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STATEMENT OF ECONOMIC INTERESTS <br />COVER PAGE <br />Agency Name <br />City of Riverside <br />Division, boarcl, Department, District, it applicable Your Position <br />- Parks, Recreation, and Community Services Commission member <br />m If filing for multiple positions, list below or on an attachment. <br />Agency: Position: <br />2. Jurisdiction of Office (Check at least one box) <br />❑ State ❑ Judge (Statewide Jurisdiction) <br />0 <br />Mufti- County <br />Fx_1 City of Riverside <br />❑ County of <br />701M <br />❑ Assuming Office: Date 0 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." s Total number of pages including this cover page; <br />F1 Schedule A-1 - Investments — schedule attached ❑ Schedule C - Income, Loans, & Business Positions — schedule attached <br />❑ Schedule A-2 - Investments — schedule attached CJ Schedule D - Income — Gffls — schedule attached <br />❑ Schedule B - Real Property — schedule attached ❑ Schedule E - Income — Gifts — Travel Payments — schedule attached <br />-or- <br />N None - No reportable interests on any schedule <br />5. Verification <br />MAILING ADDRESS STREET CITY STATE ZIP CODE <br />Date Signed ;z_ ( t ( <br />(month, day, year) <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 />FPPC Form 700 (201012011) <br />FPPC Toll-Free Helpline: 8661275-3772 www.fppc.ca.gov <br />