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CALIFORNIA F I, 0 STATEMENT OF ECONOMIC INTERESTS CEIV Official Usey <br />FAIR POLITICAL PRACTICES • OCT 312013 <br />DOCUMENT A PUBLIC COVER PAGE <br />Please type or print in ink. City of Riverside Cit � Clark'c (iffira <br />NAME OF FILER (LAST) (FIRST) (MIDDLE) <br />1. Office, Agency, or Court <br />Agency Name <br />6_� 1_R olrs <br />Division, B r , Department, District, ifs applicable j� Your Position <br />(�� _ t_Q, r � Y I -t�, C_ `D Oat. 1( J, �j1, e., 0-k �x W <br />► If filing for multiple positions, list below or on an attachment. <br />Agency: <br />2. Jurisdiction of Office (Check at least one box) <br />Position: <br />❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) <br />❑ Multi- County ❑ County of <br />[City of ❑ Other <br />3. Type of Statement (Check at least one box) <br />❑ Annual: The period covered is January 1, 2012, through <br />December 31, 2012. <br />-or- <br />The period covered is I through <br />December 31, 2012. <br />❑ Leaving Office: Date Left <br />(Check one) <br />O The period covered is January 1, 2012, through the date of <br />leaving office. <br />Assuming Office: Date assumed _yJA_,..� 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 />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 />IQ <br />/ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Guts - 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 />(Business or Agency Address Recommended - P lic Document), <br />90 o ma ,�� m� l?up", 4,, C a, "zz <br />E_MAII AnnRFSS rnPTInNAl1 <br />I have used all rea$onable 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 thi <br />I certify un4er Penalty of perjury tinder the laws of the State of California <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 />