v ; its - _ -Sve;* - W l ^sfirs^ Los Angeles City Ethics Commission June 20, 2018 The Honorable City Council c/o Holly Wolcott, City Clerk 200 North Spring Street City Hall - 3rd Floor Los Angeles CA 90012 Re: Council File Number 15-1233 Reappointment of to the Board of Fire and Police Pension Commissioners Dear Councilmembers: FOR COUNCIL CONSIDERATION was reappointed by the Mayor to the Board of Fire and Police Pension Commissioners on June 5, 2018. The Ethics Commission received Mr. Pendleton s preconfirmation financial disclosure statement on June 12, 2018. In compliance with Los Angeles Municipal Code 49.5.10, a copy of Mr. Pendleton s financial disclosure statement is enclosed. If you have questions, please feel free to contact me at (213) 978-1960. Sincerely, Alexandria Latragna Ethics Program Manager A Enclosures: Form Form 60 cc: Mayor Eric Garcetti 200 North Spring Street, Suite 2410 Los Angeles CA 90012 phone (213) 978-1960 fax (213) 978-1988 ethics.lacity.org
FAIR POLITICAL PRACTICES COMMISSION A PUBLIC DOCUMENT Please type or print in ink. STATEMENT OF ECONOMIC INTERESTS COVER PAGE Date Initial Filing Received Official Use Only Filed Date: 06/12/2018 12:55 PM SAN: 011300006-STH-0006 NAME OF FILER (LAST) Pendleton 1. Office, Agency, or Court Agency Name (Do not use acronyms) Fire & Police Pensions, Department of Division, Board, Department, District, if applicable (FIRST) Brian Your Position (MIDDLE) If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Member, Board of Fire & Police Pension Commissioners Agency: Position: 2. Jurisdiction of Office (Check at least one box) State Multi-County E City of Los Angles Judge or Court Commissioner (Statewide Jurisdiction) County of Other 3. Type of Statement (Check at least one box) Annual: The period covered is January 1, 2017, through December 31, 2017. The period covered is December 31, 2017. Assuming Office: Date assumed J. j. through j. J. d Leaving Office: Date Left (Check one) O The period covered is January 1, 2017, through the date of 06/05/2018 E Candidate: Date of Election and office sought, if different than Part 1: O The period covered is the date of leaving office. J. J. J /. through 4. Schedule Summary (must complete) Total number of pages including this cover page: Schedules attached 9 E Schedule A-1 - Investments - schedule attached E Schedule A-2 - Investments - schedule attached Schedule B - Real Property - schedule attached -or- leaving office. -or- -or- None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET (Business or Agency Address Recommended - Public Document) E Schedule C - Income, Loans, & Business Positions - schedule attached E Schedule D - Income - Gifts - schedule attached Schedule E - Income - Gifts - Travel Payments - schedule attached CITY STATE ZIP CODE DAYTIME TELEPHONE NUMBER E-MAIL 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 foregoing is true and correct. Date Signed 06/12/2018 12:55 PM (month, day, year) Signature (File the originally signed statement with your filing official.) FPPC Form (2017/2018)
SCHEDULE A-1 Investments FAIR POLITICAL PRACTICES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) Do not attach brokerage or financial statements. BLACKSTONE REAL ESTATE NAME OF BuSINESS ENTITY BLACKSTONE GROUP LP Real Estate Fund Financial Services E $100,001 - $1,000,000 FAIR MARKET value E $100,001 - $1,000,000 NATURE OF INvESTMENT NATURE OF INvESTMENT HAWKES BAY PARTNERS Health Care Fund OAKTREE RE DEBT Real Estate E $100,001 - $1,000,000 E $100,001 - $1,000,000 ADVISORY RESEARCH MLP DIGITAL RLTY TR INC Energy Real Estate E $100,001 - $1,000,000 FPPC Form (2017/2018) Sch. A-1
schedule A-1 Investments FAIR POLITICAL PRACTICES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) Do not attach brokerage or financial statements. FIRST TR NORTH AMERN (33738D101) BOEING COMPANY Energy Jetliners, Aircraft, Sattelites CISCO SYSTEMS INC Technology ARES CAPITAL CORP Asset Management KKR & CO L P MICROSOFT CORP Financial Services Technology FPPC Form (2017/2018) Sch. A-1
schedule A-1 Investments FAIR POLITICAL PRACTICES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) Do not attach brokerage or financial statements. TARGET CORP EPR PPTYS Consumer Goods Real Estate WELLTOWER INC Real Estate CARLYLE GROUP LP Financial Services VODAFONE GROUP PLC GENERAL MOTORS CO Telecommunications Automobiles FPPC Form (2017/2018) Sch. A-1
schedule A-1 Investments fair political practices commission Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) Do not attach brokerage or financial statements. WILLIAMS COMPANIES Energy Stock Q Other _ AIRBUS SE Aerospace Stock Q Other _ Stock Q Other _ Stock Q Other _ FPPC Form (2017/2018) Sch. A-1
