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STATEMENT OF ECONOMIC INTERESTS ofrlial U,, or <br />RECEIVED <br />COVER PAGE <br />Agency Name <br />City of Riverside Planning Commission <br />Division, Board, Department, District, if applicable <br />Your Position <br />Planning Commissioner <br />d If filing for multiple positions, list below or on an attachment. <br />Agency: see attachment <br />Position: <br />2. Jurisdiction Of Office (Check at least one box) <br />[] State <br />❑ Judge (Statewide Jurisdiction) <br />❑ Multi- County <br />❑ County of <br />® City of Riverside <br />❑X Other Riverside Unified School District <br />3. Type of Statement (Check at least one box) <br />❑ Annual: The period covered is January 1, 2010, through December 31, FX1 Leaving Office: Date Left 12 1 02 r 11 <br />2010. -or- <br />(Check one) <br />The period covered is __I through December 31, O The period covered is January 1, 2010, through the date of <br />2010. <br />leaving office. <br />❑ Assuming Office: Date —J_1 <br />® The period covered is 12 / 02 , 10 , through the date <br />of leaving office. <br />❑ Candidate: Election Year Office sought, if different than Part 1: <br />4. Schedule Summary <br />Check applicable schedules or "Atone." <br />► Total number of pages including this cover page: 6 <br />❑ Schedule A -1 - Investments – schedule attached <br />® Schedule C - Income, Loans, & Business Positions – schedule attached <br />® Schedule A -2 - Investments – schedule attached <br />❑ Schedule D - Income – Gifts – schedule attached <br />® Schedule B - Real Property – schedule attached <br />El Schedule E - Income – Gifts – Travel Payments – schedule attached <br />-or- <br />❑ None - No reportable interests on any schedule <br />5. Verification <br />MAILING ADDRESS STREET <br />(Business or Agency Address Recommended - Public Document) <br />CITY STATE ZIP CODE <br />Riverside CA - <br />E -MAIL ADDRESS <br />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 12/02/2011 Si natur <br />(month, day, year) g <br />FPPC Form 700 (2010/2011) <br />FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov <br />