File with: Seattle City Clerk SEEC FORM SEEC PERSONAL PO Box 94723 DOLLAR Seattle, WA 93124-4728 _1 CODE AMOUNT FINANCIAL Questions: (206) 1584-8500 a (206) 615-1248 (7118) (2) :2 000 AFFAIRS Pally-gromeattle?ov $5'000 59'999 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 $100,000 $199,999 candidate or being newly appointed to a position. $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 Individual's most recently filed federal income tax return. SMC 4.16.080 Last Name First Middle Initial Names of immediate family members. If there is no ugel James reportable information to disclose for dependent children, at other dependents living in your housebjid, do not identify them. Do identify your spouse or domestic partner. ailing Address (Use PO Box or Work Address) Li m. Box 20792 Erin Overbey A) if" ?fty Camry Zip 4 -. Seattle King 98102 If, 22:: f, i: . 2? - ?ing Status (Check only one box.) Offlce Held or Sought Of?ce title: . . -J An elected or appolnted of?Clal ?llng annual report Seattle CounCll El Final report as an elected of?cial. Term expired: Position number: Candidate running in an election: month 11 year 2019 7? Terrn beglns: 2020 ends: 1212 Newly appointed to an elective of?ce /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.) Name and Address of Employer or Source of Compensation Occupation or How Compensation Amount: Dependent (0) Was Earned (Use Code) Retired 73? We DRS LEOF 2/def comp 6 King County Sheriff, 510 3rd Ave, Seattle, 98104 6 7? Check Here if continued on attached sheet 7? 2 REAL ESTATE List street address, assessor?s parcel number, or legal description AND county for each parcel of Washingto real estate with value of over $12,000 in which you or an immediate family member held a personal ?nanciq interest during the reporting period. (Show partnership, company, etc. real estate on F-1 supplement.) ?cperty 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) ,"?operty Purchased or interest Acquired Creditor?s NameiAddress Payment Terms Security Given Mortgage Amount - (Use Code (eg. 20 at 43%) Original Current ?(All Other Property Entirely or Partially Owned g25 Comatock, 5637713, 8 Wells Fargo 20 yr, 3% Mortgage 7 7 More Check here if continued on attached sheet List bank and savings accounts, insurance policies, stock, bonds and other\ ASSETS I 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 time during the report period. . 5 1 Bpeing Employee Credit Union, Seattle 5: Name and address of each insurance company where you or an immediate family member had a policy with a cash or loan value over $24,000 during the period. 2? Name and address of each company, association, government agency, etc. in which you or an immediate family member, owned or LPL Financial 7 4 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 T. Rowe Price 5 1 decision making authority regarding individual assets/investments list each asset or investment the value and any income amountEXAMPLE: lf you self-directed an investment account identify each 8e tte Deferred Comp stock or other asset in that account. Stock shall be reported by market value at the time of reporting. Qheck 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 a. 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\ (eg. 6 years at 5.25%) None i gheck here El if continued on attached sheet. Enter Dollar Amount NET WORTH Enter your estimated net worth. . . _2.4 million r? 9. art of this report. if all answers are NO and you are a candidate or an appointee to a vacant elective of?ce filing your initial report, no F-1 is required. {incumbent elected officials ?ling an annual financial affairs report also must answer question E. An F-?l Supplement is required of these fficeholders unless all answers to questions A thru are NO. 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 At any time during the reporting period were you andlor an immediate family member an of?cer. 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? if yes, complete Supplement, Part A. 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? If yes, complete Supplement. Part A. Did you andl'or an immediate family member own a business at any time during the reporting period? if yes, complete Supplement, Part A. Did you andior 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? if yes. complete Supplement, Part B. 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 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. 4L FILERS EXCEPT CANDIDATES. Check the appropriate box. Contact Telephone: 206-919?5342 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: (work)* ?\Email: (Home) Optional tgApril?iQ .. I certify under penalty of perjury th for ation contained in this report is true and correct to the best of my knowledge. Date Signature awn 9:1? hug #5359?"- Mr. Jim Pugel 3-1.4} 3 2.1.4. . Jan-w 525 Comstock St Seattle, WA 98119?3420 . CITY LEEK P, 0,50% 94733 5547715..4. 282:3: