i:'UOVE PAGE: 1. Office, Agency, or Court
i:'UOVE PAGE: 1. Office, Agency, or Court
CALIFbRNIAFORM
~ (, .£t<
700 STATEMENT:OFEC,ONOMIC~TERESTS Official Use Only
Agency: Position:
o Assuming Office: Date ------1------1_ _ o The period covered is ------1------1_ _. through the date
of leaving office,
4. Schedule Summary
Check applicable schedules or "None," ~ Total number of pages including this cover page: __1_2__
~ Schedule A·1 • Investments - schedule attached ~ Schedule C • Income. Loans. & Business Positions - schedule attached
~ Schedule A·2 • Investments - schedule attached ~ Schedule 0 • Income - Giffs - schedule attached
~ Schedule B - Reat Property - schedule attached o Schedule E • Income - Giffs - Travel Payments - schedule attached
-or-
O None· No reporiable interests on any schedule
I certify under penalty of perjury under the laws of the State of California that t
Name
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10%) Jeffries, Kevin
Do not attach brokerage or financial statements.
Telecommunications Communications
FAIR MARKET VALUE FAIR MARKET VALUE
~ $2,000 - $10,000 o $10,001 - $100,000 ~ $2,000 - $10,000 0$10,001 - $100,000
o $100,001 - $1,000,000 DOver $l,OOO,OOQ o $100,001 - $1,000,000 DOver $1,000,000
NATURE OF INVESTMENT
Ig]Stock 0
Other _ _ _ _ _ ==-::-_____
(Describe)
NATURE OF INVESTMENT
~ Stock D Other _ _ _ _ ---;:==_____
(Describe)
o Partnership 0 Income Received of $0 - $499
o
Income Received of $500 or More (Report on Schedule C)
o Partnership 0 Income Received of SO - $499
o
Income Received of $500 or More (Report on Schedule C)
Commen~: ____________________________________________
FPPC Form 700 (2010/2011) Sch, A-1
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
SCHEDULE A-2 CALIFORNIA FORM
FAIR POLITICAL PRACTICES COMMISSION
700
Investments, Income, and Assets
Name
of Business Entities/Trusts
(Ownership Interest is 10% or Greater) Jeffries, Kevin
.. 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 IQ THE ENTITYrrRUST) SHARE OF THE GROSS INCOME IQ THE ENTITYfTRUST)
0$0 - $499 D $10,001 - $100,000 0$0 - $499 [g]
$10,001 - $100,000
0$500 - $1,000 ~ OVER $100,000 o $500 - $1,000 DOVER $100,000
0$1,001 - $10,000 0$1,001 - S10,000
.. 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 a separate sheet (f necessary) INCOME OF $10.000 OR MORE (Attach a scpamte sheet (f necessary)
AJ's Bikes, CCS Wireless, Tax Express, (no single tenant reached $10k level)
.. 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE .. 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST BUSINESS ENTITY OR TRUST
Check one box: Check one box:
o INVESTMENT jgI REAL PROPERTY o INVESTMENT [2g REAL PROPERTY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000 D $2,000 - $10,000
0$10,001 - $100.000 -----.l-----.l~ -----.l-----.l~ D $10,001 - $100,000
D $100,001 - $1,000,000 ACQUIRED DISPOSED ~ $100,001 - $1,000,000 ACQUIRED DISPOSED
~ Over $1,000,000 DOver $1,000,000
~ 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 IQ THE ENTITYITRUSn SHARE OF THE GROSS INCOME IQ THE ENTITYfTRUSn
~ 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 a separate sheet 'f ncce~saryl INCOME OF $10,000 OR MORE (Attach a separate sheet 'f necessary)
~ 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE ~ 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST BUSINESS ENTITY OR TRUST
Check one box: Check one box:
o INVESTMENT ~ REAL PROPERTY o INVESTMENT 181 REAL PROPERTY
17687 Brightman, Lake Elsinore 33274 Baldwin St, Lake Elsinore
Name of Business Entity Q( Name of Business Entity Q[
Street Address or Assessor's Parcel Number of Real Property Street Address or Assessor's Parcel Number of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
0$2,000 - $10,000 0$2,000 - $10,000
0$10,001 - $100,000 0$10,001 - $100,000
[?g $100,001 - $1,000,000 ACQUIRED DISPOSED !8] $100,001 - $1,000,000 ACQUIRED DISPOSED
DOver $1,000,000 DOver $1,000,000
D Leasehold -,,-----,--,--
Yrs. remaining
o Other _ _ _ _ _ _ _ __ D Leasehold o Other _ _ _ _ _ _ _ __
Yrs. remaining
D Check box if additional schedules reporting investments or real property
are attached
o Check box if additional schedules reporting investments or real property
are attached
~ 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 ENTITYITRUSn SHARE OF THE GROSS INCOME IQ THE ENTITYfTRUSn
~ 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 (Atbch a separatl! shl!et 'f nm:l!ssary) INCOME OF $10,000 OR MORE (Atbch a separate sheet If necessary)
~ 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE ~ 4, INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD BY THE
BUSINESS ENTITY OR TRUST BUSINESS ENTITY OR TRUST
Check one box: Check one box:
o INVESTMENT 181 REAL PROPERTY o INVESTMENT ~ REAL PROPERTY
Residential rental
Description of Business Activity Q[ Description of Business Activity Q(
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 o $2,000 - $10,000
o $10,001 - $100,000 o $10,001 - $100,000
~ $100,001 - $1,000,000 ACQUIRED DISPOSED 0$100,001 - $1,000,000 ACQUIRED DISPOSED
DOver $1,000,000 DOver $1,000,000
Name
Interests in Real Property
(Including Rental Income) Jeffries, Kevin
... STREET ADDRESS OR PRECISE LOCATION ... STREET ADDRESS OR PRECISE LOCATION
IF RENTAL PROPERTY, GROSS INCOME RECEIVED IF RENTAL PROPERTY, GROSS INCOME RECEIVED
050 - $499 0 $500 - 51,000 051,001 - $10,000 050 - $499 181 5500 - S1,OOO 0 $1,001 - $10,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of interest. list the name of each tenant that is a single source of
income of $10,000 or more. income of $10,000 or more.
* You are not required to report loans from commercial lending institutions made in the lender's regular course
of business on terms available to members of the public without regard to your official status. Personal loans
and loans received not in a lender's regular course of business must be disclosed as follows:
HIGHEST BALANCE DURING REPORTING PERIOD HIGHEST BALANCE DURING REPORTING PERIOD
D $500 - $1,000 D $1,001 - $10,000 D $500 - $1,000 D $1,001 - $10,000
D $10,001 - $100,000 DOVER $100,000 D $10,001 - $100,000 DOVER $100,000
Comments: __________________________________________________________________________________
FPPC Form 700 (2010/20111 Sch. B
FPPC Toll~Free Helpline: 866/275-3772 www.fppc.ca.gov
CALIFORNIA FORM 700
SCHEDULE B FAIR POLITICAL PRACTICES COMMISSION
Name
Interests in Real Property
(Including Rental Income) Jeffries, Kevin
.... STREET ADDRESS OR PRECISE LOCATION .... STREET ADDRESS OR PRECISE LOCATION
17657 Grand Ave (& 17662 Raley St parcels) Lot 29 of Tract 19561 (Grand Ave & Serena Way)
CITY CITY
Lake Elsinore Lake Elsinore
FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
D $2,000 - $10,000 D $2,000 - $10,000
181 $10,001 - $100,000 ---1---1.JiL ---1---1.JiL 181 $10,001 - $100,000
0$100,001 - $1,000,000 ACQUIRED DISPOSED 0$100,001 - $1,000,000 ACQUIRED DISPOSED
o Leasehold ----::---,-,---
Yrs. remaining
D - - -Other
=---- o Leasehold ----::---,-,---
Yrs. remaining
D--:: :;----
Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED IF RENTAL PROPERTY, GROSS INCOME RECEIVED
D $0 - $499 D $500 - $1,000 ~ $1,001 - $10,000 ~ SO - $499 D $500 - $1,000 D $1,001 - $10,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of interest, list the name of each tenant that is a single source of
income of $10,000 or more. income of $10,000 or more.
* You are not required to report loans from commercial lending institutions made in the lender's regular course
of business on terms available to members of the public without regard to your official status, Personal loans
and loans received not in a lender's regular course of business must be disclosed as follows:
HIGHEST BALANCE DURING REPORTING PERIOD HIGHEST BALANCE DURING REPORTING PERIOD
D $500 - $1,000 0 $1,001 - $10,000 0$500 - $1,000 0 $1,001 - $10,000
Comments: 17662 Raley St is the parking lot parcels for 17657 Grand
FPPC Form 700 (2010/2011) Sch, B
FPPC Toll-Free Helpline: 8661275-3772 www.fppc.ca.gov
CALIFORNIA FORM 700
SCHEDULE 8 FAIR POLITICAL PRACTICES COMMISSION
Name
Interests in Real Property
(Including Rental Income) Jeffries, Kevin
to- STREET ADDRESS OR PRECISE LOCATION ... STREET ADDRESS OR PRECISE LOCATION
D Leasehold --::---,-,---
Yrs. remaining
D - - :Other
::;--- D Leasehold - - : : - - - , - , - - -
Yrs. remaining
D - -Other
----
IF RENTAL PROPERTY. GROSS INCOME RECEIVED IF RENTAL PROPERTY, GROSS INCOME RECEIVED
D SO - $499 D $500 - $1,000 IZl $1,001 - $10,000 D $0 - $499 D $500 - $1,000 IZl $1,001 - $10,000
o $10,001 - $100,000 DOVER $100,000 . D 510,001 - $100,000 DOVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater SOURCES OF RENTAL INCOME: [f you own a 10% or greater
interest. list the name of each tenant that is a single source of interest. list the name of each tenant that is a single source of
income of $10,000 or more. income of $10,000 or more.
