GI Deadlines: File with: Seattle City Clerk SEEC FORM SEEC PO Box 94728 DOLLAR PERSONAL Seattle, WA 98124-4723 1 CODE AMOUNT FINANCIAL 50 (1) so - $999 AFFAIRS g; ?2333 3:33: STATEMENT (4) $10,000 - $24,999 Incumbent elected and appointed officials by April 15. (5) $25,000 .. $99,999 Candidates and others within two weeks of becoming a (5) $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 City Clerk (9) $5,000,000 or more "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 lndividual?s most recently ?led federal income tax return. SMC 4.16.080 Last Name First Middle Initial Names of immediate family members. If there is no reportable information to disclose for dependent children, or Greene Jesse other dependents living in your household,:db notidentify them. Do identify your spouse or domestid??rtnera 1., Mailing Address (Use PO Box or Work Address) '3 R3 6523 California Ave SW, Box #414 Jessica R. Greene {.71 *0 City County Zip 4 . 1 Seattle King 98136 ?if. Filing Status (Check only one box.) Of?ce Held 0r Sought :3 An elected or appointed of?cial ?ling annual report Of?ce title: Seattle City Council Final report as an elected of?cial. Term expired: Posrtron number: 01 Candidate running in an election: month 11 year 2019 . . Te'm beg'm? 0110112020 ends' Newly appornted to an elective of?ce 1 INCOME (Report interest and dividends in Item 3.) List each employer, or other source of income (pension, social security, legal judgment, etc.) from which you or an immediate family member, received compensation, in any form, of $2,400 or more during the period. Include stock options received during the reporting period that had a value of more than $2,400. Eggfs?jg?m Name and Address of Employer or Source of Compensation Occupation or How Compensation Amount: oapenuentro) Was Earned (Use Code) 8 Seattle Popcom Company Inc, 9320 15th Ave 8, Unit CD, Seattle, WA 98108 5) ACG LLC, 9320 15th Ave 8, Unit CD, Seattle WA 98108 5) Northwest Insurance Group, 5 Check Here it continued on attached sheet 2 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 durinthe reporting period. (Show partnership, company, etc. real estate on F-1 slgaplement.) REAL ESTATE 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) Not Applicable Property Purchased or Interest Acquired Creditors NamelAddress Payment Terms Security Given Mortgage Amount - (Use Code) (eg. 20 at Original Current Not Applicable All Other Property Entirely or Partially Owned Not Applicable Check here if continued on attached sheet CONTINUE ON NEXT PAGE List bank and savings accounts, insurance policies, stock, bonds and other 3 ASSETS I INVESTMENTS intangible property (including but not limited to stock options) held during the reporting 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 COGB) or an immediate family member had an account over $24,000 at any time during the report period. US Bank 5 5 B- Name and address of each insurance company where you or an Symetra 7 0 immediate family member had a policy with a cash or loan value over Symetra 7 0 $24,000 during the period. Lifewise 7 0 C. Name and address of each company, association. government agency, etc. in which you or an immediate family member. owned or Seattle Popcorn Company, 8 5 had a financial interest worth over $2,400. include stocks, bonds, ownership, retirement plan, IRA, notes, stock options, and other ACG LLC intangible property. If you or your immediate family member had (7 (5 decision making authority regarding individual assetslinvestments list each asset or investment, the value and any income amount. Above and Beyond Repair LLC 1 1 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. Check here if continued on attached sheet. 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 Secuhrlity Given original current 3W ?3 .6 ears at 5250/ one 4 3 g36yrnoths at 14930) ?one 4) (4 Navient - - - Open Line of Credit 11.9% None Nav'ent In School Deferment 6.6% None 4) (4 Check here if continued on attached sheet. In School Deferment 7.6% 5 5 Enter Dollar Amount 5 NET WORTH Enter your estimated net worth. 