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Please type or print in ink. <br />COVER PAGE <br />A Public Document <br />Date Received <br />Official Use only <br />RECEIVED <br />MARS 0 2010 <br />NAME (LAST) (FIRST) (MIDDLE) D!t f L wam ER <br />1i1'r K Ax" <br />MAILING ADDRESS STREET CITY. STATE ZIP CODL OPTIONAL: E-MAIL ADDRESS <br />C.k i ti C) <br />1. Office, Agency, or Court <br />Name of Office, Agency, or Court: <br />Division, Board, District, if applicable: <br />Your Position: <br />r <br />SS'l 04e <br />► If filing for multiple positions, list additional agency(ies)I <br />position(s): (Attach a separate sheet if necessary.) <br />Agency: <br />Position: <br />2. Jurisdiction of Office (check at least one box) <br />❑ State <br />❑ County of,, "j~ <br />City of _ tL I M.) <br />❑ Multi-County <br />❑ Other <br />13, Type of Statement (Check at least one box) <br />❑ Assuming Office/initial Date: J I <br />1W Annual: The period covered is January 1, 2009, <br />through December 31, 2009. <br />-or- <br />0 The period covered is . I through <br />December 31, 2009. <br />❑ Leaving Office Date Left: <br />(Check one) <br />O The period covered is January 1, 2009, through the <br />date of leaving office. <br />-or- <br />0 The period covered is i I , through <br />the date of leaving office. <br />❑ Candidate Election Year: <br />STATEMENT OF ECONOMIC INTERESTS <br />4. Schedule Summary <br />► Total number of pages I <br />including this cover page: 1 <br />► Check applicable schedules or "No reportable <br />interests." <br />I have disclosed interests on one or more of the <br />attached schedules: <br />Schedule A-1 ❑ Yes - schedule attached <br />Investments (Less than 10% ownership) <br />Schedule A-2 ❑ Yes - schedule attached <br />Investments (10% or Greater Ownership) <br />Schedule B ❑ Yes - schedule attached <br />Real Property <br />Schedule C ❑ Yes - schedule attached <br />Income, Loans, & Business Positions (Income Other than Gifts <br />and Travel Payments) <br />Schedule D ❑ Yes - schedule attached <br />Income - Gifts <br />Schedule E ❑ Yes - schedule attached <br />Income - Gifts - Travel Payments <br />-or- <br />_KNo reportable interests on any schedule <br />5. Verification <br />I have used all reasonable diligence in preparing this <br />statement. I have reviewed this statement and to the best <br />of my knowledge the information contained herein and in any <br />attached schedules is true and complete. <br />I certify under penalty of perjury underthe laws of the State <br />of California that the foregoing is true and correct. <br />Date Signed <br />(200912010) <br />FPPC Toll-Free Helpline: 8661ASK-FPPC www.fppc.ca.gov <br />