File with: Seattle City Clerk SEEC FORM SEEC Po Box 94728 DOLLAR Seattle, WA 93124-4723 _1 cope AMOUNT Questions: (206) 684-8500 1 $0 $9 9 (206) 615-1248 (7118) $1 000 . $4 939 pally.grow@seattle.gov (3) $5,000 $9,999 (4) $10,000 - $24,999 Deadlines: Incumbent elected and appointed of?cials - by April 15. (5) $25,000 -- $99,999 Candidates and others -- within two weeks of becoming a $100,000 -- $199,999 candidate or being newly appointed to a position. (7) $200,000 -- $999,999 (8) $1,000,000 $4,999,999 SEND REPORT TO Seattle Clty Clerk (9) $5,000,000 or more PERSONAL FINANCIAL AFFAIRS STATEMENT federal income tax return. SMC 4.16.080 "immediate family" means: a spouse or domestic partner, or a parent, parent of a spouse or domestic partner. child, child of spouse or domestic partner, sibling, uncle, aunt, cousin. niece or nephew, if that person either resides with or is a dependent on the Covered Individual's most recently ?led Middle Initial Last Name First DEMNISOIU rev Mailing Address (Use PO Box or Work Address) .35ng Rel/urea Ang County SEA?ine- Krup? Zip+4 (73/132445? Names of immediate family members. If there is no reportable information to disclose for dependent children, or other dependents living in your household, do not identify them. Do identify your spouse or domestic partner. I) ewe/U 6? Fl 72 3 ft? Ufa" Of?ce Held or Sought An elected or appointed official ?ling annual report l: Final report as an elected of?cial. Term expired: lX Candidate running in an election: month (5.10 Filing Status (Check only one box.) year; CZ Position number: Term begins: 2 220 Of?cetitle: CITY ends: 2022;: . El Newly appointed to an elective of?ce List each employer, or other source of income (pension, social security, 1 immediate family member, received compensation, in any form, of $2,400 (Report interest and dividends in Item 3.) legal judgment, etc.) from which you or an or more during the period. Include stock chow Sell Spouse Occupation or How Compensation Was Earned Name and Address of Employer or Source of Compensation pendwl (D) options received during the reporting period that had a value of more than $2,400. i - 0U MENK 'Tx 7am BN5 i: Mir. WAY WC 72 7M SOCIAL SECurti?ty' Check Here if continued on attached sheet IN H52 I I A 5ALES act-711K DC ?/HL/Zoeb COUOUC Amount: (Use Code) (Ll) . i 2 REAL ESTATE List street address, assessor?s parcel number, or legal description AND county for each parcel of Washington real estate with value of over $12,000 in which you or an immediate family member held a personal ?nancial interest during the reporting period. (Show partnership, company, etc. real estate on F-1 supplement.) Property Sold or interest Divested Assessed Name and Address of Purchaser Nature and Amount (Use Code) of Payment or Value Consideration Received (Use 1-9 - Code) A Property Purchased or Interest Acquired Creditor's NameiAddress Payment Terms Security Given Mortgage Amount - (Use Code) (eg. 20 314.3%) Original Current All Other Property Entirely or Partially Owned Check here if continued on attached sheet a .l _l CONTINUE ON NEXT PAGE List bank and savings accounts, insurance policies, stock, bonds and other] 5 3 ASSETS i INVESTMENTS INTERESTIDIVIDENDS intangible property (including but not limited to stock options) held during the Eporting period. Type of Account or Description of Asset Asset Value income Amount (Use 1-9 (Use 1-9 Code) A. Name and address of each bank or ?nancial institution in which you - 3, . Code) or an immediate family member had an account over $24,000 at any E4264) . time during the report period. LIZ. rCzL3ME/ll/ 5? I (5) 5AM aim/dc {5570: 4 B. Name and address of each insurance company where you or on Lf 16' 3 immediate family member had a policy with a cash or loan value over :9 $24,000 during the period. C. Name and address of each company. association, government agency, etc. in which you or an immediate family member, owned or had a financial interest worth over $2.400. include stocks. bonds. ownership, retirement plan, IRA, notes. stock options, and other A) (I intangible property. If you or your immediate family member had decision making authority regarding individual assetslinvestments list each asset or investment. the value and any income amount. EXAMPLE: If you self-directed an investment account identify each stock or other asset in that account. Stock shall be reported by market value at the time of reporting. I I I Check here if continued on attached sheet. . A- (cg. 6 years at 5.25%) gheck here i] if continued on attached sheet. i List each creditor you or an immediate family member owed $2,400 or more any time during the AMOUNT 4 CREDITORS period. Don?t include retail charge accounts, credit cards, or mortgages or real estate reported (USE 1-9 CODE) in Item 2. Creditor?s Name and Address Terms of Payment Security Given original Gillie?? i i Enter Dollar Amount 1 5 NET WORTH Enter your estimated net worth. 5 part of this report. If all answers are NO and you are a candidate or an appointee to a vacant elective of?ce ?ling your initial report. no F-1 Supplement is required. of?ceholders unless all answers to questions A thru are NO. but not limited to a professional limited liability company? If yes, complete Supplement. Part A. El Did you andfor an immediate family member have an owriership of10% or more in any company, corporation, partnership, joint venture or other business at anytime our the reporting period?yy 0 If yes. complete Supplement, Part A. C. Did you andlor an immediate family member own a business at any time during the reporting period? If yes, complete Supplement. Part A. pay for a currently-held public o??ice) at any time during the reporting period? - if yes. complete Supplement, Part B. E. Only for Persons Filing Annual Report. Regarding the receipt of items not provided or paid for by your governmental agency during the previous calendar year; 1) Did provide or pay in whole or in part for you and/or an immediate family member to travel or to attend a seminar or other training? If yes to either or both questions. complete Supplement. Part C. 6 All ?lers answer questions Athru below. If the answer is YES to any of these questions, the F-1 Supplement must also be completed as Incumbent elected officials ?ling an annual ?nancial affairs report also must answer question E. An F-1 Supplement is required of these A, At anytime during the reporting period were you andi?or an immediate family member {1 an of?cer. director. general partner or trustee of any corporation. company. union, association. ioint venture or other entity or (2) a partner or me er of any limited partnership. limited liability partnership. limited liability company or similar entity including Did you andior an immediate family member prepare. promote or oppose state legislation. mles. rates or standards for compensation or deferred compensation (other than you, andior an immediate family member accept a gift of food or beverages costing over $50 per occasion? or 2) Did any source other than your govemmenlal agency ALL FILERS EXCEPT CANDIDATES. Check the appropriate box. Contact Telephone: (206 525 .4755 2.04.300 regarding the use of public facilities in campaigns. Email: i (Home) Op I hold a local elected office. I have read and am familiar with SMC Email: ?3 a COVniwork)? tional report is true and correct to the best of my CERTIFICATION: I certify under penalty of per'ury that the information contained in thi knowledge. . We?? I 0/ 7 6/ I Date ?ignature? Do not use public agency addresses or teleplku?n?e?lmbers for c%c i I ljwformation. Report Not Acceptable Without Filer?s Signature a mum?! 5 L) ?9 Av: TULE DEED DUEL SUCH ETES 1000 98124 H2304 &m%hw%?gu?awj ?5 5 ?rox \Vo g6 u) SQMW 5&5 514% ?riy [la/102 3 agaw?WA 98/24?