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RECEIVED <br /> IIII IIII II JAIf' ., '� <br /> •- •- 700 STATEMENT OF ECONOMIC INTERESTS ' <br /> FAIR POLITICAL PRACTICES COMMISSION <br /> A PUBLIC DOCUMENT City of Riverside <br /> Please type or print in ink. City Clerk's Office <br /> NAME OF FILER (LAST) (FIRST) (MIDDLE) <br /> Altamirano Lorena Gladys <br /> 1. Office, Agency, or Court <br /> Agency Name <br /> City of Riverside <br /> Division,Board, Department,District,if applicable Your Position <br /> Cultural Heritage Board Board member <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 Riverside ❑Other <br /> 3. Type of Statement (Check at least one box) <br /> ❑ Annual: The period covered is January 1,2011,through ❑x Leaving Office: Date Left 08 1 30 t 2012 <br /> -or- <br /> December 31,2011. (Check one) <br /> The period covered is I I through O The period covered is January 1,2011,through the date of <br /> December 31,2011. leaving office. �f <br /> ❑ Assuming Office: Date assumed I 1 ® The period covered is�J,�J 2012 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: 3 <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 /> R 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 /> 3900 Main St. Riverside CA 92522 <br /> DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS(OPTIONAL) <br /> I have used all reasonable 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 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 for <br /> Date Signed 09/28/12 Signature <br /> (month,day,year) <br /> 011!2012) <br /> FPPC Toll-Free Helpline:8Ø!Z75-3772 www.fppc.ca.gov <br />