501(c)(3)” box for a travel payment received from a nonprot 501(c)(3) organization
or the “Speech” box if you made a speech or participated in a panel. Per Government Code
Section 89506, these payments may not be subject to the gift limit. However, they may result
in a disqualifying conict of interest.
• For gifts of travel, provide the travel destination.
DATE(S): / / - / / AMT: $
(If gift)
DATE(S): / / - / / AMT: $
(If gift)
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE
► MUST CHECK ONE:
Made a Speech/Participated in a Panel
Other - Provide Description
Gift -or- Income
► If Gift, Provide Travel Destination
► MUST CHECK ONE:
Made a Speech/Participated in a Panel
Other - Provide Description
Gift -or- Income
► If Gift, Provide Travel Destination
► MUST CHECK ONE:
Made a Speech/Participated in a Panel
Other - Provide Description
Gift -or- Income
► If Gift, Provide Travel Destination
► MUST CHECK ONE:
Made a Speech/Participated in a Panel
Other - Provide Description
Gift -or- Income
► If Gift, Provide Travel Destination
DATE(S): / / - / / AMT: $
(If gift)
DATE(S): / / - / / AMT: $
(If gift)
FPPC Form 700 - Schedule E (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 17
Travel payments reportable on Schedule E include advances
and reimbursements for travel and related expenses,
including lodging and meals.
Gifts of travel may be subject to the gift limit. In addition,
certain travel payments are reportable gifts, but are not
subject to the gift limit. To avoid possible misinterpretation or
the perception that you have received a gift in excess of the
gift limit, you may wish to provide a specic description of
the purpose of your travel. (See the FPPC fact sheet entitled
“Limitations and Restrictions on Gifts, Honoraria, Travel,
and Loans” to read about travel payments under section
89506(a).)
You are not required to disclose:
• Travel payments received from any state, local, or federal
government agency for which you provided services equal
or greater in value than the payments received, such as
reimbursement for travel on agency business from your
government agency employer.
• A payment for travel from another local, state, or federal
government agency and related per diem expenses when
the travel is for education, training or other inter-agency
programs or purposes.
• Travel payments received from your employer in the
normal course of your employment that are included in the
income reported on Schedule C.
• A travel payment that was received from a nonprot
entity exempt from taxation under Internal Revenue
Code Section 501(c)(3) for which you provided equal or
greater consideration, such as reimbursement for travel on
business for a 501(c)(3) organization for which you are a
board member.
Note: Certain travel payments may not be reportable
if reported via email on Form 801 by your agency.
To Complete Schedule E:
• Disclose the full name (not an acronym) and address of the
source of the travel payment.
• Identify the business activity if the source is a business
entity.
• Check the box to identify the payment as a gift or income,
report the amount, and disclose the date(s).
• Travel payments are gifts if you did not provide
services that were equal to or greater in value than the
payments received. You must disclose gifts totaling $50
or more from a single source during the period covered
by the statement.
When reporting travel payments that are gifts, you must
provide a description of the gift, the date(s) received,
and the travel destination.
• Travel payments are income if you provided services
that were equal to or greater in value than the
payments received. You must disclose income totaling
$500 or more from a single source during the period
covered by the statement. You have the burden of
proving the payments are income rather than gifts.
When reporting travel payments as income, you must
describe the services you provided in exchange for the
payment. You are not required to disclose the date(s)
for travel payments that are income.
Example:
City council member MaryClaire Chandler is the chair of a
501(c)(6) trade association, and the association pays for her
travel to attend its meetings. Because MaryClaire is deemed
to be providing equal or
greater consideration for
the travel payment by
virtue of serving on the
board, this payment may
be reported as income.
Payments for MaryClaire
to attend other events for
which she is not providing
services are likely
considered gifts. Note that
the same payment from a
501(c)3 would NOT be reportable.
Example:
Mayor Kim travels to China on a trip organized by China
Silicon Valley Business Development, a California nonprot,
501(c)(6) organization. The Chengdu Municipal People’s
Government pays for Mayor Kim’s airfare and travel costs,
as well as his meals and
lodging during the trip.
The trip’s agenda shows
that the trip’s purpose is
to promote job creation
and economic activity
in China and in Silicon
Valley, so the trip is
reasonably related to a
governmental purpose.
Thus, Mayor Kim must
report the gift of travel,
but the gift is exempt from the gift limit. In this case, the travel
payments are not subject to the gift limit because the source
is a foreign government and because the travel is reasonably
related to a governmental purpose. (Section 89506(a)(2).)
Note that Mayor Kim could be disqualied from participating in
or making decisions about The Chengdu Municipal People’s
Government for 12 months. Also note that if China Silicon
Valley Business Development (a 501(c)(6) organization) paid
for the travel costs rather than the governmental organization,
the payments would be subject to the gift limits. (See the
FPPC fact sheet, Limitations and Restrictions on Gifts,
Honoraria, Travel and Loans, at www.fppc.ca.gov.)
