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RECEIVED <br />Please type or print in ink. <br />Date Received <br />STATEMENT OF ECONOMIC INTERESTS JA `11 1W <br />COVER PAGE City of Riverside <br />City Clerk's Office <br />NAME OF FILER (LAST) (FIRST) (MIDDLE) <br />C° L) f Iii z ?` !-� C:. L <br />1. Office, Agency, or Court <br />Agency Name `/Z / f ) G K _S i 4D 41 1 <br />Division, Board, Department, District, if applicable Your Position <br />► If filing for multiple positions, list below or on an atlachment. <br />Agency: <br />2. Jur isdiction of Office (Check at least one box) <br />❑ State <br />❑ Multi - County <br />City of ILrr i5r�� <br />Position: <br />❑ Judge (Statewide Jurisdiction) <br />❑ County of <br />❑ Other <br />3. Type of Statement (Check at least one box) <br />M nnual: The period covered is January 1, 2010, through December 31, <br />2010. .or- <br />The period covered Is through December 31, <br />2010. <br />❑ Assuming Office: Date <br />❑ Candidate: Election Year <br />❑ Leaving Office: Date Left — 1. <br />(Check one) <br />O The period covered is January 1, 2010, through the date of <br />leaving office. <br />O The period covered is <br />of leaving office. <br />Office sought, if different than Part 1: <br />through the date <br />4. Schedule Summary <br />Check applicable schedules or "None." <br />► Total number of pages including this cover page: <br />❑ Schedule A -1 - Investments – schedule attached ❑ Schedule C - Income, Loans, 8 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 i�_ i C A <br />MAILING ADDRESS STREET <br />(Business or Agency Address Recommended - Public Document) <br />CITY <br />L ADDRESS <br />I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best 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 />I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. <br />Date Signed �- �n" -C�4 f D r 2:'D f + Signature <br />U (monk day, year) fficial.) <br />FPPC Form 700 (201 012011) <br />FPPC Toll -Free Helpline: 8661275 -3772 www.fppc.ca.gov <br />