* You are not required to report loans from commercial lending institutions made in the lender's regular course
of business on terms available to members of the public without regard to your official status. Personal loans
and loans received not in a lender's regular course of business must be disclosed as follows:
HIGHEST BALANCE DURING REPORTING PERIOD HIGHEST BALANCE DURING REPORTING PERIOD
o $500 - $1,000 D $1,001 - 510,000 D $500 $1,000
w D $1,001 - $10,000
Comments: _________________________________________________________________________________
FPPC Form 700 (2010/2011) Sch. B
FPPC TollwFree Helpline: 866/275-3772 www.fppc.ca.gov
CALIFORNIA FORM 700
SCHEDULE 8 FAIR POLITICAL PRACTICES COMMISSION
Name
Interests in Real Property
(Including Rental Income) Jeffries, Kevin
... STREET ADDRESS OR PRECISE LOCATION ... STREET ADDRESS OR PRECISE LOCATION
o Leasehold - : - : - - - , - , - - -
Yrs. remaining
D - - -Other
=---- D Leasehold -c-:---,-,---
Yrs. remaining
o---:::::-cc---
Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED IF RENTAL PROPERTY, GROSS INCOME RECEIVED
D $0 - $499 D $500 - $1,000 Ig] $1,001 - $10,000 D $0 - $499 0 $500 - $1,000 181 $1,001 - $10,000
0$10,001 - $100,000 DOVER $100,000 D $10,001 - $100,000 DOVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of interest, list the name of each tenant that is a single source of
income of $10,000 or more. income of $10,000 or more.
* You are not required to report loans from commercial lending institutions made in the lender's regular course
of business on terms available to members of the public without regard to your official status, Personal loans
and loans received not in a lender's regular course of business must be disclosed as follows:
HIGHEST BALANCE DURING REPORTING PERIOD HIGHEST BALANCE DURING REPORTING PERIOD
D $500 - $1,000 D $1,001 - $10,000 D $500 - $1,000 D $1,001 - $10,000
Commenm: ___________________________________________________________________________________
FPPC Form 700 (2010/2011) Sch, B
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.goY
.'
, '
SCHEDULE C CALIFORNIA FORM 700
FAIR POLITICAL PRACTICE.S COMMISSION
Income, Loans, & Business
Name
Positions
(Other than Gifts and Travel Payments) Jeffries, Kevin
Investments Investments
YOUR BUSINESS POSITION YOUR BUSINESS POSITION
CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR WHICH INCOME WAS RECEIVED
D Salary D Spouse's or registered domestic partner's income o Salary o Spouse's or registered domestic partner's income
o Commission or 0 Rental Income, list each source of $10,000 or more D Commission or o Rental Income, list each source of $10,000 or more
[g] Othe, did NOT take salary in 2010 [g] Othe, did NOT take salary in 2010
(Describe) (QesClibe)
* 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:
----'% D None
ADDRESS (Business Address Acceptable)
SECURITY FOR LOAN
0$500 - $1,000
City
D $1,001 - $10,000 o Guarantor _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
D $10,001 - $100,000
DOVER $100,000 D Othe' _ _ _ _ _ _ _ _ ==-::-_______
(Describe)
Comments:
Investments
YOUR BUSINESS POSITION YOUR BUSINESS POSITION
President I partner
GROSS INCOME RECEIVED GROSS INCOME RECEIVED
CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR VVHICH INCOME WAS RECEIVED
D D Spouse's or registered domestic partner's income
Salary o Salary D Spouse's or registered domestic partner's income
o loan repayment 0 Partnership D Loan repayment o Partnership
o SaJe of _ _ _ _ _ _--=-_-,---_-,----,---,--,-_ _ _ _ __
(Property. car, boat, etc,)
o Sale of _ _ _ _ _ _ -=_-,-___-,-___= - - - - - -
(Property, car. boat, etc.)
o Commission or 0 Rental Income, list each source of $10,000 or more o Commission or D Rental Income, list each source of $10,000 or more
* 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:
----'0/0 0 None
ADDRESS (Business Address Acceptable)
DOVER $100,000
D Other ------------==-:::------------
(Describe)
Comments: