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Statement of Economic Interest Form 700 public
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700 Elliott (1-1-12 - 12-31-12)
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CALIFORNIA • ' STATEMENT OF ECONOMIC INTERESTS �-° t F' 'b <br /> FAIR POLITICAL PRACTICES COMMISSION` ' " COVER PAGE MAR 2013 <br /> Please type or print in ink. City t)f Riverside <br /> NAME OF FILER (LAST) (FIRST) G k4 III <br /> 1. Office, Agency, or Court <br /> Agency Name <br /> f U ", N (0-r l lt�I <br /> Division, Board, Department, Distric, if applicable Your Position <br /> !ltd a f)`C 112:2 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 1 �i ' El Other <br /> 3. Type Statement (Check at least one box) <br /> Annual: The period covered is January 1, 2012,through ❑ Leaving Office: Date Left—�—J <br /> -or- <br /> December 31,2012. (Check one) <br /> The period covered is_J_J through O The period covered is January 1, 2012, through the date of <br /> December 31,2012. leaving office. <br /> ❑ Assuming Office: Date assumed—lam O The period covered is through <br /> the date of leaving office. <br /> ❑ Candidate: Election year and 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 /> ["one- No reportable interests on any schedule <br /> 5. Verification - <br /> MAILING ADDRESS CITY <br /> (Business or Agency A ocumen STA ZIP CODE <br /> DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS(OPTIONAL) <br /> I fiave 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 t <br /> Date Signed ,,7.ti/T_ /-j Sign <br /> g <br /> (month,day,year) <br /> FPPC Form 700(2012/2013) <br /> FPPC Advice Email:advice @fppc.ca.gov <br /> FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov <br />
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