765,811 6 All filers answer questions A thru below. If the answer is YES to any of these questions, the F-1 Supplement must also be completed as part of this report. If all answers are NO and you are a candidate or an appointee to a vacant elective office ?ling your initial report, no F-1 Supplement is required. Incumbent elected of?cials ?ling an annual ?nancial affairs report also must answer question E. An F-1 Supplement is required of these of?ceholders unless all answers to questions Athru are NO. A. At any time during the reporting period were you andlor an immediate family member (1) an of?cer, director, general partner or trustee of any corporation, company, union, association. joint venture or other entity or a partner or member of any limited partnership, limited liability partnership. limited liability company or similar entity including but not limited to a professional limited liability company? yes If yes, complete Supplement, Part A. B. Did you andlor an immediate family member have an ownership of 10% or more in any company. corporation, partnership, joint venture or other business at any time during the reporting period? YES If yes. complete Supplement, Part A. Did you and/or an immediate family member own a business at any time during the reporting period? YES If yes, complete Supplement. Part A. D. Did you andlor an immediate family member prepare, promote or oppose state legislation, rules. rates or standards for compensation or deferred compensation (other than pay for a currently-held public of?ce) at any time during the reporting period? NO If yes, complete Supplement. Part B. E. Only for Persons Filing Annual Report. Regarding the receipt of items not previded or paid for by your governmental agency during the previous calendar year: 1) Did you, andlor an immediate family member accept a gift of food or beverages costing over $50 per occasion? or 2) Did any source otherthan your governmental agency provide or pay in whole or in part for you andlor 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. ALL FILERS EXCEPT CANDIDATES. Check the appropriate box. Contact Telephone: 206 779?41 18 v: 1 hold a local elected of?ce. I have read and am familiar with SMC . 2.04.300 regarding the use of public facilities in campaigns. Ema'I' Jesse@seattlepopcmn.com (work) Email: (Home) Optional CERTIFICATION: certify under penalty of perjury that the information contained in this report is true and correct to the best of my knowledge. 214:19 Date ?Signature, Do not use public agency addtesses or telephone numbers for contact information. Report Not Acceptable Without Filer?s Signature EEC sums arms I. a ELECTIONS I206) 51 5'12? SUPPLEMENT File with: Seattle City Clerk PO BOX 94728 SEEC FORM Seattle, WA 98124-4728 SUPPLEMENT PAGE PERSONAL FINANCIAL AFFAIRS STATEMENT Polly.Grow@Seattle.gov 8) PROVIDE INFORMATION FOR YOU AND ANY IMMEDIATE FAMILY MEMBERS Last Name First Middle Initial DATE Greene Jesse 02104119 OFFICE HELD: Provide the following information if, during the reporting period, you or any immediate family member A BUSINESS INTERESTS: (1) were an of?cer, director, general partner, trustee, or 10 percent or more owner of a corporation, non?pro?t organization, union, partnership, joint venture or other entity; andlor (2) were a partner or member of a limited partnership, limited liability partnership, limited liability company or similar entity, including but not limited to a professional limited liability company. Legal Name: Report name used on legal documents establishing the entity. Trade or Operating Name: Report name used for business purposes if different from the legal name. Position or Percent of Ownership: The of?ce, title andror percent of ownership held. Brief Description of the BusinessIOrganization: Report the purpose, product(s), andfor the service(s) rendered. Payments from Governmental Unit: If the governmental unit in which you hold or seek of?ce made payments to the business entity concerning which you?re reporting, show the purpose of each payment and the actual amount received. Payments from Business Customers and Other Government Agencies: List each corporation, partnership, joint venture, sole proprietorship, union, association, business or other commercial entity and each government agency (other than the one you seeklhoid of?ce) which paid compensation of $12,000 or more during the period to the entity. Briefly say what property, goods, services or other consideration was given or performed for the compensation. Washington Real Estate: Identify real estate owned by the business entity if the quali?cations referenced below are met. ENTITY NO. 1 Reporting For: Self Spouse Registered Domestic Partner CI Dependent LEGAL NAME: ACG LLC POSITION OR PERCENT OF OWNERSHIP TRADE OR OPERATING ADDRESS: 9320 15th Ave AME: Above and Beyond Repair Member and Manager 8, Unit CD, Seattle, WA 98108 BRIEF DESCRIPTION OF THE Property Management Construction Services Provider PAYMENTS ENTITY RECEIVED FROM GOVERNMENTAL UNIT IN WHICH YOU SEEKIHOLD OFFICE: Purpose of payments Amount (actual dollars) Not Applicable 0 PAYMENTS ENTITY RECEIVED FROM OTHER GOVERNMENT AGENCIES OF $12,000 OR MORE: Agency name: Purpose of payment (amount not required) Not Applicable None PAYMENTS ENTITY RECEIVED FROM BUSINESS CUSTOMERS OF $12,000 OR MORE Customer name: Purpose of payment (amount not required) SJC Property Management Construction Services WASHINGTON REAL ESTATE IN WHICH ENTITY HELD A DIRECT FINANCIAL INTEREST (Complete only if ownership in the ENTITY is 10% or more and assessed value of property is over $24,000. List street address, assessor parcel number, or legal description and county for each parcel): Not Applicable Check here if continued on attached Sheet CONTINUE PARTS AND ON NEXT PAGE File with: Seattle City Clerk SEEC FORM 5 E. EC 3333: 3313831244723 F-1 SUPPLEMENT PAGE stints miss I. ??ES?ijm ma? PERSONAL FINANCIAL AFFAIRS STATEMENT neutrons (205) 5 5'12? SUPPLEMENT Polly.Ger@Seattle.gov 8] PROVIDE INFORMATION FOR YOU AND ANY IMMEDIATE FAMILY MEMBERS Last Name First Middle Initial DATE Greene Jesse 2l3I19 OFFICE HELD: Provide the following information if, during the reporting period, you or any immediate family member A BUSINESS (1) were an of?cer, director, general partner. trustee, or 10 percent or more owner of a corporation, non-pro?t organization, union, partnership. joint venture or other entity; andlor (2) were a partner or member of a limited partnership. limited liability partnership, limited liability company or similar entity, including but not limited to a professional limited liability company. 0 Legal Name: Report name used on legal documents establishing the entity. . Trade or Operating Name: Report name used for business purposes if different from the legal name. - Position or Percent of Ownership: The of?ce. title and/or percent of ownership held. . Brief Description of the Business/Organization: Report the purpose, product(s), and/or the service(s) rendered. - Payments from Governmental Unit: If the governmental unit in which you hold or seek of?ce made payments to the business entity concerning which you?re reporting, show the purpose of each payment and the actual amount received. . Payments from Business Customers and Other Government Agencies: List each corporation, partnership. ioint venture. sole proprietorship, union, association. business or other commercial entity and each government agency (other than the one you seek/hold of?ce) which paid compensation of $12,000 or more during the period to the entity. Brie?y say what property. goods, services or other consideration was given or performed for the compensation. - Washington