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Statement of Economic Interest Form 700 public
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700 Elliot (01-01-10 - 12-31-10)
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STATEMENT OF ECONOMIC INTERESTS RECEIVE. <br />COVER PAGE JAN 21 201t <br />Please type or print in ink. Ci of Riverside <br />City Clerks Office <br />NAME OF FILER (LAST) (FIRST) (MIDDLE) <br />1. Office, Agency, or Court <br />Agency Name <br />7Mb /// <br />Division, Board, Department, District, if applicable j <br />o. If filing for multiple positions, list below or on an attachment. <br />Your Position <br />Agency: Position: <br />2. Jurisdiction of Office (Check at least one box) <br />❑ State ❑ Judge (Statewide Jurisdiction) <br />❑ Multi- County ❑ County of <br />❑ City of ����(�/ Z&z El Other <br />3. Type of Statement (Check at least one box) <br />Annual: The period covered is January 1, 2010, through December 31, ❑ Leaving Office: Date Left - -I � <br />2010. -or (Check one) <br />The period covered is through December 31, O The period covered is January 1, 2010, through the date of <br />2010. leaving office. <br />❑ Assuming Office: Date __� —� O The period covered is through the date <br />of leaving office. <br />❑ Candidate: Election Year <br />Office sought, if different than Part 1: <br />4. Schedule Summary <br />Check applicable schedules or "None." ► Total number of pages including this cover page: <br />❑ Schedule A -1 - Investments - schedule attached ❑ Schedule C - Income, Loans, & Business Positions -- schedule attached <br />❑ Schedule A -2 - Investments - schedule attached ❑ Schedule D - Income - Gifts - schedule attached <br />❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached <br />-or- <br />[�/None - No reportable interests on any schedule <br />5. Verification <br />MAILING ADDRESS U I Y STATE <br />(Business or Agemy Address Recommended - Pubic Document) <br />of my knowledge the information contained <br />herein and in any attached schedules is true and complete. I acknowledge this is a public document. <br />FPPC Form 700 (201012011) <br />FPPC Toil -Free Helpline: 856/275 -3772 www.fppc.ca.gov <br />
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