Beusterien - 700CALIFORNIA FORM700
FAIR POLITICAL PRACTICES COMMISSION
Please type or print in ink.
STATEMENT OF ECONOMIC INTEREST
COVER PAGE
PAGE
A PUBLIC DOCUMENT
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CITY or:
In
Filing Official Use Only
AUG 08 2022
NAME OF FILER (LAST)
(FIRST) (MIDDLE)
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
Division, Board, Department, District, if applicable Your Position
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency: Position•
2. Jurisdiction of Office (Check at least one box)
j State [_ Judge, Retired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
L County of
❑ Multi -County
❑ City of
Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2021, through ❑ Leaving Office: Date Left /
December 31, 2021. (Check one circle.)
-or-
The period covered is J , through ❑ The period covered is January 1, 2021, through the date of
December 31, 2021. leaving office.
-Or-
Assuming Office: Date assumed —J I Li The period covered is / 1 through
the date of leaving office.
Candidate: Date of Election and office sought, if different than Part 1.
4. Schedule Summary (must complete) ► Total number of pages including this cover page:
Schedules attached
❑ Schedule A-1 - Investments – schedule attached
Schedule A-2 - Investments – schedule attached
1_1 Schedule B - Real Property – schedule attached
-or- [I None - No reportable interests on any schedule
5. Verification
Schedule C - income, Loans, & Business Positions – schedule attached
Schedule D - Income – Gifts – schedule attached
Schedule E - Income – Gifts – Travel Payments – schedule attached
MAILING ADDRESS STREET
(Business or Agency Address Recommended - Public Document)
CITY
STATE ZIP CODE
DAYTIME TELEPHONE NUMBER
)
EMAIL ADDRESS
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained
herein and in any attached schedules is true and complete. I acknowledge this is a public document.
I certify under penalty of perjury under the laws of the State of California that the fore is tjue and correct.
Date Signed t f 14 1 .k�
(month, day, year)
Signature
•
( official.)
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FPPC Form 700 - Cover Page (2021/2022)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page -5
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
Name
► 1. INCOME RECEIVED
O. 1. INCOME RECEIVED
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
$500 - $1,000
El $10,001 - $100,000
L ] No Income - Business Position Only
L] $1,00i - $10,000
OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary El Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
] Sale of
(Real property, car, boat, etc.)
❑ Loan repayment
Commission or
Rental Income, list each source of $10,000 or more
(Describe)
• Other
(Describe)
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
$500 - $1,000
$10,001 - $100,000
No Income - Business Position Only
El $1,001 - $10,000
H OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary 1 f Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
Sale of
(Real property, car, boat, etc.)
• Loan repayment
Commission or
Rental Income, list each source of $10,000 or more
(Describe)
Other
(Describe)
► 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD
* You are not required to report loans from a commercial lending institution, or any indebtedness created as part of
a retail installment or credit card transaction, made in the lender's regular course of business on terms available
to members of the public without regard to your official status. Personal loans and loans received not in a lender's
regular course of business must be disclosed as follows:
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOD
$500 - $1,000
L' $1,001 - $10,000
]] $10,001 - $100,000
OVER $100,000
INTEREST RATE TERM (Months/Years)
None
SECURITY FOR LOAN
❑ None LI Personal residence
L] Real Property
Street address
City
Guarantor
• Other
(Describe)
Comments:
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FPPC Form 700 - Schedule C (2021/2022)
advicegafppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page -13