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CALIFORNIA FORm 700 : RECEIVED <br /> STATEMENT OF ECONOMIC INTEktSTS Official use Only <br /> COMMISSION FAIR POLITICAL PRACTICES APR 04 2013 <br /> PUBLIC '• COVER PAGE <br /> City of Riverside <br /> Please type or print in ink. City Clerk'S Office <br /> NAME OF FILER (LAST) (FIRST) <br /> (MIDDLE) <br /> 1. Office, Agency, or Court <br /> Agenc Name <br /> Division, Board, IlepartVi6ni, District, if applicable O p Your Position <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– i�f�e �'/'©ts� ❑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—/_J <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 /> Øf Assuming Office: Date assumed J O The period covered is__J__/ 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 /> 5r None- No reportable interests on any schedule <br /> 5. Verification <br /> MAILING ADDRESS STREET CITY <br /> (Business or Agency Addres STATE ZIP CODE <br /> DAYTIME TELEPHONE N ��� L�� <br /> E-M <br /> I have used all reasonable diligence in preparing this statement. I have reviewed es o t my owe ge 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 Califor ' <br /> Date Signed Q S— A 0;&0 g <br /> (month,day,year) <br /> 012/2013) <br /> ppc.ca.gov <br /> FPPC Toll-Free Helpline:8661275-3772 www,fppc.ca.gov <br />