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CALIFORNIA FAIR POLITICAL PRACTICES COMMISSION 0 0 STATEMENT OF ECONOMIC INTEREST Dote Received <br /> ` PUBLIC DOCUMENT COVER PAGE <br /> Please type or print in ink. fv 2 2 201 <br /> NAME OF FILER (LAST) (FIRST) <br /> &rri eAa� f_64a-r- " City Clerk's 61 <br /> 1. Office, Agency, or Court <br /> Agency Name <br /> Division, Board, $partment, District, if/applicable / Your Position / / - <br /> 0,t ✓Ø-� t-K r i ØZ• Ract rd 0e v©( E 1"(egGl l� <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 /> City of let S f -- ❑Other <br /> 3. Type of Statement (check at Least one box) <br /> Annual: The period covered is January 1, 2011,through ❑ Leaving Office: Date Left__J__/ <br /> -or- <br /> December 31, 2011. (Check one) <br /> The period covered is—l__ I through O The period covered is January 1, 2011,through the date of <br /> December 31, 2011. leaving office. <br /> ❑ Assuming Office: Date assumed I 1 O The period covered is—I 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 ❑ 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. Verification <br /> CITY STATE ZIP CODE <br /> E-MAIL D <br /> I have used all reasonabl diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained <br /> herein and in any attache schedules is true and complete. I acknowledge this is <br /> X <br /> I certify under penalt o ury under the laws of the State of California that <br /> 2 <br /> Date Signed I 6 s1 Signatur <br /> ( nth,day,year) <br /> 0 FPPC Form 700(2011/2012) <br /> FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov <br />