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DZ1t(! Rece·\/Dd
STATEMENT OF ECONOMIC INTERESTS j\t
C6VER PAGE
A ;pdHlic Document
Vlkki
CiT'!
1. Office, Agency, or Court
-~ ... ~.~.~.~.--~--
... Total number of pages
Including this cover page: _ _ __
.. Check applicable schedu~es or "No reportable
interests."
member Board of dist':ct 3
I "ave disc~ose-d irteres:s on o'"'e or mote of the
Your POSHIO""',
attacned schedLles:
member
Sc"edu'e A-l
... If fl~:ng for mu~hp~e ,DOSJtlons. list ad:::hro;,al age;,CYi:es)J
posftlonis) (Attacr: a separate sheet If necessary;
Eastern S:erra Trans:!
Schedu!c- B Yes ;,c(ledu!p attached
Position: Yosemite Area Rca! Property
,--------_ _--
2. Jurisdiction of Office at
...••
(Check
....... _ .. .
least aile box)
Sd1edu~e C ~ Yes
incomo. 1.o.:m:;, & 13miness Positions
schedu~e att3cl1ed
[ir:~XXik QJ,,<:¥' Ih3n G~I'J
.In;; P;,y;YYY'JS)
Slale
Schedule 0 Yes schedule attached
County of ..~ •. _ ... ~ •..~.~ ____..•..•.._ __ i:Jcomp ~ Gift;;
City of ...._ ........._ .•.•..... __._._.. _ .. ~....~.~.. Schedule E eYes sCfledule attac r1ed
MUlti-County ~_ .•..• ~ ..._ ....................................... income Gifts Tmvo! Payry/ents
-or-
13. Type of Statement (Check at least one box)
Date ..........,_~
5. Verification
x· "n"u,,' The p"'Iod :over"d s Jelluary " 2009.
I "avp Lsr,d a'i ,-('.850n;;,t;'e d'ligerce in orepar:ng t;';Ls
P"'tOugh De::embe r 31 2009,
staten~ert I "ave ~eviewed this statemert a'"'d to the best
-or- of my kr:O\·\tledge the :nto~.'Tlat;o'"' (::onta:ned here:n and ''"' any
o Trle r.:-er'od CO'JC'red I:S __ attached scrediJles :5 trLe and Domp1ete.
Oecerr.ber 31 2CC9,
! certify under pena!ty of perjury under the laws of the State
Leav,'nJ Office Date Left _.~...~.J ••.._ of California that the foregOing is true and correct.
iCh0CK onp:.
o Thf' penod cr)'JC',~ed ,;, J.:lnU;lfY 1, 2GDCI, ttle
date ::If ieavlng of::ce.
-or-
o TI'e pr~t',od covered IS ihrougfi
the date of leaVing office Signature
C;:mdldate Efoc:lon Yp.?ir
FPpC Form 700 (2009/-2010)
FPPC Tott·Free Helphne: B66/ASK-FPPC wWVIIJppc.ca,g(JV
SCHEDULE C CALIFORNIA FORM
FAIR POLITICAL PRACTICES COMMISSION
700
Income, Loans, & Business
Positions
(Ot~ler than (3ifts and Travel Payments)
... 1. lNCOME RECBVEO .. 1 INCOME RECEIVED
John A. Nielson
PO. Box 810, June Lake, Ca 93529 487 N Fowler St, Bishop, Ca93514 ... _ _ _ _ _ ._
:,WSINJ,SS N':;ll'jl'-Y', iF .:'<NY o~ SOUi;:CJ
Motel Communications sub--.-contractor
Manager technjcian
Gi:;>O'SS rNCOi,,',[ 'KLCEI'}CO GROSS INCQi",1[ R[CDVED
$500 $~ 000 ~ $1,001 - $',0,000 55.00 - S1 ,000
0$10,001 - $100,000 O\tl: f( 'blOO,OOO ~J ~10,001 $100_000
,~or\)SiDEPMjON f-OR WhiCH INCOML \i'h\S j:;:EUlVfO CONSJDERilTJON FOR WHICH iNCOME WAS RfC[)V[D
~ S(1[(1;:Y Spou",p',; l..'r Ipgi'-ilP1f'd dOfT'r'~trc ;X;rlf]c;r-:; '"z:ome ';&l spau,;.; ; or nqrsv:rcd dornes/le ~i;r;rv(:, irlCOi-:'O
r--=:; Lo.;rn ,C{'-'lyrr-cnl
._._-_._-._._._._-----
..- Z. LOANS RECEIVED OR OUTSfANDING 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:
)\u\rvI[ OF U~NDER'
~---.-'-~---'-- ---~--- ..
- - -.. -.--~---
("I'j
Comments:
FPPC Form 700 (2009/2010) Sch, C
FPPC TolI·Free Helpline: 866/ASK·FPPC www.fppc.ca.gov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
.. 1 INCOME RECEIVED .. 1 INCOME RECEIVED
June Lake Fire Protection District
P.O Box 144, June Lake, Ca 93529
Fire Department
YOUR 8u5iM.SS ,"'GSI Tim]
Chief
GROSS iNCCM[ REceivED GROSS iNCOME Rl::Ci.:J1JED
CJ SSC0 - $1,000 $.1,')01 - $10,DC{) [J $500 . $1,000 $-;,00, . S10,000
iE! $10 001 '!, 100,000 ovr_R S10C',OQ[: C 510,001 - $100,000 L! OI,L R 510(;,000
CONSIDf-.R(<lICN FOR 'iVI-ilCH iNCOME. Wi\S i<:{-U!\/i--D CONSIiJr:::RrlfION rOR \,VHrCH INCOMr~ 'i'J/iS RU:;E'rVrO
... Z 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:
INT[Ri;':Si RAT[ rl;~M (M0nti1~S, YIJill-\)
- - - . _.. _ - ; ~,I()'l"
~ ~ Gei,lid',:,,! ----.,---,-------,,-,--------_._-_.-
r:J "d-r ___ , __ ,___ , __ ,_________ 'M' _ _ _ " _ _ _ .-' _ _ _.
Comments; --_._-----------_. -----_.--------------
FPPC Form 700 (2009/2010) Sch. C
FPPC Toll-Free Helpline: 866!ASK-FPPC www.fppc.ca.gov
