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C ALIFORNIA • ' m 700 <br />STATEMENT <br />OF ECONOMIC INTERESTS .A <br />U Only <br />FAIR PO LITICAL <br />Official <br />PR <br />A PUBL DOCU CO MMISSION <br />COVER PAGE ��'' 01Z <br />Please type or print in ink. <br />City of R iversid e <br />NAME OF FILER (LAST) <br />-.r <br />(FIRST) (MIDDLE) <br />_TE_4z <br />I V 0 -Y LOOM , s <br />1. Office, Agency, or Court <br />Agency Name <br />Division, Board, Department, District, if applicable <br />Your Position <br />C �(� Ik 1--,:X 4- � e�^ l3�a <br />�cl L -, <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 <br />❑ Judge or Court Commissioner (Statewide Jurisdiction) <br />❑ Multi- County <br />❑ County of <br />W City of IS 1,V Z= } S I b E <br />❑ Other <br />3. Type of Statement (Check at least one box) <br />Annual: The period covered is January 1, 2011, through <br />❑ Leaving Office: Date Left <br />December 31, 2011. <br />(Check one) <br />- or - <br />The period covered is _—I I <br />through O The period covered is January 1, 2011, through the date of <br />December 31, 2011. <br />leaving office. <br />❑ Assuming Office: Date assumed __// <br />O The period covered is —J_J through <br />the date of leaving office. <br />❑ Candidate: Election Year Office sought, if different than Part 1: <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 <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 />❑ Schedule E - Income - Gifts - Travel Payments - schedule attached <br />"or- <br />14 None - No reportable Interests on any schedule <br />5. Verification <br />MAILING ADDRESS STREET <br />CITY STATE ZIP CODE <br />aii reasonaole difigencein 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 <br />Date Signed -3 1 a ll A / a <br />(month, day, year) <br />is true and correct. <br />FPPC Form 700 (2011/2012) <br />FPPC Toll -Free Helpline: 866 /275 -3772 www.fppo.ca.gov <br />