Gyllenhammer, John Form 700 AmendmentSTATEMENT OF ECONOMIC INTERESTS Date Initial Fdmg
COVER PAGE
A PUBLIC DOCUMENT
"ease type or print in ink.
,AME of FILER (LAST) (FIRST) (MIDDLE)
MrACr . 01tin ECMw"ck
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
G__3
__4 CD
Orange Gay Counc+
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ce
Division, Board, epartment, bistrict, if applicable Your Position
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bNs-hr c+ 6 Clay Cvw%c;1 AuAkoe.r
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► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
('�1
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
—] State 1 Judge, Retired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
J Multi -County County of
City of Dra.Y1AQ Gib► other
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2021, through Leaving Office: Date Left I
December 31, 2021. (Check one circle.)
.or -
The period covered is through
December 31, 2021,
Assuming Office: Date assumed
:_) The period covered is January 1, 2021, through the date of
-or- leaving office.
The period covered is —J--/ through
the date of leaving office.
/Candidate: Date of Election �4 � and office sought, if different than Part 1:
Schedule Summary (must complete) ► Total number of pages including this cover page:
Schedules attached
Schedule A-1 - Investments - schedule attached
Schedule A-2 - Investments - schedule attached
Schedule B - Real Property - schedule attached
-or- —11 None - No reportable interests on any schedule
/chedule C - Income, Loans, & Business Positions - schedule attached
Schedule D - Income - Gifts - schedule attached
Schedule E - Income - Gifts - Travel Payments - schedule attached
5. Veritication
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Aoencv Address Recommended - Public Document)
n AVTIAAG TM
E`A
e.I CA 12In
I have used all reasonable diligence in preparing this statement. I have reviewecTthis statement and to the ifest of my knowledge the information contained
herein and in any attached schedules is true and complete. I acknowledge this is a public document. (_c(-� ZZ�
1 certify under penalty of perjury under the laws of the State of California that the'^•^^n0^^ '� •• ^ ^^a ^^-•^^'
Date Sigr
014 1,;I22. Signature
advice@fppc.ca.gov - 866-275-3772 - www.fppc.ca.gov
Page - 5
SCHEDULE C • - • - 1 1
Income, Loans, & Business FAIR POLITICAL PRACTICES COMMISSION
Positions Name
(Other than Gifts and Travel Payments) Join CT jt�evikoL nran ¢ r
NAME OF SOURCE OF INCOME
W*4t/3NV a-f CA , - r# n
ADDRESS (Business Address Acceptable)
R8 C q NA W She aw Omme , M
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
i?,e sQAvrk pa p sso r
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
$10,001 - $100,000 ❑ OVER $100,000
CONS IDERATI�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
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Describe)
(Describe)
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
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
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Describe)
(Describe)
You are not required to report loans from a commercial lending institution, or any indebtedness created as part of
a retail installment or credit card transaction, made in the lender's regular course of business on terms available
to members of the public without regard to your official status. Personal loans and loans received not in a lender's
regular course of business must be disclosed as follows:
NAME OF LENDER'
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001- $10,000
❑ $10,001 - $100,000
11 OVER $100,000
Comments:
INTEREST RATE TERM (Months/Years)
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
❑ Guarantor
Street address
City
❑ Other
(Describe)
FPPC Form 700 - Schedule C (2021/2022)
advice@fppc.ca,gov • 866.275-3772 • www.fppc.ca.gov
Page -13
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
Ayr a zon,
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
(,cJCl.2'hc�yLt9' �n� �OLl1cS�CS
YOUR BUSINESSe SI/TII�ON
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
A�/ 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
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
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
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
(Describe) (Describe)
❑ Other ❑ Other
(Describe) (Describe)
LOANS• • OUTSTANDING DURING THE REPORTINGPERIOD
* You are not required to report loans from a commercial lending institution, or any indebtedness created as part of
a retail installment or credit card transaction, made in the lender's regular course of business on terms available
to members of the public without regard to your official status. Personal loans and loans received not in a lender's
regular course of business must be disclosed as follows:
NAME OF LENDER* INTEREST RATE TERM (MonthsiYears)
% ❑ None
ADDRESS (Business Address Acceptable)
SECURITY FOR LOAN
BUSINESS ACTIVITY, IF ANY, OF LENDER ❑ None ❑ Personal residence
n Real Pronertv
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
❑ Guarantor
❑ Other
Street address
city
(Describe)
FPPC Farm 700 - Schedule C (2020/2021)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page -13