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STATEMENT OF ECONOMIC INTERESTS Date Received RECEIVED 5 , Off h €�Pt lgte Only A PUBLIC DOCUMENT COVER PAGE (,oity o Riverside Please type or print in ink. CR Y C l erk' s Of NAME OF FILER (LAST) (FIRST) (MIDDLE) 1. Office, Agency, or Court Agency Name Division, Board, Department, District, if applicable Your Position ► If filing for multiple positions, list below or on an attachment. Agency: through O The period covered is January 1, 2011, through the date of leaving office. 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi- County ❑ County of City of a I � ❑ Other 3. Ty e of Statement (Check at least one box) Annual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left December 31, 2011. (Check one) - or - The period covered is December 31, 2011. ❑ Assuming Office: Date assumed ❑ Candidate: Election Year Position: O The period covered is — the date of leaving office. Office sought, if different than Part 1: through 4. Schedule Summary Check applicable schedules or 'None." ► Total number of pages including this cover page: ❑ Schedule A -1 - Investments - schedule attached Schedule C - Income, Loans, & Business Positions - schedule attached Schedule A -2 - Investments - schedule attached ❑ Schedule D - Income - Gifts - schedule attached ❑ Schedule B - Rea/ Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached -or- None - No reportable interests on any schedule 5. Verification MAILING ADDRESS I have used all reasonable diligence in preparing this statement. I have reviewed , herein and in any attached schedules is true and complete. I acknowledge this is a public document. certify under penalty of perjury under the laws of the State of California that the Date Signed - Signature (month, day, year) ZIP CODE FPPC Form 700 (201112012) FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov