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f <br />ORNIA 1 <br />CALIF <br />STATEMENT OF ECONOMIC INTERESTS <br />Date ecewe <br />t <br />. <br />FAIR POLITICAL PRACTICES COMMISS1104 <br />COVER PAGE <br />- <br />j L i lQ <br />" <br />A Public Document <br />. <br />. <br />Please type or print in ink. <br />NAME (LAST) <br />(FIRST) <br />(MIDDLE) <br />DAYTI(C1tE TELEPHONE NUMBER <br />Megna <br />Ralph <br />Jamieson <br />MAILING ADDRESS STREET <br />CITY <br />STATE <br />ZIP CODE <br />OPTIONAL: E-MAIL ADDRESS <br />(Business Address Acceptable) <br />Riverside <br />CA <br />1. Office, Agency, or Court <br />Name of Office, Agency, or Court: <br />City of Riverside Cultural Heritage Board <br />Division, Board, District, if applicable: <br />Your Position: <br />Board Member <br />► If filing for multiple positions, list additional agency(ies)/ <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 Riverside <br />❑ Multi-County <br />❑ Other <br />4. Schedule Summary <br />► Total number of pages 4 <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 TO% ownership) <br />Schedule A-2 ❑X Yes - schedule attached <br />investments (to% 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 Gilts <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 />3. Type of Statement (Check at least one box) <br />❑ Assuming Office/Initial Date: <br />0 Annual: The period covered is January 1, 2009, <br />through December 31, 2009. <br />-or- <br />0 The period covered is through <br />December 31, 2009. <br />❑ Leaving Office Date Left: -l -J <br />(Check one) <br />0 The period covered is January 1, 2009, through the <br />date of leaving office. <br />-or- <br />0 The period covered is J! , through <br />the date of leaving office, <br />rl Candidate Election Year: <br />❑ 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 Pena Ity of perjury under the laws of the State <br />of California that the foregoing is true and correct. <br />Date Signed 14 rf <br />(month, day, year) <br />Signature <br />