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IVE® <br />Date Received <br />STATEMENT OF ECONOMIC INTERESTS _ filff Only <br />DOCUMENT A PUBLIC COVER PAGE id, JI riverside <br />Please type or print in ink. p ".: Clerk's Office <br />NAME OF FILER (LAST) (FIRST) (MIDDLE) <br />Segura Gustavo <br />1. Office, Agency, or Court <br />Agency Name <br />C ity of R P ublic Utilities <br />Division, Board, Department, District, if applicable Your Position <br />Board of Public Utilities Board Member <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 />City of Riverside <br />❑ County of <br />❑ Other <br />3. Type of Statement (Check at least one box) <br />x❑ Annual: The period covered is January 1, 2011, through <br />December 31, 2011. <br />-or- <br />- The <br />❑ Assuming Office: Date assumed <br />❑ Candidate: Election Year <br />❑ Leaving Office: Date Left I I <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 — <br />the date of leaving office. <br />through <br />Office sought, if different than Part 1: <br />4. Schedule Summary <br />Check applicable schedules or 'None." P-. Total number of pages including this cover page: none <br />❑ Schedule A -1 - Investments - schedule attached ❑ Schedule C - Income, Loans, & Business Positions - schedule attached <br />❑ Schedule A -2 - Investments - schedule attached ❑ Schedule D - Income - Gifts - schedule attached <br />❑ Schedule B - Real Property- schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached <br />-or- <br />None - No reportable interests on any schedule <br />5. Verifi <br />MAILING ADDRESS STREET CITY STATE ZIP CODE <br />(Business or Agency Address Recommended - Public Document) <br />Riverside CA <br />I certify under penalty of perjury under the laws of the State of California <br />Date Signed May 2, 2012 <br />(month, day, year) <br />FPPC Form 700 (2011/2012) <br />FPPC Toll -Free Helplinw 866/275 -3772 www,fppc.ca.gov <br />I have used all reasonable diligence in preparing this statement. I have reviewed formation contained <br />herein and in any attached schedules is true and complete. I acknowledge this <br />