Real Estate: Identify real estate owned by the business entity if the quali?cations referenced below are met. ENTITY NO. 1 Reporting For: Self Spouse CI Registered Domestic Partner Dependent LEGAL NAME: Seattle Popcorn Company. Inc. POSITION OR PERCENT OF OWNERSHIP TRADE OR OPERATING NAME: Uncle Woody's Popcorn Company President ADDRESS: 9320 15th Ave 8. Unit CD Seattle WA 98108 BRIEF DESCRIPTION OF THE BUSINESSIORGANIZATION: Specialty POPCOITI Manufacturer PAYMENTS ENTITY RECEIVED FROM GOVERNMENTAL UNIT IN WHICH YOU SEEKJHOLD OFFICE: Purpose of payments Amount (actual dollars) Not Applicable 5 0 PAYMENTS ENTITY RECEIVED FROM OTHER GOVERNMENT AGENCIES OF $12,000 OR MORE: Agency name: Purpose of payment (amount not required) Not Applicable PAYMENTS ENTITY RECEIVED FROM BUSINESS CUSTOMERS OF $12000 OR MORE Customer name: Purpose of payment (amount not required) Bartell Drugs, Crown Paci?c Fine Foods, DPI Specialty Foods. Eurest Dining Services, Ross. Seattle Fudge, TJX Corporation, Ahab, Shipping Popcorn Sales WASHINGTON REAL ESTATE IN WHICH ENTITY HELD A DIRECT FINANCIAL INTEREST (Complete only if ownership in the ENTITY is 10% or more and assessed value of property is over $24,000. List street address, assessor parcel number, or legal description and county for each parcel): Not Applicable Check here Cl if continued on attached sheet CONTINUE PARTS AND ON NEXT PAGE File with: Seattle City Clerk SEEC FORM 3 PO BOX 94723 - F-1 SUPPLEMENT PAGE SEATTLE Ethics: 2 1 1 4 PERSONAL FINANCIAL AFFAIRS STATEMENT cannussrou I 6 5' 2 3 SUPPLEMENT Polly.Grow@Seattle.gov {ms} PROVIDE INFORMATION FOR YOU AND ANY IMMEDIATE FAMILY MEMBERS Last Name First Middle Initial DATE Greene Jesse 02204119 OFFICE HELD: Provide the following information if, during the reporting period. you or any immediate family member A BUSINESS (1) were an of?cer. director, general partner. trustee, or 10 percent or more owner of a corporation, non-pro?t INTERESTS: organization. union. partnership. joint venture or other entity; andi'or (2) were a partner or member of a limited partnership, limited liability partnership, limited liability company or similar entity, including but not limited to a professional limited liability company. a Legal Name: Report name used on legal documents establishing the entity. 0 Trade or Operating Name: Report name used for business purposes if different from the legal name. - Position or Percent of Ownership: The of?ce, title and/or percent of ownership held. 0 Brief Description of the Busineslerganization: Report the purpose, product(s). andlor the service(s) rendered. a Payments from Governmental Unit: If the governmental unit in which you hold or seek of?ce made payments to the business entity concerning which you?re reporting. show the purpose of each payment and the actual amount received. 0 Payments from Business Customers and Other Government Agencies: List each corporation, partnership. joint venture, sole proprietorship. union. association. business or other commercial entity and each government agency (other than the one you seeklhold of?ce) which paid compensation of $12,000 or more during the period to the entity. Brie?y say what property. goods, services or other consideration was given or performed for the compensation. . Washington Real Estate: Identify real estate owned by the business entity if the quali?cations referenced below are met. ENTITY No.1 Reporting For: Self Spouse [3 Registered Domestic Partner Dependent LEGAL NAME: Above and Beyond Repair LLC POSITION OR PERCENT OF OWNERSHIP Member and Manager TRADE OR OPERATING NAME: ADDRESS: 9320 15th Ave 8., Unit CD, Seattle, WA 98108 BRIEF DESCRIPTION OF THE BUSINESSIORGANIZATION: Property Management Construction Services Provider PAYMENTS ENTITY RECEIVED FROM GOVERNMENTAL UNIT IN WHICH YOU OFFICE: Purpose of payments Amount (actual dollars) Not Applicable 0 PAYMENTS ENTITY RECEIVED FROM OTHER GOVERNMENT AGENCIES