SCHEDULE A-2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) FAIR POLITICAL PRACTICES COMMISSION Name 1. business entity or trust & Chad Goldman Trust Name 1. business entity or trust High Five Group, Inc. Name Address (Business Address Acceptable) Check one E Trust, go to 2 Address (Business Address Acceptable) Check one Business Entity, complete the box, then go to 2 Trust, go to 2 E Business Entity, complete the box, then go to 2 Business Consulting Services $0 - $1,999 FAIR MARKET value $0 - $1,999 NATURE OF INvESTMENT Partnership Q Sole Proprietorship Q Other NATURE OF INvESTMENT Partnership Sole Proprietorship E Stock Other YOUR BUSINESS POSITION YOUR BUSINESS POSITION President 2. IDENTIFY The GROSS INCOME RECEIVED (INCLuDE YOuR PRO RATA share of the gross income to the entity/trust) $0 - $499 $500 - $1,000 E OVER $100,000 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOuRCE OF INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.) None or High Five Group, Inc. E Names listed below 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLuDE YOuR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRuST) $0 - $499 $500 - $1,000 E OVER $100,000 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOuRCE OF INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.) None or E Names listed below OmniForce, LLC 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BuSINESS ENTITY OR TRuST Check one box: 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BuSINESS ENTITY OR TRuST Check one box: INVESTMENT REAL PROPERTY INVESTMENT REAL PROPERTY Name of Business Entity, if Investment, or Assessor s Parcel Number or Street Address of Real Property Name of Business Entity, if Investment, or Assessor s Parcel Number or Street Address of Real Property Description of Business Activity or City or Other Precise Location of Real Property Description of Business Activity or City or Other Precise Location of Real Property NATURE OF INTEREST Property Ownership/Deed of Trust J / J /. J / J / NATURE OF INTEREST Stock Partnership Property Ownership/Deed of Trust Stock Partnership Leasehold Other Leasehold Other Yrs. remaining Yrs. remaining Check box if additional schedules reporting investments or real property are attached Check box if additional schedules reporting investments or real property are attached. FPPC Form (2017/2018) Sch. A-2
SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) FAIR POLITICAL PRACTICES COMMISSION Name 1. INCOME Received NAME OF SOURCE OF INCOME Diamond & Elias Restaurants Inc 1. INCOME received NAME OF SOURCE OF INCOME High Five Group, Inc Restaurant YOUR BUSINESS POSITION Passive Investor Consulting Services YOUR BUSINESS POSITION President GROSS INCOME RECEIVED No Income - Business Position Only GROSS INCOME RECEIVED No Income - Business Position Only E $500 - $1,000 $500 - $1,000 OVER $100,000 [E OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED Salary 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.) CONSIDERATION FOR WHICH INCOME WAS RECEIVED E Salary 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 Sale of (Real property, car, boat, etc.) E Loan repayment Loan repayment (Real property, car, boat, etc.) Commission or Rental Income, list each source of $10,000 or more Commission or Rental Income, list each source of $10,000 or more Other Other 2. LOANS RECEIVED OR OuTSTANDING DuRING The REPORTING PERIOD * You are not required to report loans from commercial lending institutions, 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* INTEREST RATE TERM (Months/Years) BUSINESS ACTIVITY, IF ANY, OF LENDER.% None SECURITY FOR LOAN None Personal residence HIGHEST BALANCE DURING REPORTING PERIOD $500 - $1,000 OVER $100,000 Real Property Guarantor Other Street address City FPPC Form (2017/2018) Sch. C
schedule c Income, Loans, & Business Positions (Other than Gifts and Travel Payments) FAIR POLITICAL PRACTICES COMMISSION Name 1. INCOME RECEIVED NAME OF SOURCE OF INCOME Kinetic Operations LLC 1. INCOME RECEIVED NAME OF SOURCE OF INCOME Television Show Production YOUR BUSINESS POSITION Vendor YOUR BUSINESS POSITION GROSS INCOME RECEIVED No Income - Business Position Only GROSS INCOME RECEIVED No Income - Business Position Only E $500 - $1,000 $500 - $1,000 OVER $100,000 OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED Salary 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.) CONSIDERATION FOR WHICH INCOME WAS RECEIVED Salary 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 Sale of (Real property, car, boat, etc.) Loan repayment Loan repayment (Real property, car, boat, etc.) Commission or E Rental Income, list each source of $10,000 or more Commission or Rental Income, list each source of $10,000 or more Other Other 2. LOANS RECEIVED OR OuTSTANDING DuRING THE REPORTING PERIOD * You are not required to report loans from commercial lending institutions, 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* INTEREST RATE TERM (Months/Years) BUSINESS ACTIVITY, IF ANY, OF LENDER % None SECURITY FOR LOAN None Personal residence HIGHEST BALANCE DURING REPORTING PERIOD $500 - $1,000 OVER $100,000 Real Property Guarantor Other Street address City FPPC Form (2017/2018) Sch. C
