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RLTdTQ E'YED <br /> CALIFORNIA FORm7OO STATEMENT OF ECONOMIC INTERESTS O,f,-.ai Use OWY <br /> FAIR POLITICAL PRACTICES COMMISSION MAR 3 0 2012 <br /> DOCUMENT A PUBLIC COVER PAGE City of Riverside <br /> Please type or print in ink. City Clerk's Office <br /> NAME OF FILER (LAST) (FIRST) (MIDDLE) <br /> Hurtado Jaime <br /> 1. Office, Agency, or Court <br /> Agency Name <br /> City of Riverside <br /> Division, Board, Department, District, if applicable Your Position <br /> Parks District Commissioner <br /> ► 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 or Court Commissioner(Statewide Jurisdiction) <br /> ❑Multi-County ❑County of <br /> ❑X City of Riverside ❑Other <br /> 3. Type of Statement (Check at least one box) <br /> ❑ <br /> X Annual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left,J_ I <br /> December 31, 2011. (Check one) <br /> or L{ f O The period covered is January 1, 2011,through the date of <br /> The period covered is—�—� , through P Y 9 <br /> December 31, 2011, leaving office. <br /> ❑ Assuming Office: Date assumed O The period covered is 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." ► Total number of pages including this cover page: <br /> ❑ Schedule A-1 - Investments-schedule attached ❑ Schedule C - Income, Loans, &Business Positions-schedule attached <br /> ❑ Schedule A-2- Investments-schedule attached ❑X Schedule D- income-Gifts-schedule attached <br /> ❑ Schedule B- Real Property-schedule attached ❑ Schedule E - Income- Gifts- Travel Payments-schedule attached <br /> -or- <br /> El None- No reportable interests on any schedule <br /> 5. Verification <br /> MAILING ADDRESS STREET CITY STATE ZIP CODE <br /> (Business or Agency Address Recommended-Public.Document) <br /> Riverside CA <br /> DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS(OPTIONAL) <br /> I have used all reasonable diligence in preparing this statement. I have re <br /> herein and in any attached schedules is true and complete. I acknowled <br /> I certify under penalty of perjury yuunder the laws of the State of Calif <br /> Date Signed _' / <br /> �y,year) <br /> v <br />