?i nova") File with: Seattle City Clerk SEEC FORM SEEC PO Box 94723 DOLLAR Seattle, WA 98124-4728 _1 CODE ?gmu Questions: (206} 684-8500 1 suction: (206polly.grow@seattle.gov g; (4) Deadlines: Incumbent elected and appointed of?cials -- by April 15. (5) Candidates and others -- within two weeks of becoming a (5) candidate or being newly appointed to a position. 8 SEND REPORT TO Seattle City Clerk AMOUNT $0 -- $999 $1,000 -- $4,999 $5,000 -. $9,999 $10,000 -- $24,999 $25,000 -- $99,999 $100,000 -- $199,999 $200,000 -- $999,999 $1,000,000 -- $4,999,999 $5,000,000 or more PERSONAL FINANCIAL AFFAIRS STATEMENT 5 "immediate family" means: a spouse or domestic partner, or a parent, parent of a spouse or domestic partner. child. child offs?alse'or dobj?stid partner. sibling, uncle, aunt, cousin. niece or nephew. if that person either resides with or is a dependent on the Covered FeQenIIy?Led- federal income tax return. SMC 4.16.080 l? :5th a Last Name First Middle Initial Names of immediate family membe?? If there is r191?. Hoffman reportable information to disclose for depe?nt children, or Al'l other dependents living in your household,.do, not identify them. Do identify your spouse or domestiocpartner. Mailing Address (Use PO Box or Work Address) . PO Box 80443 Jessma Russak Hoffman- Spouse City Seattle COUW Zip 4 in 9 98108 ?rtatus (Check only one box.) Office Held or Sought . CounCll Member An elected or appointed of?cial ?ling annual report Office title: El Final report as an elected of?cial. Term expired: 2 Position number: Candidate runnin in an election: month ear Term begins: 1/2020 ends; 12/31/202 Newly appointed to an elective office 1 INCOME 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. (Report interest and dividends in Item 3.) Show 590(8) Spouse Dependent (D) 3 SP 8 Lion Logistics LLC 6222 Chatham Dr Seattle WA 98118 RR Terminals 5301 2nd Ave Seattle WA 98108 Seattle Girls High School 5142 5 Holly St Seattle WA 98118 BCMH Synagogue 5145 Morgan St Seattle WA 98118 Check Here if continued on attached sheet Name and Address of Employer or Source of Compensation Occupation or How Compensation Was Earned Real Estate Real Estate Teache r. Youth Director Amount: (Use Code) (5) 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 Value (Use 1-9 Code) i) Name and Address of Purchaser Nature and Amount (Use Code) of Payment or Consideration Received Property Purchased or interest Acquired Creditor's NameiAddress Payment Terms Security Given Mortgage Amount - (Use Code) (eg. 20 at Original Current i i i All Other Property Entirely or Partially Owned Umpqua Bank 30 yr ?xed 7 6222 Chat ham Dr Seattle WA 98118 Check here CI if continued on attached sheet PO. Box 1820 Roseburg, OR 97 470 3.88% CONTINUE ON NEXT PAGE List bank and savings accounts, insurance policies, stock, bonds and other 3 ASSETS INVESTMENTS DWIDENDS 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 Code) or an immediate family member had an account over $24,000 at any anner an . time during the report period. Checking and (5 (5 B. Name and address of each insurance company where you or an immediate family member had a policy with a cash or loan value over Safeco Insurance 8 (8 $24,000 during the period. . Fmancral 8 8 Brighthouse 8 C. Name and address of each company, association, government 8 agency, etc. in which you or an immediate family member, owned or Edward Jones (5 had a ?nancial interest worth over $2,400. Include stocks, bonds, 5 ownership. retirement plan, IRA. notes, stock options. and other Amusements On Demand intangible property. If you or your immediate family member had (8 (8 decision making authority regarding individual assetslinvestments list each asset or investment, the value and any income amount. i 5 5 EXAMPLE: If you self-directed an investment account identify each on LLC 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 Security Given original current Umpqua Bank Heloc leg. Byears at5-25%) Deed USAA Auto ilitle (1 (1 Check here if continued on attached sheet. 5 Enter Dollar Amount . NET WORTH nter your estimated net worth 768,696 .09 6 All ?lers 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-?l Supplement is required. Incumbent elected of?cials ?ling an annual ?nancial affairs report also must answer question E. An F-?l Supplement is required of these officeholders unless all answers to questions Athru are NO. association. joint venture or other entity or (2) a partner 0 bar of any limited partnership. limited liability partnership, limited liability company or similar entity including A. At any time during the reporting period were you and/or im diate family member (1 an of?cer. director. general partner or trustee of any corporation. company. union, but not limited to a professional limited liability companyle yes. complete Supplement. Part A. B. Did you andlor an immedl 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? If yes, complete Supplement. Part A. C. Did you andlor an immediate family member own a business at any time during the reporting period? 2 If yes, complete Supplement. Part A. D. Did you andlor an immediate family member prepare. promote or oppose st to ation. 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? if yes. complete Supplement, Part E. E. Only for Persons Filing Annual Report. Regarding the receipt of items not rovi 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 other than 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; 206 295'5888 I 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. Email: CERTIFICATION: I certify under penalty of perjury that the information contained in this report is true and correct to the best of my knowledge. 10/6/2018 (work)* Email: (Home) Optional Date Signature Do not use public agency addresses or telephone numbers for contact information. Report Not Acceptable Without Filer?s Signature File with: Seattle City Clerk PO BOX 94728 SEEC FORM 3 Seattle, WA98124-4728 F-1 SUPPLEMENT PAGE sums ETl-llcs PERSONAL FINANCIAL AFFAIRS STATEMENT ELECTIDIS nunurssrou I I SUPPLEMENT Polly.Grow@Seattle.gov [7,1 3) PROVIDE INFORMATION FOR YOU AND ANY IMMEDIATE FAMILY MEMBERS Last Name First Middle Initial DATE Hoffman 11/6/18 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: andior 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. 0 Position or Percent of Ownership: The of?ce, title andror percent of ownership held. - Brief Description Of the Businessr?Organization: Report the purpose. product(s), andlor the service(s) rendered. . Payments from Governmental Unit: If the governmental unit in which you hold or seek office 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 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 N0. 1 Reporting For: Selfg Spouse Registered Domestic Partner Dependent I: LEGAL NAME: Lion Logistics LLC POSITION OR PERCENT OF OWNERSHIP President ,3 33 TRADE OR OPERATING NAME: - 1.1 ADDRESS: 6222 Chatham Dr :2 a jog?" Seattle WA 98118 3-5 3L 5 BRIEF DESCRIPTION OF THE BUSINESSIORGANIZATION: .. Property Management 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 (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): Check here if continued on attached sheet CONTINUE PARTS AND ON NEXT PAGE Information Continued Supplement Name ENTITY N0. Reporting For: Self mpouse Congregation Bikur Cholim Machzikay Hadath RegiStered Partner Dependent LEGAL NAME: lSeattIe JerSh Chapel POSITION OR PERCENT OF OWNERSHIP TRADE OR OPERATING NAME: ADDRESS: 5145 S. Morgan St BRIEF DESCRIPTION OF THE BUSINESSIORGANIZATION: Seattle, WA 98118 Synagogue 2nd Vice President- BCMH PAYMENTS ENTITY RECEIVED FROM GOVERNMENTAL UNIT IN WHICH YOU SEEKJHOLD OFFICE: Purpose of payments PAYMENTS ENTITY RECEIVED FROM OTHER GOVERNMENT AGENCIES OF $12,000 OR MORE: Agency name: PAYMENTS ENTITY RECEIVED FROM BUSINESS CUSTOMERS OF $12,000 OR MORE Customer name: Amount (actual dollars) Purpose of payment (amount not required) 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): LOBBYING: Person to Whom Services Rendered Description of Legislation. Rules. Etc. Compensation (Use Code 1-9) FOOD TRAVEL . SEMINARS (continued) Date Donor's Name. City and State Brief Description Actual Dollar Value Received Amount (Use Code 1-9) Page 2 Supplement Name ENTITY N0. 2 Reporting For: Self E/Spouse Registered Domestic Partner Dependent LEGAL NAME: Amusements On Demand POSITION OR PERCENT OF OWNERSHIP TRADE OR OPERATING NAME: owner ADDRESS: 5301 2nd Ave Seattle, WA 98108 BRIEF DESCRIPTION OF THE BUSINESSIORGANIZATION: Party Rentals PAYMENTS ENTITY RECEIVED FROM GOVERNMENTAL UNIT IN WHICH YOU 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): Check here if continued on attached sheet List persons for whom you, or any immediate family member, lobbied or prepared state legislation or state rules. LOBBYING: 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) Check here it continued on attached sheet 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 Code1-9) Check here it continued on attached sheet