File with: Seattle City Clerk SEEC FORM SEEC
PO BOX 94728 DOLLAR PERSONAL
Seattle. WA 93124-4723 _1 CODE AMOUNT FINANCIAL
Questions: (206) 584-8500
(206) 61 5-1243 8) (y :3 000 -- $4533: AFFAIRS
pally-growoseattleggv fag 35'000 59'999 STATEM ENT
(4) $10,000 -- $24,999
Deadlines: Incumbent elected and appointed officials -- by April 15. (5) $25,000 -- $99,999
Candidates and others -- within two weeks of becoming a (6) $100,000 .. $199,999
candidate or being newly appointed to a position. (7) 5200300 -- $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. childcoi spouse or domestic
partner sibling. uncle aunt. cousin niece or nephew. if that person either resides with or is a dependent on the Covered Individuafemosuecentlyi ?led

 

 

 

 

 

 

 

federal? Income tax returnLast Name First Middle Initial Names of immediate family memgrs. lithere Is 'nd_ i
reportable information to disclosem dep?'Identohildren. or
Herbold Lisa A other dependents living in your hoHsehodeo notlidentify
them. Do identify your spouse or domesl?ig partner.
Mailing Address (Use PO Box or Work Address) 231
7915 9th SW Robert Combs
City County Zip 4
Seattle King 98106
Filing Status (Check only one box.) Of?ce Held 0i SOUQN
IXI An elected or appointed of?cial ?ling annual report Of?ce tltlei oun cil member
Final report as an elected official. Term expired:
Position number: 1
El Candidate running in an election: month year 
Term begins: 1 I1 [16 ends: 1231 119
El Newly appointed to an elective of?ce 
1 List each employer. or other source of income (pension, social security, legal judgment, etc.) from which you or an
INCOME 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.
(Report interest and dividends in Item 3.)

 

 

 

 

 

 

 

 

Name and Address of Employer or Source of Compensation Occupation or How Compensation Amount:
Dependent (0) Was Earned (Use Code)
5 City of Seattle. 600 4th Ave, Seattle. WA 98124 Councilmember 6 
5 Oracle: 500 Oracle Parkway; REDWOOD 94065 Engineering Manager 6 
SP Highland Consulting; 12832 464th SE: North Bend. WA: 98045 Proprietor 2 
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List street address. assessor?s parcel number, or legal description AND county for each parcel of Washington
2 REAL ESTATE real estate with value of over $12,000 in which you or an immediate family member held a personal financial
interest during the reporting period. (Show partnership. com pany. 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)

Property Purchased or Interest Acquired Creditor?s Name/Address Payment Terms Security Gil-'80 Mortgage Amount - (Use Code)
(eg. 20 at Original Current


All Other Property Entirely or Partially Owned
me am sw; Seattle:WA:98106 7) PNC 1101mm Ave, Bellevue WA 98004 51.3501mo:3.65% properly 6 5 
12832 464th sE, North Bend. WA 95045 7) 3? 5' Franklin 5' properly 6 6 
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CONTINUE ON NEXT PAGE

 

List bank and savings accounts, insurance policies, stock. bonds and other

 

3 ASSETS INVESTMENTS DIVIDENDS intangible property (including but not limited to stock options) held during the
reportingperiod.
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 financial institution in which you Code)

or an immediate family member had an account over $24.000 at any MA

time during the report period. 
B. Name and address of each insurance company where you or an NM
immediate family member had a policy with a cash or loan value over 

$04000 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. 5

ownership. retirement plan, IRA. notes. stock options. and other 

intangible property. If you or your immediate family member had 593"? Emmy? ?meme? T) 

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. 

 

 

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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 current
Alaska usa; (eg. 5 years at 525%) 4 3 
US Treasury: PD. Bax 7704'. San Francisco. 94120-7704 SEBBimonth. 4% Car 4 3 
U.S. Bank; 1420 51h Ave; Seattle. 98101 sedormunth: 5% none
Soil; P.O. Dallas. TX: 75255 52?0lmm'lhivanablu "one 4 4 
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Enter Dollar Amount
5 NET WORTH Enter your estimated net worth. $527,000

 

 

 

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 filing your Initial report. no F-1
Supplement is required.

Incumbent elected officials filing an annual financial affairs report also must answer question E. An F-1 Supplement is required of these
officeholders unless all answers to questions A thru are NO.

 

A. At any time during the reporting period were you andlor an immediate family member (1 an officer. director. general partner or trustee of any corporation. company. union.
association. joint venture or other entity or (2) 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? 3'35 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? lies if yes. complete Supplement. Part A.

