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CALIFORNIA FO_ r <br />Please type or print in ink. <br />NAME (LAST) <br />v L <br />MAILING A DRESS STREET <br />(Business Address Acceptable) <br />STATEMENT OF ECONOMIC INTEREST E D a ~ a otz "COVER PAGE 2u10 <br />A Public Document <br />2ST) (MIDDLE) <br /> <br />CITY STATE ZIP CODE <br />1. Office, Agency, or Court <br />Name of Office, Agency, or Court: <br />Division, Board, District, if applicable: <br />Your Position: <br />► If filing for multiple positions, list additional agency(ies)l <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 of4 n ►c...._ <br />❑ Multi-County <br />❑ Other <br />13. Type of Statement (Check at least one box) <br />❑ Assuming Office/Initial Date: I -I <br />[:J~Annual: The period covered is January 1, 2009, <br />through December 31, 2009. <br />-or- <br />0 The period covered is I~._....-J through <br />December 31, 2009. <br />❑ Leaving Office Date Left: I_ I <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 J_J , through <br />the date of leaving office. <br />[T] Candidate Election Year: <br />,utv <br />d 0, '?C0 <br />DAYTIME TELEPHONE NUMBER <br />OPTIONAL: E-MAIL ADDRESS <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 io% 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 />Zo 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 />F <br />Date Signed y-i , 1 (D <br />Imonth 'dev vearl <br />Signatu <br />with your ifing official.) <br />FPPC Form 700 (200912010) <br />FPPC Toll-Free Helpline: 8661ASK-FPPC www.fppc.ca.gov <br />