Instructions – Schedule E
Travel Payments, Advances,
and Reimbursements
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 18
Income – Gifts
and Reimbursements
CALIFORNIA FORM
700
Name
•
•
•
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BuSINESSACTIvITY,IFANY,OFSOuRCE
DATE(S):
/ / - / / AMT: $
(If gift)
► MuST CHECK ONE:
Gift Income
Made a Speech/Participated in a Panel
Other - Provide Description
►If Gift, Provide Travel Destination
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BuSINESSACTIvITY,IFANY,OFSOuRCE
DATE(S):
/ / - / / AMT: $
(If gift)
► MuST CHECK ONE:
Gift Income
Made a Speech/Participated in a Panel
Other - Provide Description
►If Gift, Provide Travel Destination
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BuSINESSACTIvITY,IFANY,OFSOuRCE
DATE(S):
/ / - / / AMT: $
(If gift)
► MuST CHECK ONE:
Gift Income
Made a Speech/Participated in a Panel
Other - Provide Description
►If Gift, Provide Travel Destination
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BuSINESSACTIvITY,IFANY,OFSOuRCE
DATE(S):
/ / - / / AMT: $
(If gift)
► MuST CHECK ONE:
Gift Income
Made a Speech/Participated in a Panel
Other - Provide Description
►If Gift, Provide Travel Destination
FPPC Form 700 (2016/2017) Sch. E
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Health Services Trade Association
1230 K Street, Suite 610
Sacramento, CA
Association of Healthcare Workers
550.00
Travel reimbursement for
board meeting.
Chengdu Municipal People's Government
2 Caoshi St, CaoShiJie, Qingyang Qu, Chengdu Shi,
Sichuan Sheng, China, 610000
09
XX
XX
3,874.38
08
09
04
Travel reimbursement for
trip to China.
Sichuan Sheng, China
Clear Page
Print
Income – Gifts
and Reimbursements
CALIFORNIA FORM
700
Name
•
•
•
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BuSINESSACTIvITY,IFANY,OFSOuRCE
DATE(S):
/ / - / / AMT: $
(If gift)
► MuST CHECK ONE:
Gift Income
Made a Speech/Participated in a Panel
Other - Provide Description
►If Gift, Provide Travel Destination
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BuSINESSACTIvITY,IFANY,OFSOuRCE
DATE(S):
/ / - / / AMT: $
(If gift)
► MuST CHECK ONE:
Gift Income
Made a Speech/Participated in a Panel
Other - Provide Description
►If Gift, Provide Travel Destination
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BuSINESSACTIvITY,IFANY,OFSOuRCE
DATE(S):
/ / - / / AMT: $
(If gift)
► MuST CHECK ONE:
Gift Income
Made a Speech/Participated in a Panel
Other - Provide Description
►If Gift, Provide Travel Destination
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
CITY AND STATE
501 (c)(3) or DESCRIBE BuSINESSACTIvITY,IFANY,OFSOuRCE
DATE(S):
/ / - / / AMT: $
(If gift)
► MuST CHECK ONE:
Gift Income
Made a Speech/Participated in a Panel
Other - Provide Description
►If Gift, Provide Travel Destination
FPPC Form 700 (2016/2017) Sch. E
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Health Services Trade Association
1230 K Street, Suite 610
Sacramento, CA
Association of Healthcare Workers
550.00
Travel reimbursement for
board meeting.
Chengdu Municipal People's Government
2 Caoshi St, CaoShiJie, Qingyang Qu, Chengdu Shi,
Sichuan Sheng, China, 610000
09
XX
XX
3,874.38
08
09
04
Travel reimbursement for
trip to China.
Sichuan Sheng, China
Clear Page
Print
Restrictions and Prohibitions
The Political Reform Act (Gov. Code Sections 81000-
91014) requires most state and local government ocials
and employees to publicly disclose their personal assets
and income. They also must disqualify themselves
from participating in decisions that may aect their
personal economic interests. The Fair Political Practices
Commission (FPPC) is the state agency responsible for
issuing the attached Statement of Economic Interests,
Form 700, and for interpreting the law’s provisions.
Gift Prohibition
Gifts received by most state and local ocials, employees,
and candidates are subject to a limit. In 2019-2020, the gift
limit is $500 from a single source during a calendar year.
Additionally, state ocials, state candidates, and certain
state employees are subject to a $10 limit per calendar
month on gifts from lobbyists and lobbying rms registered
with the Secretary of State. See Reference Pamphlet,
page 10.
State and local ocials and employees should check with
their agency to determine if other restrictions apply.
Disqualication
Public ocials are, under certain circumstances, required
to disqualify themselves from making, participating in, or
attempting to inuence governmental decisions that will
aect their economic interests. This may include interests
they are not required to disclose. For example, a personal
residence is often not reportable, but may be grounds for
disqualication. Specic disqualication requirements
apply to 87200 lers (e.g., city councilmembers, members
of boards of supervisors, planning commissioners, etc.).
These ocials must publicly identify the economic interest
that creates a conict of interest and leave the room before
a discussion or vote takes place at a public meeting. For
more information, consult Government Code Section
87105, Regulation 18707, and the Guide to Recognizing
Conicts of Interest page at www.fppc.ca.gov.
Honorarium Ban
Most state and local ocials, employees, and candidates
are prohibited from accepting an honorarium for any
speech given, article published, or attendance at a
conference, convention, meeting, or like gathering. (See
Reference Pamphlet, page 10.)
Loan Restrictions
Certain state and local ocials are subject to restrictions
on loans. (See Reference Pamphlet, page 14.)
Post-Governmental Employment
There are restrictions on representing clients or employers
before former agencies. The provisions apply to elected
state ocials, most state employees, local elected ocials,
county chief administrative ocers, city managers,
including the chief administrator of a city, and general
managers or chief administrators of local special districts
and JPAs. The FPPC website has fact sheets explaining
the provisions.
Late Filing
The ling ocer who retains originally-signed or
electronically led statements of economic interests may
impose on an individual a ne for any statement that is led
late. The ne is $10 per day up to a maximum of $100.
Late ling penalties may be reduced or waived under certain
circumstances.
Persons who fail to timely le their Form 700 may be
referred to the FPPC’s Enforcement Division (and, in some
cases, to the Attorney General or district attorney) for
investigation and possible prosecution. In addition to the
late ling penalties, a ne of up to $5,000 per violation may
be imposed.
For assistance concerning reporting, prohibitions, and
restrictions under the Act:
• Email questions to advice@fppc.ca.gov.
• Call the FPPC toll-free at (866) 275-3772.
Form 700 is a Public Document
Public Access Must Be Provided
Statements of Economic Interests are public
documents. The ling ocer must permit any
member of the public to inspect and receive a copy
of any statement.
• Statements must be available as soon as possible
during the agency's regular business hours, but
in any event not later than the second business
day after the statement is received. Access to the
Form 700 is not subject to the Public Records Act
procedures.
• No conditions may be placed on persons seeking
access to the forms.
• No information or identication may be required
from persons seeking access.
• Reproduction fees of no more than 10 cents per
page may be charged.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 19
Questions and Answers
General
Q. What is the reporting period for disclosing interests
on an assuming oce statement or a candidate
statement?
A. On an assuming oce statement, disclose all
reportable investments, interests in real property, and
business positions held on the date you assumed
oce. In addition, you must disclose income (including
loans, gifts and travel payments) received during the 12
months prior to the date you assumed oce.
On a candidate statement, disclose all reportable
investments, interests in real property, and business
positions held on the date you le your declaration of
candidacy. You must also disclose income (including
loans, gifts and travel payments) received during the
12 months prior to the date you le your declaration of
candidacy.
Q. I hold two other board positions in addition to my
position with the county. Must I le three statements of
economic interests?
A. Yes, three are required. However, you may complete
one statement listing the county and the two boards on
the Cover Page or an attachment as the agencies for
which you will be ling. Report your economic interests
using the largest jurisdiction and highest disclosure
requirements assigned to you by the three agencies.
Make two copies of the entire statement before
signing it, sign each copy with an original signature,
and distribute one original to the county and to each
of the two boards. Remember to complete separate
statements for positions that you leave or assume
during the year.
Q. I am a department head who recently began acting as
city manager. Should I le as the city manager?
A. Yes. File an assuming oce statement as city
manager. Persons serving as “acting,” “interim,” or
“alternate” must le as if they hold the position because
they are or may be performing the duties of the
position.
Q. My spouse and I are currently separated and in the
process of obtaining a divorce. Must I still report my
spouse’s income, investments, and interests in real
property?
A. Yes. A public ocial must continue to report a spouse’s
economic interests until such time as dissolution of
marriage proceedings is nal. However, if a separate
property agreement has been reached prior to that
time, your estranged spouse’s income may not have to
be reported. Contact the FPPC for more information.
Q. As a designated employee, I left one state agency to
work for another state agency. Must I le a leaving
oce statement?
A. Yes. You may also need to le an assuming oce
statement for the new agency.
Investment Disclosure
Q. I have an investment interest in shares of stock in a
company that does not have an oce in my jurisdiction.
Must I still disclose my investment interest in this
company?
A. Probably. The denition of “doing business in the
jurisdiction” is not limited to whether the business has
an oce or physical location in your jurisdiction. (See
Reference Pamphlet, page 13.)
Q. My spouse and I have a living trust. The trust holds
rental property in my jurisdiction, our primary residence,
and investments in diversied mutual funds. I have full
disclosure. How is this trust disclosed?
A. Disclose the name of the trust, the rental property and
its income on Schedule A-2. Your primary residence
and investments in diversied mutual funds registered
with the SEC are not reportable.
Q. I am required to report all investments. I have an IRA
that contains stocks through an account managed by
a brokerage rm. Must I disclose these stocks even
though they are held in an IRA and I did not decide
which stocks to purchase?
A. Yes. Disclose on Schedule A-1 or A-2 any stock worth
$2,000 or more in a business entity located in or doing
business in your jurisdiction.
Q. The value of my stock changed during the reporting
period. How do I report the value of the stock?
A. You are required to report the highest value that the
stock reached during the reporting period. You may
use your monthly statements to determine the highest
value. You may also use the entity’s website to
determine the highest value. You are encouraged to
keep a record of where you found the reported value.
