Wayne CoSTATEMENT OF ECONOMIC
COVER PAGE I I MAP 2 1 201
Please type or print in ink. I 'k—$ ll T q- LLRK'S
1. Office, Agency, or Court
Agency Na rr y) �
M W
DivisiqaAoard, D District, if applicable
Your Position
C - art e / `7
If fling for multiple positions, list below or on & attachment.
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Judge (Statewide Jurisdiction)
❑ Multi-County
F1 County of
4city of yAD
❑ Other
3. Type of Statement (Check at least one box)
�9- Annual: The period covered is January 1, 2010, through December 31, ❑ Leaving Office: Date Left
2010. -or-
(Check one)
The period covered is —J , through December
31, O The period covered S January 1, 2010, through the date of
2010
leaving office.
❑ Assuming Office: Date --J _—
O The period covered is ��, through the date
of leaving office.
❑ Candidate: Election Year Office sought, if different than Part 1:
4. Schedule Summary
Check applicable schedules or "None."
► Total number of pages including this cover page:
❑ Schedule A -1 - Investments — schedule attached
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule A -2 - Investments — schedule attached
❑ Schedule D - Income — GiRs — schedule attached
❑ Schedule B - Real Property — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
-or-
❑ None - No reportable interests on any schedule
5. Verification
MAIDNG ADDRESS STREET
CITY STATE ZIP CODE
(Business orAgencyA - PPuub/li�c Document) �J.� �
/`� ��
D IME TELEPHONE NUMBER
E- MAILADDRESS
I have used all reasonable diligence in preparing this statement. I have
reviewed this statement and to the 6est of my knowledge the information contained
herein and in any attached schedules is true and complete. I acknowledge
this is a public document.
I certify under penalty of pe'ury u er the laws of the State of California that the foregoing is true and correct.
lf� 201/
�! r,�rcreur��
Date Signed
(month, tlay, year)
Signature
(He the originally signed statement wdh your filing alfidal)
FPPC Form 700 (2 01 012 011(
FPPC Tall -Free Helpline: 866!275-3772 www.fppc.ca.gov