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CALIFORNIA �I - <br /> • ' STATEMENT OF ECONOMIC INTERESTS tta it;�c �`F <br /> FAIR POLITICAL PRACTICES COMMISSION MAR 2 <br /> A PUBLIC DOCUMENT COVER PAGE City of Riverside <br /> Please type or print in ink. City Clerk's Office <br /> NAME OF FILER T� {LAST) � (FIRST) (MIDDLE) <br /> l� 1".'I <br /> 1. Office, Agency, or Court <br /> Agency Name <br /> L dv_.. - <br /> Division, goald, Department, District, if.appiicable Your Position <br /> CA/ &,be <br /> ► If filing for multiple positions, list below or orl 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-Count ❑County of <br /> City of 4 J t'.✓� I b <br /> Li Other <br /> 3. Ty a of Statement (Check at least one box) <br /> Annual: The period covered is January 1, 2012,through ❑ Leaving Office: Date Left__I I <br /> -or- <br /> December 31,2012. (Check one) <br /> The period covered is—J_I through O The period covered is January 1, 2012,through the date of <br /> December 31, 2012. leaving office. <br /> ❑ Assuming Office: Date assumed I 1 O The period covered is_J— I 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 /> None- No reportable interests on any schedule <br /> 5. Verification <br /> MAILING ADDRESS STREET CITY STATE ZIP CODE <br /> E-MAIL ADDRESS(OPTIONAL <br /> I have used all reasonable diligence in preparing this statement. I have reviewed ntained <br /> herein and in any attached schedules is true and complete. I acknowledge this <br /> 1 certify under penalty of perjury under the laws of the State of California t <br /> Date Signed Signa <br /> (month,day,year) <br /> 1212013) <br /> c.ca.gov <br /> FPPC Toll-Free Helpline:8661275-3772 www.fppc.ca.gov <br />