Note that for an assuming oce statement, you must
report the value of the stock on the date you assumed
oce.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 20
Questions and Answers
Continued
Q. I am the sole owner of my business, an S-Corporation.
I believe that the nature of the business is such that it
cannot be said to have any “fair market value” because
it has no assets. I operate the corporation under
an agreement with a large insurance company. My
contract does not have resale value because of its
nature as a personal services contract. Must I report
the fair market value for my business on Schedule A-2
of the Form 700?
A. Yes. Even if there are no tangible assets, intangible
assets, such as relationships with companies and
clients are commonly sold to qualied professionals.
The “fair market value” is often quantied for other
purposes, such as marital dissolutions or estate
planning. In addition, the IRS presumes that “personal
services corporations” have a fair market value. A
professional “book of business” and the associated
goodwill that generates income are not without a
determinable value. The Form 700 does not require a
precise fair market value; it is only necessary to check
a box indicating the broad range within which the value
falls.
Q. I own stock in IBM and must report this investment
on Schedule A-1. I initially purchased this stock in
the early 1990s; however, I am constantly buying
and selling shares. Must I note these dates in the
“Acquired” and “Disposed” elds?
A. No. You must only report dates in the “Acquired” or
“Disposed” elds when, during the reporting period, you
initially purchase a reportable investment worth $2,000
or more or when you dispose of the entire investment.
You are not required to track the partial trading of an
investment.
Q. On last year’s ling I reported stock in Encoe valued at
$2,000 - $10,000. Late last year the value of this stock
fell below and remains at less than $2,000. How should
this be reported on this year’s statement?
A. You are not required to report an investment if the value
was less than $2,000 during the entire reporting period.
However, because a disposed date is not required for
stocks that fall below $2,000, you may want to report
the stock and note in the “comments” section that the
value fell below $2,000. This would be for informational
purposes only; it is not a requirement.
Q. We have a Section 529 account set up to save money
for our son’s college education. Is this reportable?
A. If the Section 529 account contains reportable interests
(e.g., common stock valued at $2,000 or more), those
interests are reportable (not the actual Section 529
account). If the account contains solely mutual funds,
then nothing is reported.
Income Disclosure
Q. I reported a business entity on Schedule A-2. Clients of
my business are located in several states. Must I report
all clients from whom my pro rata share of income is
$10,000 or more on Schedule A-2, Part 3?
A. No, only the clients located in or doing business on a
regular basis in your jurisdiction must be disclosed.
Q. I believe I am not required to disclose the names of
clients from whom my pro rata share of income is
$10,000 or more on Schedule A-2 because of their right
to privacy. Is there an exception for reporting clients’
names?
A. Regulation 18740 provides a procedure for requesting
an exemption to allow a client’s name not to be
disclosed if disclosure of the name would violate a
legally recognized privilege under California or Federal
law. This regulation may be obtained from our website
at www.fppc.ca.gov. (See Reference Pamphlet, page
14.)
Q. I am sole owner of a private law practice that is not
reportable based on my limited disclosure category.
However, some of the sources of income to my law
practice are from reportable sources. Do I have to
disclose this income?
A. Yes, even though the law practice is not reportable,
reportable sources of income to the law practice of
$10,000 or more must be disclosed. This information
would be disclosed on Schedule C with a note in the
“comments” section indicating that the business entity
is not a reportable investment. The note would be for
informational purposes only; it is not a requirement.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 21
Questions and Answers
Continued
Q. I am the sole owner of my business. Where do I
disclose my income - on Schedule A-2 or Schedule C?
A. Sources of income to a business in which you have an
ownership interest of 10% or greater are disclosed on
Schedule A-2. (See Reference Pamphlet, page 8.)
Q. My husband is a partner in a four-person rm where
all of his business is based on his own billings and
collections from various clients. How do I report my
community property interest in this business and the
income generated in this manner?
A. If your husband’s investment in the rm is 10% or
greater, disclose 100% of his share of the business
on Schedule A-2, Part 1 and 50% of his income on
Schedule A-2, Parts 2 and 3. For example, a client of
your husband’s must be a source of at least $20,000
during the reporting period before the client’s name is
reported.
Q. How do I disclose my spouse’s or registered domestic
partner’s salary?
A. Report the name of the employer as a source of income
on Schedule C.
Q. I am a doctor. For purposes of reporting $10,000
sources of income on Schedule A-2, Part 3, are the
patients or their insurance carriers considered sources
of income?
A. If your patients exercise sucient control by selecting
you instead of other doctors, then your patients, rather
than their insurance carriers, are sources of income to
you. (See Reference Pamphlet, page 14.)
Q. I received a loan from my grandfather to purchase my
home. Is this loan reportable?
A. No. Loans received from family members are not
reportable.
Q. Many years ago, I loaned my parents several thousand
dollars, which they paid back this year. Do I need to
report this loan repayment on my Form 700?
A. No. Payments received on a loan made to a family
member are not reportable.
Real Property Disclosure
Q. During this reporting period we switched our principal
place of residence into a rental. I have full disclosure
and the property is located in my agency’s jurisdiction,
so it is now reportable. Because I have not reported
this property before, do I need to show an “acquired”
date?
