Weaver, Tracy Form 700 2018.2019STATEMENT OF ECONOMIC INTERESTS Date Initial Fil Received
• - • - 700
OnC,ToniFAIR POLITICAL PRACTICES
G�
COMMISSION
COVER PAGE \J�QS01
Please type or print in ink. A PUBLIC DOCUMENT �G� ���
NAME OF FILER (LAST) (FIRST) G \ IDDLE
J.
Weaver Tracy Lee
1. Office, Agency, or Court D''
Agency Name (Do not use acronyms)
City of El Segundo
Division, Board, Department, District, if applicable
Clerk's office
Your Position
Elected City Clerk
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi -County —
❑x City of El Segundo
Position
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of _
❑ Other —
3. Type of Statement (Check at least one box)
❑x Annual: The period covered is January 1, 2018, through ❑ Leaving Office: Date Left I I
December 31, 2018. (Check one circle.)
.or -
The period covered is
December 31. 2018.
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
through O The period covered is January 1, 2018, through the date of
-or- leaving office.
O The period covered is through
the date of leaving office.
and office sought, if different than Part 1
4. Schedule Summary (must complete) ► Total number of pages including this cover page: 2
Schedules attached
❑ Schedule A-1 - Investments - schedule attached ❑x Schedule C - 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- ❑ None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
350 Main Street ElSegundo CA 90245
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
( 310 ) 524-2305 tweaver@elsegundo.org
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 co4ct. ,1
Date Signed 2-25-2019
(month, day, year)
(File the or ppatty signed paper statement with your filing official.)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page - 5
SCHEDULE C CALIFORNIA F1
Income, Loans, & Business FAIR POLITICAL
Positions Name
(Other than Gifts and Travel Payments) Tracy L Weaver
NAME OF SOURCE OF INCOME
Lighthouse eDiscovery
ADDRESS (Business Address Acceptable)
51 University St. #400 Seattle WA 98101
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
Project Manager
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑X OVER $100.000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑ Salary ❑X 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)
NAME OF SOURCE OF INCOME
Pottery Barn - Williams Sonoma Inc
ADDRESS (Business Address Acceptable)
3250 Van Ness Ave San Franciso CA 94109
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
Sales Associate
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 X❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑X 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' INTEREST RATE TERM (Months/Years)
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
❑ OVER $100,000
Comments:
❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
Street address
❑ Guarantor
❑ Other
City
(Describe)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page -13