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Please type or print in ink. <br />COVER PAGE <br />A Public Document <br />AE (LAST) (FIRST) <br />- A U 61464, _,T U-4 ilJ <br />LING ADDRESS STREET CITY <br />1. Office, Agency, or Court <br />Name of Office. enn or court: <br />Division, Board, District, if applicable: <br />~t/ <br />Your Position: ► If filing for multiple positions, list additional agency(ies)1 <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 <br />City of `e _,Q y ❑ Multi-County <br />❑ Other <br />13. Type of Statement (Check at least one box) <br />❑ Assuming Office/Initial Date: - I <br />[/Annual: The period covered is January 1, 2009, <br />through December 31, 2009. <br />-or- <br />0 The period covered is I I , through <br />December 31, 2009. <br />❑ Leaving Office Date Left: __J___J <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 <br />the date of leaving office. <br />❑ Candidate Election Year: - <br />STATEMENT OF ECONOMIC INTERESTS <br />through <br />(MIDDLE) <br />Ra (J 6 L <br />STATE ZIP CODE <br />P <br />F <br />F 7 2611 <br />DAYTIME TELEPHONE <br />4. Schedule Summary <br />► Total number of pages <br />. including this cover page: <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 e _'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 />El No 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 under the laws of the State <br />of California that the foregoing is true and correct. <br />Date Signed <br />E <br />0 <br />official.) <br />orrrr (2809!2010) <br />FPPC Toll-Free Helpline: 8661ASK-FPPC www.fppe.ca.gov <br />~a e <br />4• <br />