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STATEMENT OF ECONOMIC INTERESTS <br />COVER PAGE <br />nam�w nmrcp <br />7at,pcet�e� <br />�Rro � mF Jse. d my . <br />1r ]] e <br />9 201? <br />Please type or print in ink. q(: �' R, 'r akft <br />NAME OF FILER (LAST) (FIRST) (MIDDLE) <br />1. Office, Agency, or Court <br />Agency Name <br />City of Riverside <br />Division, Board, Department, District, if applicable <br />Your <br />► If filing for multiple positions, list below or on an attachment. <br />Agency: <br />Position: <br />2. Jurisdiction of Office (Check at least one box) <br />❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) <br />❑ Multi- County <br />Q City of Riverside <br />❑ County of <br />❑ Other _ <br />3. Type of Statement (Check at least one box) <br />0 Annual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left I I <br />-or- <br />December 31, 2011. <br />The period covered is through <br />December 31, 2011. <br />❑ Assuming Office: Date assumed <br />❑ Candidate: Election Year <br />(Check one) <br />O The period covered is January 1, 2011, through the date of <br />leaving office, <br />O The period covered is J I through <br />the date of leaving office. <br />Office sought, if different. than Part 1: <br />4. Schedule Summary <br />Check applicable schedules or 'None." <br />E2 A -1 - Investments - schedule attached <br />❑ Schedule A -2 - Investments - schedule attached <br />❑ Schedule B - Real Property- schedule attached <br />► Total number of pages including this cover page: <br />❑ Schedule C - Income, Loans, & Business Positions - schedule attached <br />52-'�c edule D - Income - Gifts - schedule attached <br />Schedule E - Income - Gifts - Travel Payments - schedule attached <br />- or- <br />F None - No reportable interests on any schedule <br />5. Verification <br />MAILING ADDRESS STREET CITY STATE ZIP CODE <br />herein and in any attached schedules is true and complete. I acknowledge this is a public document. <br />certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. <br />Date Signed ) A L Signatur <br />(mont day, year) <br />FPPC Form 700 (2011 /2012) <br />FPPC Toll -Free Helpline: 866 /275 -3772 www.fppo.ca.gov <br />