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CALIFORNIA II RE art Y,,; <br /> �. <br /> • 1 1 STATEMENT OF ECONOMIC INTERESTS QF,4�Ø <br /> POLITICAL FAIR • • ,�'�L'I', Yd ".0 13 <br /> DOCUMENT COVER PAGE <br /> Please type or print in ink. <br /> City of Rivef31d0 <br /> NAME OF FILER (LAST) (FIRST) j D E <br /> Berq Mark David <br /> 1. Office, Agency, or Court <br /> Agency Name <br /> City of Riverside <br /> Division, Board,Department,District, if applicable Your Position <br /> Parks, Recreation and Community Services Commission Commissioner <br /> P. 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 1,2012,through ❑ Leaving Office: Date Left_I <br /> -or- <br /> December 31,2012. (Check one) <br /> The period covered is— 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—_!-1 O The period covered is__J—J through <br /> the date of leaving office. <br /> n 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 /> 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 92506 <br /> E-MAIL ADDRESS(OPTIONAL) <br /> I have used all reasonable diligence in preparing this statement. I have reviewe d 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 th <br /> Date Signed 03/20/2013 Signature <br /> (month,day,year) g <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 />