A. No, you are not required to show an “acquired” date
because you previously owned the property. However,
you may want to note in the “comments” section that
the property was not previously reported because it was
used exclusively as your residence. This would be for
informational purposes only; it is not a requirement.
Q. I am a city manager, and I own a rental property located
in an adjacent city, but one mile from the city limit. Do I
need to report this property interest?
A. Yes. You are required to report this property because
it is located within 2 miles of the boundaries of the city
you manage.
Q. Must I report a home that I own as a personal residence
for my daughter?
A. You are not required to disclose a home used as a
personal residence for a family member unless you
receive income from it, such as rental income.
Q. I am a co-signer on a loan for a rental property owned
by a friend. Since I am listed on the deed of trust, do I
need to report my friend’s property as an interest in real
property on my Form 700?
A. No. Simply being a co-signer on a loan for property
does not create a reportable interest in real property for
you.
Gift Disclosure
Q. If I received a reportable gift of two tickets to a concert
valued at $100 each, but gave the tickets to a friend
because I could not attend the concert, do I have any
reporting obligations?
A. Yes. Since you accepted the gift and exercised
discretion and control of the use of the tickets, you must
disclose the gift on Schedule D.
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 22
Q. Julia and Jared Benson, a married couple, want to
give a piece of artwork to a county supervisor. Is each
spouse considered a separate source for purposes of
the gift limit and disclosure?
A. Yes, each spouse may make a gift valued at the gift
limit during a calendar year. For example, during 2019
the gift limit was $500, so the Bensons may have given
the supervisor artwork valued at no more than $1,000.
The supervisor must identify Jared and Julia Benson as
the sources of the gift.
Q. I am a Form 700 ler with full disclosure. Our agency
holds a holiday rae to raise funds for a local charity.
I bought $10 worth of rae tickets and won a gift
basket valued at $120. The gift basket was donated by
Doug Brewer, a citizen in our city. At the same event,
I bought rae tickets for, and won a quilt valued at
$70. The quilt was donated by a coworker. Are these
reportable gifts?
A. Because the gift basket was donated by an outside
source (not an agency employee), you have received a
reportable gift valued at $110 (the value of the basket
less the consideration paid). The source of the gift
is Doug Brewer and the agency is disclosed as the
intermediary. Because the quilt was donated by an
employee of your agency, it is not a reportable gift.
Q. My agency is responsible for disbursing grants. An
applicant (501(c)(3) organization) met with agency
employees to present its application. At this meeting,
the applicant provided food and beverages. Would
the food and beverages be considered gifts to the
employees? These employees are designated in our
agency’s conict of interest code and the applicant is a
reportable source of income under the code.
A. Yes. If the value of the food and beverages consumed
by any one ler, plus any other gifts received from the
same source during the reporting period total $50 or
more, the food and beverages would be reported using
the fair market value and would be subject to the gift
limit.
Q. I received free admission to an educational conference
related to my ocial duties. Part of the conference
fees included a round of golf. Is the value of the golf
considered informational material?
A. No. The value of personal benets, such as golf,
attendance at a concert, or sporting event, are gifts
subject to reporting and limits.
Questions and Answers
Continued
FPPC Form 700 (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 23
Limitations and
Restrictions on
Gifts, Honoraria,
Travel and Loans
A Fact Sheet For
Local Elected Officers and Candidates for Local
Elective Offices
Local Officials Specified in Government Code
Section 87200
Judicial Candidates
Designated Employees of Local Government
Agencies
California Fair Political
Practices Commission
Toll-free advice line: 1 (866) ASK-FPPC
Email advice: advice@fppc.ca.gov
Web site: www.fppc.ca.gov
February 2019
www.fppc.ca.gov
FPPC Advice: advice@fppc.ca.gov (866.275.3772 )
FPPC EAED • 046 2-2019 • Page 2 of 14
Introduction
The Political Reform Act
1
(the “Act”) imposes limits on gifts, prohibits honoraria payments, and imposes
limits and other restrictions on the receipt of travel payments received by:
- Local elected officers and other local officials specified in Government Code Section 87200,
2
excluding judges;
3
- Designated employees of local government agencies (i.e., individuals required to file statements of
economic interests under a local agency’s conflict of interest code); and
- Candidates
4
for any of these offices or positions and judicial candidates. (Sections 89502 and
89503.)
The Act also imposes limits and other restrictions on personal loans received by certain local officials.
This fact sheet summarizes the major provisions of the Act concerning gifts, honoraria, travel, and loans.
It contains highlights of the law, but does not carry the weight of law. For more information, contact the
Fair Political Practices Commission at (866) 275-3772 or advice@fppc.ca.gov or visit our website at
www.fppc.ca.gov. Commission advice letters are available on our website. Public officials may also be
subject to local restrictions on gifts, honoraria, or travel.
Enforcement
Failure to comply with the laws related to gifts, honoraria, loans, and travel payments may,
depending on the violation, result in criminal prosecution and substantial fines, or in
administrative or civil monetary penalties for as much as $5,000 per violation or three times the
amount illegally obtained. (See Sections 83116, 89520, 89521, 91000, 91004 and 91005.5.)
