Rafael FajardoSTATEMENT OF ECONOMIC
Please type or print in ink.
COVER PAGE
A Public Document
OF IC
NAME (LAST)
(FIRST) (MIDDLE) _ NUMBER
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MAILING ADDRESS STREET
CITY STATE
ZIP CODE
OPTIONAL: E- MAILADDRESS
(Business Address Acceptable)
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1 . Office, Agency, or Court
Name of Office, Agency, or Court:
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Division, Board, District, if applicable:
Your Position:
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► If fling for multiple positions, list additional agency(ies)I
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (Check at feast one box)
State
W County of ', P� �21 cs
❑ City or
❑ Multi -County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date: ___J _J—
❑ Annual: The period covered is January 1, 2009,
through December 31, 2009.
-or-
0 The period revered is __J __J—, through
December 31, 2009.
❑ Leaving Office Date Left:
(Check one)
O The period covered is January 1, 2009, through the
date of leaving office.
-or-
0 The period covered is ��� through
the date of leaving office.
❑ Candidate Election Year:
4. Schedule Summary
► Total number of pages I
including this cover page: —
► Check applicable schedules or "No reportable
interests."
I have disclosed interests on one or more of the
attached schedules:
Schedule A -1 ❑ Yes - schedule attached
Investments (Less than lo% ownership)
Schedule A -2 ❑ Yes - schedule attached
Investments (70% w Greater Ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions (Income other than Gifts
and Travel Payments)
Schedule D ❑ Yes - schedule attached
Income - Gifts
Schedule E ❑ Yes - schedule attached
Income - Gifts - Travel Payments
-or-
O NO reportable interests on any schedule
5. Verification
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 herein and in any
attached schedules is true and complete.
I certify under penalty of perjury under the laws of the State
of California that the foregoing is true and correct.
Date Signed o g / 03 / 1 0
da ,year)
Signature
ile the originally signed slatement with your filing oH/cial.)
FPPC Form 700 (200912010)
FPPC Toll -Free Helpline: 866/ASK-FPPC www.fppc.ca.gov
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