OF $12,000 OR MORE: Agency name: Purpose of payment (amount not required) Not Applicable PAYMENTS ENTITY RECEIVED FROM BUSINESS CUSTOMERS OF $12,000 OR MORE Customer name: Purpose of payment (amount not required) SJC Property Managment Construction Services WASHINGTON REAL ESTATE IN WHICH ENTITY HELD A DIRECT FINANCIAL INTEREST (Complete only if ownership in the ENTITY is 10% or more and assessed value of property is over $24,000. List street address. assessor parcel number. or legal description and county for each parcel): Not Applicable Check here if continued on attached sheet CONTINUE PARTS AND ON NEXT PAGE File with: Seattle City Clerk 5 PO Box 94723 SEEC FORM Seattle, WA 93124-4723 1 SUPPLEMENT PAGE . .. .. . . . .. . I - smut ETHICS II 684 8500 PERSONAL FINANCIAL AFFAIRS STATEMENT ELECTIONS I I 15' 2 a SUPPLEMENT Polly.Grow@Seattle.gov (7118) PROVIDE INFORMATION FOR YOU AND ANY IMMEDIATE FAMILY MEMBERS Last Name Greene DATE 2(3119 First Middle Initial Jessica BUSINESS INTERESTS: A OFFICE HELD, Provide the following information if. during the reporting period, you or any immediate family member (1) were an of?cer, director, general partner, trustee. or 10 percent or more owner of a corporation, non-pro?t organization, union, partnership, joint venture or other entity; andlor (2) were a partner or member of a limited partnership, limited liability partnership, limited liability company or similar entity, including but not limited to a professional limited liability company. Legal Name: Report name used on legal documents establishing the entity. Trade or Operating Name: Report name used for business purposes if different from the legal name. Position or Percent of Ownership: The of?ce, title and/or percent of ownership held. Brief Description of the Business/Organization: Report the purpose. product(s). and/or the service(s) rendered. Payments from Governmental Unit: If the governmental unit in which you hold or seek of?ce made payments to the business entity concerning which you're reporting, show the purpose of each payment and the actual amount received. Payments from Business Customers and Other Government Agencies: List each corporation, partnership. joint venture, sole proprietorship, union, association, business or other commercial entity and each government agency (other than the one you seekrhold of?ce) which paid compensation of $12,000 or more during the period to the entity. Brie?y say what property. goods, services or other consideration was given or performed for the compensation. . Washington Real Estate: Identify real estate owned by the business entity if the quali?cations referenced below are met. ENTITY NO. 1 Reporting For: Self Spouse Registered Domestic Partner Dependent LEGAL NAME: Seattle Popcorn Company, Inc. TRADE OR OPERATING NAME: Uncle Woody's Popcom Company ADDRESS: 9320 15th Ave 8, Unit CD Seattle WA 98108 BRIEF DESCRIPTION OF THE BUSINESSIORGANIZATION: Specialty Popcorn Manufacturer PAYMENTS ENTITY RECEIVED FROM GOVERNMENTAL UNIT IN WHICH YOU SEEKIHOLD OFFICE: Purpose of payments Not Applicable PAYMENTS ENTITY RECEIVED FROM OTHER GOVERNMENT AGENCIES OF $12,000 OR MORE: Agency name: Not Applicable PAYMENTS ENTITY RECEIVED FROM BUSINESS CUSTOMERS OF $12.000 OR MORE Customer name: Bartell Drugs, Crown Paci?c Fine Foods, DPI Specialty Foods, Eurest Dining Services, Ross, Seattle Fudge, TJX Corporation, Ahab, Shipping POSITION OR PERCENT OF OWNERSHIP Treasurer Amount (actual dollars) 0 Purpose of payment (amount not required) Purpose of payment (amount not required) Popcorn Sales WASHINGTON REAL ESTATE IN WHICH ENTITY HELD A DIRECT FINANCIAL INTEREST (Complete only if ownership in the ENTITY is 10% or more and assessed value of property is over $24,000. List street address, assessor parcel number. or legal description and county for each parcel): Not Applicable Check here if continued on attached sheet CONTINUE PARTS AND ON NEXT PAGE