1
The Political Reform Act is contained in Government Code Sections 81000 through 91014. All statutory
references are to the Government Code, unless otherwise indicated. The regulations of the Fair Political Practices
Commission are contained in Sections 18110 through 18997 of Title 2 of the California Code of Regulations. All
regulatory references are to Title 2, Division 6 of the California Code of Regulations, unless otherwise indicated.
2
Local officials specified in Government Code Section 87200 include: members of boards of supervisors and city
councils, mayors, city/county planning commissioners, city/county chief administrative officers, city/county treasurers,
district attorneys, county counsels, city managers, city attorneys, court commissioners and public officials who
manage public investments.
3
The gift limits and honoraria ban in the Political Reform Act do not apply to a person in his or her capacity as
judge. However, candidates for judicial offices are subject to the restrictions contained in the Political Reform Act.
(Sections 89502 and 89503.)
4
For purposes of the gift limit and honoraria prohibition, an individual becomes a “candidate” when he or she files a
statement of organization (Form 410) as a controlled committee for the purpose of seeking elective office, a
candidate intention statement (Form 501), or a declaration of candidacy, whichever occurs first. If an individual is an
unsuccessful candidate, he or she will no longer be subject to the gift limit and honoraria prohibition when he or she
has terminated his or her campaign filing obligations, or after certification of election results, whichever is earlier.
(Sections 89502(b) and 89503(b).)
www.fppc.ca.gov
FPPC Advice: advice@fppc.ca.gov (866.275.3772 )
FPPC EAED • 046 2-2019 • Page 3 of 14
Gifts
Limitations
Local elected officers, candidates for local elective office, local officials specified in Government Code
Section 87200, and judicial candidates, may not accept gifts from any single source totaling more than
$500 in a calendar year. (Section 89503.)
5
Employees of a local government agency who are designated in the agency’s conflict of interest code
may not accept gifts from any single source totaling more than $500in a calendar year if the employee is
required to report receiving income or gifts from that source on his or her statement of economic interests
(Form 700). (Section 89503(c).)
What is a “Gift”?
A “gift” is any payment or other benefit that confers a personal benefit for which a public official does not
provide payment or services of equal or greater value. A gift includes a rebate or discount in the price of
anything of value unless the rebate or discount is made in the regular course of business to members of
the public. (Section 82028.) (See Regulation 18946 for valuation guidelines.)
Except as discussed below, a public official has “received” or “accepted” a gift when he or she has actual
possession of the gift or when he or she takes any action exercising direction or control over the gift,
including discarding the gift or turning it over to another person. This includes gifts that are accepted by
someone else on the official’s behalf and gifts made to others at the direction of the official. (Regulation
18941.)
Gifts to Family Members
Under certain circumstances, a gift to an official’s family member* is considered a gift to the official.
(Regulation 18943.) Anything given to a family member is presumed to be a gift to the official if: (1) there
is no established relationship between the donor and the family member where it would generally be
considered appropriate for the family member to receive the gift or; (2) the donor is someone who lobbies
the official’s agency, is involved in an action before the official’s agency in which the official may
foreseeably participate, or engages in business with the agency in which the official will foreseeably
participate. (Wedding gifts are treated differently, see below.)
*For purposes of this rule, an official’s “family member” includes the official’s spouse; registered domestic
partner; any minor child of the official who the official can claim as a dependent for federal tax purposes;
and a child of the official who is aged 18 to 23 years old, attends school, resides with the official when not
attending school, and provides less than one-half of his or her own support.
5
The gift limit is adjusted biennially to reflect changes in the Consumer Price Index. For 2019-2020, the gift limit is
$500. (Section 89503; Regulation 18940.2.) Gifts from a single source aggregating to $50 or more must be disclosed,
and gifts aggregating to $500 or more during any 12-month period may subject an official to disqualification with
respect to the source. (Section 87103(e).) Designated employees should obtain a copy of their conflict of interest
code from their agency. Some conflict of interest codes require very limited disclosure of income and gifts. Gifts from
sources that are not required to be disclosed on the Form 700 are not subject to the $500 gift limit but still may
subject the public official to disqualification.
www.fppc.ca.gov
FPPC Advice: advice@fppc.ca.gov (866.275.3772 )
FPPC EAED • 046 2-2019 • Page 4 of 14
Source of Gift
Under most circumstances, it is clear who the source of a gift is, but if the circumstances indicate that the
gift is being provided by an intermediary, the public official must determine both the donor and the
intermediary in reporting the gift. Regulation 18945 provides the rules for determining the source of the
gift.
Gifts from Multiple Sources
In determining the cumulative value of any reportable gifts, separate gifts from an individual and an entity
that the individual controls must be aggregated as one source to comply with the reporting and limit
requirements. For example, separate gifts from the owner of a company and from the company itself
would be treated as if from one source if the owner has more than a 50 percent interest in the company,
unless the making of the gift was determined by someone else in the company. In that case, the gift from
the company would be aggregated with any gifts made by that determining individual. (Regulation
18945.1.)
