File with: Seattle City Clerk SEEC FORM SEEC
s- PO BOX 94728 DOLLAR PERSONAL
Seattle, WA 981 24-4728 _1 CODE AMOUNT FINANCIAL
Questions: (206) 684-8500
5mm ETHICS r.
a? (206) 615-1248 (7118) (1) $0 $999 AFFAIRS
Polly.grow@seattle.gov g; 3?33: STATEMENT
(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) -- $199,999
candidate or being newly appointed to a position. (7) $200,000 -. $999399
(8) $1,000,000 -- $4,999,999
SEND REPORT TO Seattle City Clerk (9) $5,000,000 or more 
2.0

 

 

 

"immediate family? means: a spouse or domestic partner. or a parent, parent ofa spouse or domestic partner. child, child of spge or?e?mestic
partner, sibling. uncle, aunt, cousin, niece or nephew, if that person either resides with or is a dependent on the Covered filed

federal income tax return. SMC 4.16.080

*1


h!


 

Last Name First Middle Initial

1;
K. Ii (-I 


 

Mailing Address (Use PO Box or Work Address) 



{23; f, (13W j; 

 

 

Names of immediate family men?rs. If there'is ?g
reportable information to disclosdjord or
other dependents living in your hggseho . do?ot?ldentify
them. Do identify your spouse or domestic partner.

Katina






 

 

City . I ounty Zip 4

cups. canFiling Status (Check only one box.) Office Held or Sought

. . .. . . . .4. 

I: An elected or appomted of?cral filing annual report Office tItle. 
El Final report as an elected of?cial. Term expired:
. . (m Position number: I
a Candidate running in an election: month year fl

El Newly appointed to an elective of?ce

Term begins: 0t Apt/.15 {3 ends: 

 

 

1 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.)

 

Spouse (SPIDP)

Show Slims) Name and Address of Employer or Source of Compensation Occupation or How Compensation Amount:
Dependenl(D) 5, a, Was Earned (Use Code)
a 9?4 (#4517. 
g' l? 
V0 tax a real Lift 



 

Check Here if continued on attached sheet

 

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, company, etc. real estate on F-1 supplement.)
Properly 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)
i 

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

All Other Property End?? or Partially Owned . A .. h.
5.35f9?; lot-C 7" 

(Ml)

 

 

Check here if continued on attached sheet

(Ling) at

 

 

 

 

CONTINUE ON NEXT PAGE

 

 

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

 

 

 

 

 

3 ASSETS I INVESTMENTS DIVIDENDS intangible property (including but not limited to stock options) held during the
reporti?g 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
time during the report period. 
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 (.3)
$24,000 during thep_eriod. I, I i, 
5325 .2 new: .5, c: ..
5,31,, 
C. Name and address of each company, assOCIation, government
agency, etc. in which you or an immediate family member, owned or 
had a ?nancial interest worth over $2,400. Include stocks, bonds,
ownership, retirement plan, IRA, notes, stock options, and other
intangible property. If you or your immediate family member had 
decision making authority regarding individual assetsiinvestments list
each asset or investment, the value and any income amount. I 
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 El 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 CUfrent
II- . Iv.? 5 (eg. 6 years at 5.25%) (L) 

it, Uni uni, In I.. 1 i 
Check here El if continued on attached sheet. 9 

 

 

 

 

Enter Dollar Amount

5 NET WORTH Enteryourestimated net worth. 3 3 

 

 

 

6 All filers answer questions A thru below. If the answer is YES to any of these questions, the 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 and/or 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? i If yes, complete Supplement, Part A.

B. Did you andior an im \ediate 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? Ifyes, complete Supplement, Part A.

I

 

C. Did you andior an immediate family member own a business at any time during the reporting period? '5 If yes, complete Supplement, Part A.

Did you and/or 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? 1' .- . 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 famiiy 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 andior 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 EXCEPT CANDIDATES. Check the appropriate box. 
Contact Telephone. 
El I hold a local elected of?ce. have read and am familiar with SMC -. I
2.04.300 regarding the use of public facilities in campaigns. Ema'l? (work)
Email: (Home) Optional

 

 

 

CERTIFICATION: I certify under penalty of perjury that the information contained in this report is true and correct to the best of my
knowledge(i-I
i

 

 

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

 


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