 

C. Did you andlor 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 office) at any time during the reporting period? ll" 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
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 governmental agency
provide or pay in whole or in part for you andr'or an immediate family member to travel or to attend a seminar or other training? 3'95 If yes to either or both questions.
complete Supplement. Part C.

 

 

 

 

ALL FILERS EXCEPT CANDIDATES. Check the appropriate box. Contact Telephone: mm l.
I hold a local elected office. have read and am familiar with SMC .. ?sahemomseamegw 
2.04.300 regarding the use ofpublic facilities in campaigns. marl. (work)
Email: Ilsalouh@hotmail.com (Home) Optional

 

 

 

CERTIFICATION: certify under penalty of per'ury that the information contained in this report is true and correct to the best of my
I




Do not use public agency addresses or telephone numbers for contact information. Report Not Acceptable Without Filer?s Signature

 

 

Date Signature

 

 

 

File with: Seattle City Clerk

PO Box 94728 SEEC FORM
Seattle,WA98124-4728 F-1 SUPPLEMENT PAGE

a PERSONAL FINANCIAL AFFAIRS STATEMENT
(2?53 515'? 3 SUPPLEMENT
Polly.Grow@Seattle.gov {7118}

 

 

 

 

 

 

PROVIDE INFORMATION FOR YOU AND ANY IMMEDIATE FAMILY MEMBERS

 

 

 

Last Name First Middle Initial DATE
Herbold Lisa A 4/15/19
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-profit
INTERESTS: organization. union. partnership. joint venture or other entity; andror

(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 tiability 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 andlor percent of ownership held.

. Brief Description of the Report the purpose. product(s), andior 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
seekihold 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 El Dependent 

LEGAL NAME: Highland Consulting POSITION OR PERCENT OF OWNERSHIP 100%

TRADE OR OPERATING NAME:

12832 464 North Bend; 98045

BRIEF DESCRIPTION OF THE BUSINESSIORGANIZATION: Software 

PAYMENTS ENTITY RECEIVED FROM GOVERNMENTAL UNIT IN WHICH YOU SEEKIHOLD OFFICE:

Purpose of payments Amount (actual dollars)
MIA
PAYMENTS ENTITY RECEIVED FROM OTHER GOVERNMENT AGENCIES OF 312.000 OR MORE:
Agency name: Purpose of payment (amount not required)


PAYMENTS ENTITY RECEIVED FROM BUSINESS CUSTOMERS OF 312.000 OR MORE
Customer name: Purpose of payment (amount not required}

NJA

WASHINGTON REAL ESTATE lN 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 parcet number, or legal description and county for each parcel):

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CONTINUE PARTS AND ON NEXT PAGE

 

 

Page 2 Supplement

 

 

Name
ENTITY N0. 2 Reporting For: Self Spouse El

Registered Domestic Partner Dependent 
LEGAL NAME: POSITION OR PERCENT OF OWNERSHIP

TRADE OR OPERATING NAME:
ADDRESS:

BRIEF DESCRIPTION OF THE 

PAYMENTS ENTITY RECEIVED FROM GOVERNMENTAL UNIT IN WHICH YOU SEEKIHOLD OFFICE:
Purpose of payments Amount (actual dollars)



PAYMENTS ENTITY RECEIVED FROM OTHER GOVERNMENT AGENCIES OF $12,000 OR MORE:
Agency name: Purpose of payment (amount not required)

PAYMENTS ENTITY RECEIVED FROM BUSINESS CUSTOMERS OF $12,000 OR MORE
Customer name: Purpose of payment (amount not required)

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):

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List persons for whom you, or any immediate family member, lobbied or prepared state legislation or state rules,
rates, or standards for compensation or deferred compensation. Do not list pay from government body in which you
are an elected official or professional staff member.

 

 

 

 

 

 

 

Person to Whom Services Rendered Description of Legislation. Rules, Etc, Compensation (Use Code 1- 9)


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FOOD Complete this section if a source other than your own governmental agency paid for or otherwise provided all or a
TRAVEL portion of the following items to you, your spouse, registered domestic partner or dependents, or a combination
SEMINARS thereof: 1) Food and beverages costing over $50 per occasion; 2) Travel occasions; or 3) Seminars, educational
programs or other training.
Date Donor's Name, City and State Brief Description Actual Dollar Value
Received Amount (Use Code1~9l
Local Progress Annual Convening $363.00 1 

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