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700 Berg, M (1-1-13 - 3-10-14)
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RECEIVED <br /> • ' •' STATEMENT OF ECONOMIC INTERESTS VARReceived 014 <br /> FAIR POLITICAL PRACTICES COMMISSION <br /> A PUBLIC DOCUMENT __J COVER PAGE City of Riverside <br /> Please type or print in ink. City Clerk's Office <br /> NAME OF FILER (LAST) (FIRST) <br /> (MIDDLE) <br /> Berg Mark David <br /> 1. Office, Agency, or Court <br /> Agency Name (Do not use acronyms) <br /> City of Riverside <br /> Division, Board, Department, District, if applicable Your Position <br /> Parks, Recreation and Community Service Commission Commissioner <br /> ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) <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 <br /> ❑Other <br /> 3. Type of Statement (Check at least one box) <br /> ❑ Annual: The period covered is January 1, 2013,through © Leaving Office: Date Left- 03 10 r 2014 <br /> -or- <br /> December 31, 2013. (Check one) <br /> The period covered is—J— I through ® The period covered is January 1, 2013,through the date of <br /> December 31, 2013. leaving office. <br /> ❑ Assuming Office: Date assumed_1 O The period covered is 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 /> (Business or Agency Address Recommended-Public Document <br /> I have 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 that It <br /> Date Signed 03/25/2014 Signature <br /> (month,day,year) (File the originally signed statement with your filing official.) <br /> FPPC Form 700(2013/2014) <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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