Group gifts, where a public official receives a single gift from multiple donors (such as a retirement gift
from coworkers), need not be reported unless any person contributes $50 or more to the total cost of the
gift. In that case, the public official would only report a gift from each of those persons. (Regulation
18945.2.)
Valuing Gifts
The general rule for determining the value of a gift is to apply the fair market value at the time the gift is
received. Fair market value can be determined by finding any local or Internet advertisement for the item.
Special exceptions to the fair market value rule are contained in Regulations 18946.1 through 18946.5
covering admission to ticketed and invitation-only events, wedding gifts, attendance at nonprofit and
political fundraisers, and air travel. (Regulation 18946.) For example, for ticketed events, the value is the
face value of the ticket.
General Gift Exceptions
Form 700 Reporting
C/I § 87100
Honoraria Ban
$500 Gift Limit
No
No
No
No
The following payments are exceptions to the definition of gift and are not considered gifts or income.
1. Return or Reimbursement of Gift. Items that are returned (unused) to the donor, or for which the
public official reimburse the donor, within 30 days of receipt. (Section 82028(b)(2); Regulation 18941.)
2. Donation of Gift to Nonprofit Group. Items that are donated (unused) to a non-profit, tax-exempt
(501(c)(3)) organization in which the official (or immediate family member) does not hold a position, or to
a government agency, within 30 days of receipt without claiming a deduction for tax purposes. (Section
82028(b)(2); Regulation 18941.)
3. Gifts from Family. Gifts from the public official’s spouse (or former spouse), child, parent,
grandparent, grandchild, brother, sister, current or former parent-in-law, brother-in-law, sister-in-law, aunt,
uncle, niece, nephew, or first cousin or the spouse of any such person, unless he or she is acting as an
agent or intermediary for another person who is the true source of the gift. (Section 82028(b)(3);
Regulation 18942(a)(3).) This exception includes great grandparents, great uncles and aunts, great
nieces and nephews, and first cousins once removed.
4. Informational Material. Informational material provided to assist the public official in the performance
of his or her official duties, including books, reports, pamphlets, calendars, periodicals, videotapes, or free
admission or discounts to informational conferences or seminars.
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“Informational material” may also include scale models, pictorial representations, maps, and other such
items. However, if the item’s fair market value is more than $-500, the public official has the burden of
demonstrating that the item is informational. In addition, on-site demonstrations, tours, or inspections,
including air flights over an area that is the subject of the information and designed specifically for public
officials, are considered informational material. However, this exception does not apply to meals or
lodging. Furthermore, the exception generally does not apply to transportation to the site, except for any
portion of the transportation that is not commercially available. (Section 82028(b)(1); Regulations
18942(a)(1) and 18942.1.)
5. Inheritance. A devise or inheritance. (Section 82028(b)(5); Regulation 18942(a)(5).)
6. Campaign Contributions. Campaign contributions to an official, including rebates or discounts
received in connection with campaign activities (Section 82028(b)(4); Regulations 18942(a)(4), 18950(a)
and 18950.3(a)) and permissible expenditures of campaign funds for campaign-related expenses,
including payments for transportation, lodging or food (Regulations 18950(a) and 18950.3(b)), provided
they comply and are properly reported in accordance with applicable campaign finance laws.
7. Plaques. Personalized plaques and trophies with an individual value of less than $250. (Section
82028(b)(6); Regulation 18942(a)(6).)
8. Ceremonial Role. Free admission to a ticketed event (including any benefits included in the price of
the ticket such as a free meal) for the official and one guest at an event where the official performs a
ceremonial role, such as throwing out the first pitch at a Dodgers’ game, so long as the official’s agency
complies with the posting provisions set forth in Regulation 18944.1(d). (Regulation 18942(a)(13);
Regulation 18942.3; also see discussion of Form 802 below under “Gifts Exceptions Requiring Alternate
Reporting.”)
9. Event Where Official Makes a Speech. Free admission, and food and nominal items (such as a pen,
pencil, mouse pad, note pad or similar item) available to all attendees, at the event at which the official
makes a speech (as defined in Regulation 18950(b)(2)), so long as the admission is provided by the
person who organizes the event. (Regulation 18942(a)(11).)
10. Attending Wedding Reception. Benefits received as a guest attending a wedding reception where
the benefits are the same as those received by the other guests at the reception. (Regulation
18942(a)(15).)
11. Bereavement Offerings. Bereavement offerings, such as flowers at a funeral received in memory of
a close family member. (Regulation 18942(a)(16).)
12. Acts of Neighborliness. Benefits received as an act of neighborliness such as the loan of an item,
an occasional ride, or help with a repair where the act is consistent with polite behavior in a civilized
society and would not normally be part of an economic transaction between like participants under similar
circumstances. (Regulation 18942(a)(17).)
13. Campaign or Nonprofit Fundraiser. Two tickets for admission, for use by only the official and one
guest, to attend a fundraiser for a campaign committee or candidate, or to a fundraiser for an organization
exempt from taxation under Section 501(c)(3) of the Internal Revenue Code. The ticket(s) must be
received from the organization or committee holding the fundraiser. (Regulation 18946.4.)
