LLC D Corporation VTA & MTG: Regional D Trust IB] Governmental Agency D Nonprofit Organization □ T
Son 1Jose Cfty c 2016 OCT 17 PH 31 31 INCOME AND TIME DISCLOSURE STATEMENT (San Jose Municipal Code Chapter 12.19) NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER Liccardo Sam T. 408-535-4800 REPORTING PERIOD During the Reporting Period, how many hours did you spend rendering seNices unrelated to your duties of office forwhich you earned Income? (Ifyour answer is none, please proceed to Section 2 below.) □ LESS$500 IB1$500-$1,000 [xi$1,001-$10,000 □ $10,001-$100,000 □ OVER$100,000 *If aggregate in Reporting Year is more than$500, proceed to Section 2. If aggregate in Reporting Year is less than$500, proceed to Section 5. □ $0-$499* □ $500-$1,000 [x]$1,001-$10,000 □ $10,001-$100,000 □ OVER$100,000 *If aggregate in Reporting Year is less than$500, proceed to Section 5. If aggregate in Reporting Year is more than$500, proceed to Section 3. NAME OF BUSINESS ENTITYffRUST/GOVERNMENTAL AGENCY Valley Transportation Authority; Metropolitian TransportationCom m ission ADDRESS VTA: 3331 N. 1st. St. San Jose, 95134; MTG: 375 Beale St. #800 San Francisco, 94105 TYPE OF BUSINESS ENTITYffRUST/GOVERNMENTAL AGENCY: D Proprietorship D Partnership □ LLC D Corporation VTA & MTG: Regional D Trust IB] Governmental Agency D Nonprofit Organization □ T.-... .-.c-nr..-t .... tir..-. /1.,..,,.....,,,..;,...c, other GENERAL DESCRIPTION OF BUSINESS ENTITYffRUST/GOVERNMENTAL AGENCY ACTIVITY: VTA & MTG: Regional Transportation Agencies POSITION: VrA· Boardmeamhear MIC· Cammissianear Perct_iem paym ents GENERAL DESCRIPTION OF SERVICES RENDERED: _ _ _ _ _ _ _ _ _ _ _________________ I have used all reasonable diligence in pr artfl this statement.
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