SCHEDULE D Income - Gifts FAIR POLITICAL PRACTICES COMMISSION Name NAME OF SOURCE (Not an Acronym) Tony Gamboa NAME OF SOURCE (Not an Acronym) President, United Firefighters Of Los Angeles City DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) 01 / 15 / 18 100 LA Rams Ticket $. j /. $. j /. j /. j /. j /. NAME OF SOURCE (Not an Acronym) NAME OF SOURCE (Not an Acronym) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) NAME OF SOURCE (Not an Acronym) NAME OF SOURCE (Not an Acronym) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) FPPC Form (2017/2018) Sch. D
FTH ICS COMMISSION _ it'tt II tu 1 HJI 11- Ethics Commission 200 N Spring Street City Hall 24th Floor Los Angeles, CA 90012 (213) 978-1960 ethics.lacity.org Filed Date: 06/12/2018 12:51 PM SAN: 011300006-STH-0006 Restricted Source Financial Disclosure Statement Form 60 Elected City officials, general managers and chief administrative officers of City agencies, members of City boards and commissions, and individuals nominated to positions subject to City Council approval must file this form in conjunction with the state Form. Please refer to the attached instructions for additional information. 2 0 Original Filing Amended Filing (original filed on / /20 ) Total Pages: Name: (Last, First, Middle) Pendleton, Brian Agency: Fire & Police Pensions, Department of Position: Member, Board of Fire & Police Pension Commissioners Phone: Email: Type of Statement: 13 Pre-confirmation Date of nomination: 06 / / 2018 Assuming Office Annual Leaving Office First day in position: / / 20 Last day in office: _ / / 20 through December 31, 20. _ / / 20 I had the following interests associated with restricted sources during this reporting period: 1. REAL PROPERTY section attached. Interests in real property leased from or to, co-owned by, purchased from, or sold to a restricted source. 2. INVESTMENTS section attached. Investments (other than real property) co-owned by, purchased from, or sold to a restricted source. 3. INCOME section attached. Income received from a restricted source. 4. GIFTS section attached. Gifts, cumulatively valued at $50 or more, received from a restricted source. 5. BOARD POSITIONS section attached. Positions held on the board of a restricted source. - Or - 6. NO INTERESTS I had no interests in real property, investments, income, gifts, or board positions associated with restricted sources during this reporting period. Certification I declare under penalty of perjury under the laws of the City of Los Angeles and the state of California that I have read the instructions for this form and the information I have provided is true and complete. 06/12/2018 12:51 PM Date Signature January 2016 Los Angeles Municipal Code 49.5.2, 49.5.9, 49.5.10
CIVICS COMMISSION Name: (Last, First, Middle) Ethics Commission 200 N Spring Street City Hall 24th Floor Los Angeles, CA 90012 (213) 978-1960 ethics.lacity.org Pendleton, Brian Form 60 Section 4 - Gifts The following gifts cumulatively valued at $50 or more were received from a restricted source. Name of restricted source: Tony Gamboa Address of restricted source: Name of restricted source: Address of restricted source: Business activity of restricted source: President, United Firefighters Of Los Angeles City Gift(s) received by: Me My spouse/registered domestic partner My dependent child Business activity of restricted source: Gift(s) received by: Me My spouse/registered domestic partner My dependent child Date received: Value: Description of gift(s): Date received: Value: 01 /15 / 20. 18 100 LA Rems Tieket $ J / 20 $. Description of gift(s): Name of restricted source: Name of restricted source: Address of restricted source: Address of restricted source: Business activity of restricted source: Business activity of restricted source: Gift(s) received by: Me My spouse/registered domestic partner My dependent child Gift(s) received by: Me My spouse/registered domestic partner My dependent child Date received: Value: Description of gift(s): Date received: Value: Description of gift(s): January 2016 Los Angeles Municipal Code 49.5.2, 49.5.9, 49.5.10