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CA Form 700 Statement of Economic Interests - Campbell RECEIVED CITY OF RANCHO PALOS VERDES Date Initial Filing CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS MAR 3 a�.liaised FAIR PuLl TICAL PkAC:l ICFs COMMISSION A PUBLIC DOCUMENT COVER PAGE _ Please type or print in ink. CITY CLERK'S OFFICE NAME OF FILER (LAST) (FIRST) (MIDDLE) Campbell Brian 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of Rancho Palos Verdes Division, Board, Department, District, if applicable Your Position City Council/Successor Agency/Improvement Authority Councilman/Member ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑State ❑Judge or Court Commissioner(Statewide Jurisdiction) ❑Multi-County ❑County of ©City of Rancho Palos Verdes ❑Other 3. Type of Statement (Check at least one box) © Annual: The period covered is January 1, 2014,through ❑ Leaving Office: Date Left-J____J December 31, 2014. (Check one) -or- The period covered is-J-_/ ,through 0 The period covered is January 1, 2014,through the date of December 31, 2014. leaving office. ❑ Assuming Office: Date assumed_-I-. __/ 0 The period covered is-J-J ,through the date of leaving office. ❑ Candidate: Election year and office sought, if different than Part 1: 4. Schedule Summary Check applicable schedules or "None." ► Total number of pages including this cover page: 3 ❑ edule A-1 -Investments-schedule attachedvo)soh \j2C-Income, Loans, &Business Positions-schedule attached Schedule A-2-Investments-schedule attached ❑ Schedule D-Income-Gifts-schedule attached ❑ Schedule B-Real Property-schedule attached ❑ Schedule E-Income-Gifts-Travel Payments-schedule attached -or- 0 None-No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended-Public Document) DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS ( 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 Signedalem..--- . PZe7-41-rAka,- ) FPPC Form 700(2014/2015) FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov SCHEDULE A-2 CALIFORNIA FORM 700 Investments, Income, and Assets FAIR POLITICAL PRACTICES COMMISSION Name of Business Entities/Trusts (Ownership Interest is 10% or Greater) Brian Campbell ► 1. BUSINESS ENTITY OR TRUST ► 1. BUSINESS ENTITY OR TRUST BC Urban, LLC Name Name Address(Business Address Acceptable) Address(Business Address Acceptable) Check one Check one ❑ Trust,go to 2 0 Business Entity,complete the box, then go to 2 0 Trust,go to 2 0 Business Entity,complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑$0-$1,999 0$0-$1,999 ❑$2,000-$10,000 / / 14 / /14 0$2,000-$10,000 / / 14 / /14 ❑$10,001 -$100,000 ACQUIRED DISPOSED 0$10,001 -$100,000 ACQUIRED DISPOSED o$100,001 -$1,000,000 0$100,001 -$1,000,000 ▪ Over$1,000,000 0 Over$1,000,000 NATURE OF INVESTMENT LLC NATURE OF INVESTMENT o Partnership 0 Sole Proprietorship m Other 0 Partnership 0 Sole Proprietorship 0 Other YOUR BUSINESS POSITION Managing Member YOUR BUSINESS POSITION ► 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) ❑$0-$499 0$10,001 -$100,000 ❑$0-$499 0$10,001 -$100,000 o$500-$1,000 J OVER$100,000 0$500-$1,000 ❑OVER$100,000 ❑$1,001 -$10,000 ❑$1,001 -$10,000 ► 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF ► 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF $10,000 OR MORE (Attach separate sheet it necessary.) INCOME OF $10,000 OR MORE (Attach a separate sheet it necessary., 171 None or 0 Names listed below • None or U Names listed below See note below in comments ► 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR P. 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST LEASED BY THE BUSINESS ENTITY OR TRUST Check one box: Check one box: o INVESTMENT ❑REAL PROPERTY ❑ INVESTMENT ❑REAL PROPERTY Name of Business Entity,if Investment,g Name of Business Entity,if Investment,oC Assessor's Parcel Number or Street Address of Real Property Assessor's Parcel Number or Street Address of Real Property Description of Business Activity QC Description of Business Activity gC City or Other Precise Location of Real Property City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE,LIST DATE: o$2,000-$10,000 ❑$2,000-$10,000 ❑$10,001 -$100,000 14 14 ❑$10,001 -$100,000 / / 14 / / 14 ❑$100,001 -$1,000,000 ACQUIRED DISPOSED ❑$100,001 -$1,000,000 ACQUIRED DISPOSED ❑Over$1,000,000 ❑Over$1,000,000 NATURE OF INTEREST NATURE OF INTEREST o Property Ownership/Deed of Trust 0 Stock ❑Partnership ❑Property Ownership/Deed of Trust ❑Stock ❑ Partnership o Leasehold ❑Other ❑ Leasehold ❑Other Yrs.remaining Yrs.remaining ❑Check box if additional schedules reporting investments or real property ❑Check box if additional schedules reporting investments or real property are attached are attached All income sources not within the jurisdiction. FPPC Form 700(2014/2015)Sch.A-2 Comments: FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov • SCHEDULE C CALIFORNIA FORM 700 Income, Loans, & Business FAIR POLITICAL PRACTICES COmmISSION Positions Name (Other than Gifts and Travel Payments) Brian Campbell ► 1. INCOME RECEIVED ► 1. INCOME RECEIVED NAME OF SOURCE OF INCOME NAME OF SOURCE OF INCOME ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable) BUSINESS ACTIVITY,IF ANY,OF SOURCE BUSINESS ACTIVITY,IF ANY,OF SOURCE YOUR BUSINESS POSITION YOUR BUSINESS POSITION GROSS INCOME RECEIVED GROSS INCOME RECEIVED ❑$500-$1,000 ❑$1,001 -$10,000 0$500-$1,000 ❑$1,001 -$10,000 ❑$10,001 -$100,000 0 OVER$100,000 ❑$10,001 -$100,000 ❑OVER$100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR WHICH INCOME WAS RECEIVED 0 Salary ❑Spouse's or registered domestic partner's income ❑Salary ❑Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) (For self-employed use Schedule A-2.) ❑Partnership(Less than 10%ownership. For 10%or greater use 0 Partnership(Less than 10%ownership. For 10%or greater use Schedule A-2.) Schedule A-2.) ❑Sale of 0 Sale of (Real property,car,boat,etc.) (Real property,car,boat,etc.) O Loan repayment ❑ Loan repayment 0 Commission or 0 Rental Income,list each source of$10,000 or more 0 Commission or ❑ Rental Income,list each source of$10,000 or more (Describe) (Describe) ❑Other 0 Other (Describe) (Describe) ► 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD * You are not required to report loans from commercial lending institutions, 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(Months/Years) BC Urban, LLC % None ADDRESS(Business Address Acceptable) SECURITY FOR LOAN BUSINESS ACTIVITY,IF ANY,OF LENDER 171 None 0 Personal residence ❑ Real Property HIGHEST BALANCE DURING REPORTING PERIOD Street address ❑$500-$1,000 City • 171$1,001 -$10,000 0 Guarantor ID$10,001 -$100,000 ❑OVER$100,0000 Other (Describe) Comments: Forgave and Paid Loans to 2013 Campaign Account FPPC Form 700(2014/2015)Sch.C FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov