Fppc Form 700 - Statement Of Economic Interests - 2017/2018 Page 21
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23700
CALIFORNIA FORM
SChEDuLE D
FAIr POLITICAL PrACTICES COMMISSION
Name
Income – Gifts
► NAME OF SOURCE (Not an Acronym)
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
ADDRESS (Business Address Acceptable)
BuSINESS ACTIvITY, IF ANY, OF SOuRCE
BuSINESS ACTIvITY, IF ANY, OF SOuRCE
DATE (mm/dd/yy)
vALuE
DESCRIPTION OF GIFT(S)
DATE (mm/dd/yy)
vALuE
DESCRIPTION OF GIFT(S)
/
/
/
/
$
$
/
/
/
/
$
$
/
/
/
/
$
$
► NAME OF SOURCE (Not an Acronym)
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
ADDRESS (Business Address Acceptable)
BuSINESS ACTIvITY, IF ANY, OF SOuRCE
BuSINESS ACTIvITY, IF ANY, OF SOuRCE
DATE (mm/dd/yy)
vALuE
DESCRIPTION OF GIFT(S)
DATE (mm/dd/yy)
vALuE
DESCRIPTION OF GIFT(S)
/
/
/
/
$
$
/
/
/
/
$
$
/
/
/
/
$
$
► NAME OF SOURCE (Not an Acronym)
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
ADDRESS (Business Address Acceptable)
BuSINESS ACTIvITY, IF ANY, OF SOuRCE
BuSINESS ACTIvITY, IF ANY, OF SOuRCE
DATE (mm/dd/yy)
vALuE
DESCRIPTION OF GIFT(S)
DATE (mm/dd/yy)
vALuE
DESCRIPTION OF GIFT(S)
/
/
/
/
$
$
/
/
/
/
$
$
/
/
/
/
$
$
Comments:
FPPC Form 700 (2017/2018) Sch. D
FPPC Advice Email: advice@fppc.ca.gov
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FPPC Toll-Free Helpline: 866/275-3772
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