14. Unused Passes or Tickets. Passes or tickets that provide admission or access to facilities, goods,
services, or other benefits (either on a one-time or repeated basis) that the public official does not use
and do not give to another person. (Regulation 18946.1.)
15. Items Provided to Government Agency. Subject to certain conditions, items provided to a
government agency and used by public officials in the agency for agency business. This may include
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passes or tickets to (see Regulation 18944.1) or payments for other types of items or activities (see
Regulation 18944). An agency must disclose specified payments on a form provided by the FPPC and
post the form on its website. (See discussion of Forms 801 and 802 below under ““Gift Exceptions
Requiring Alternate Reporting.”) Contact the FPPC for detailed information.
16. Emergency Leave Credits. Leave credits (e.g., sick leave or vacation credits) received under a bona
fide catastrophic or emergency leave program established by the public official’s employer and available
to all employees in the same job classification or position. Donations of cash are gifts and are subject to
limits and disclosure. (Regulation 18942(a)(9).)
17. Disaster Relief. Food, shelter, or similar assistance received in connection with a disaster relief
program. The benefits must be received from a governmental agency or charity and must be available to
the general public. (Regulation 18942(a)(10).)
18. Agency Raffle. Items awarded in an agency raffle received by the agency from an employee who is
not acting as an intermediary for another donor. This exception applies when an agency holds an
employee raffle and the item awarded in the raffle has been obtained with agency funds, or is otherwise
an asset of the agency and not donated to the agency by a non-agency source. This exception does not
apply to passes or tickets of the type described in Regulation 18944.1. (Regulation 18944.2(a) and (b).)
19. Employee Gift Exchange. Items received by an employee during an employee gift exchange, so
long as the items received are provided by another employee of the agency and the gifts are not
substantially disproportionate in value. (Regulation 18944.2(c).)
Limited Gift Exceptions
Form 700 Reporting
C/I § 87100
Honoraria Ban
$500 Gift Limit
No
No
No
No
1. Home Hospitality. Gifts of hospitality including food, drink or occasional lodging that an official
receives in an individual’s home when the individual or a member of his or her family is present.
(Regulation 18942(a)(7).) For this exception to apply, the official must have a relationship, connection or
association with the individual providing the in-home hospitality that is unrelated to the official’s position
and the hospitality must be provided as part of that relationship. Generally, this means functions like
children’s birthday parties, soccer team parties, neighborhood barbeques, etc., where other guests attend
who are not part of the lobbying process. (Regulation 18942.2.)
2. Reciprocal Holiday Gifts. Gifts commonly exchanged between an official and another individual on
holidays, birthdays, or similar occasions to the extent that the gifts exchanged are not substantially
disproportionate in value. (Regulation 18942(a)(8)(A).)
3. Reciprocal Exchanges. Reciprocal exchanges between an official and another individual that occur
on an ongoing basis so long as the total value of payments received by the official within the calendar
year is not substantially disproportionate to the amount paid by the official and no single payment is $500
or more. For example, if two people get together regularly for lunches and rotate picking up the lunch tab
so that each pays approximately half the total value over the course of the calendar year, no gift need be
reported. (Regulation 18942(a)(8)(B).)
4. Dating Relationship. Personal benefits commonly received from a dating partner. These gifts are not
disclosable or limited but are subject to disqualification under the conflict of interest laws if the dating
partner has certain business before the official as set forth in Regulation 18942(a)(18)(D). (Regulation
18942(a)(18)(A).)
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5. Acts of Human Compassion. Assistance, financial or otherwise, to offset family medical or living
expenses that the official can no longer meet without private assistance because of an accident, illness,
employment loss, death in the family, or other unexpected calamity; or to defray expenses associated
with humanitarian efforts such as the adoption of an orphaned child, so long as the source of the donation
is an individual who has a prior social relationship with the official of the type where it would be common
to provide such assistance, or the payment is made without regard to official status under other
circumstances in which it would be common to receive community outreach. (Regulation 18942
(a)(18)(B).) This exception does not apply if the person providing the benefit to the official is an individual
who otherwise has business before the official as set forth in Regulation 18942(a)(18)(D).
6. Long-Time Friend. Benefits received from a long-time personal friend where the gift is unrelated to the
official’s duties. The exception does not apply if the individual providing the benefit to the official is
involved in some manner with business before the official. (Regulation 18942(a)(18)(C).) This exception
does not apply if the person providing the benefit to the official is an individual who otherwise has
business before the official as set forth in Regulation 18942(a)(18)(D).
7. Existing Personal Relationship. Benefits received from an individual where it is clear that the gift was
made because of an existing personal or business relationship unrelated to the official’s position and
there is no evidence whatsoever at the time the gift is made that the official makes or participates in the
type of governmental decisions that may have a reasonably foreseeable material financial effect on the
individual who would otherwise be the source of the gift. (Regulation 18942(a)(19).)
Very Limited Gift Exception
Reporting
C/I § 87100
Honoraria Ban
$500Gift Limit
Yes - ½ value as gift