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CALIFORNIA FORM 700 <br />FAIR POLITICAL PRACTICES COMMISSION <br />A PUBLIC DOCUMENT <br />Please type or print in ink. <br />STATEMENT OF ECONOMIC INTERESTS <br />COVER PAGE <br />Oft G- 4 FPPC. <br />C.EIVED <br />Date Initci. Ain rRechejvIy <br />City of Riverside <br />City Clerk's Office <br />NAME OF FILER (LAST) <br />Soubirous <br />(FIRST) <br />Michael <br />(MIDDLE) <br />Philip <br />1. Office, Agency, or Court <br />Agency Name (Do not use acronyms) <br />City of Riverside - City Council <br />Division, Board, Department, District, if applicable <br />Ward 3 <br />Your Position <br />Councilmember <br />s If filing for multiple positions, list below or on an attachment. (Do not use acronyms) <br />Community Action Commission - Riverside County Commissioner <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 />Riverside <br />City of ❑ Other <br />3. Type of Statement (Check at least one box) <br />2 Annual: The period covered is January 1, 2016, through ❑ Leaving Office: Date Left <br />December 31, 2016. (Check one) <br />-or- <br />The period covered is —_J —_l , through 0 The period covered is January 1, 2016, through the date of <br />December 31, 2016. leaving office. <br />-or- <br />0 The period covered is _J_J , through <br />the date of leaving office. <br />❑ Candidate: Election year and office sought, if different than Part 1 <br />❑ Assuming Office: Date assumed _J_J <br />4. Schedule Summary (must complete) I. Total number of pages including this cover page: <br />Schedules attached <br />❑ Schedule A -1 - Investments – schedule attached <br />Schedule A -2 - Investments – schedule attached <br />© Schedule B - Real Property – schedule attached <br />5 <br />-pr- <br />❑ None - No reportable interests on any schedule <br />❑ Schedule C - Income, Loans, & Business Positions – schedule attached <br />Schedule D - Income – Gifts – schedule attached <br />❑ Schedule E - Income – Gifts – Travel Payments – schedule attached <br />5. Verification <br />MAILING ADDRESS STREET <br />(Business or Agency Address Recommended - Public Document) <br />3900 Main Street <br />DAYTIME TELEPHONE NUMBER <br />( 951 ) 515 -1663 <br />CITY <br />Riverside <br />STATE <br />ZIP CODE <br />CA 92522 <br />E -MAIL ADDRESS <br />msoubirous @mac.com <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 />f <br />I certify under penalty of perjury under the laws of the State of California that the foreg ing"is true a d co ect. <br />i /// <br />Date Signed March 21, 2017 Signature <br />(month, day, year) g <br />(File the originally signed statement with your riling official.) <br />FPPC Form 700 (2016/2017) <br />FPPC Advice Email: advice @fppc.ca.gov <br />FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov <br />