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karen OganaSTATEMENT OF ECONOMIC Please type or print in ink COVER PAGE A Public Document C E a Nib Uceived OF ROSCN4' 'A'De oy ,ill 12 2005 CITY CLERK'S OFFICE NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER. ©C�A0JA So,)M V_4Q� LYAI,Ja Gzt f69 -z /z/ MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS (May use business address) - - 5838 E. VArLL -may ALA/0- 4 66ML� CAY 9/7 '7 626569 -2303 1 . Office, Agency, or Court Name of Office, Agency, or Court: Division, Board, District, if applicable: Your Position: F /�rl�r�a� Ane�cTa,e If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ County of kzCityof d�osznf & A-o ❑ Multi- County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date:_J� Annual: The period covered is January 1, 2004, through December 31, 2004. -or- 0 The period covered is through December 31, 2004. ❑ Leaving Office Date Left: (Check one) • The period covered is January 1, 2004, through the date of leaving office. -or- O The period covered is through the date of leaving office. ❑ Candidate 4. Schedule Summary (Check applicable schedules or "No reportable Interests.') — During the reporting period, did youfiave any reportable interests to .disclose on: Schedule A -1 ❑ Yes schedule attached Investments (Less than 10% Ownership) Schedule A -2 ❑ Yes — schedule attached Investments (ta% or greater Ownership) Schedule B ❑ Yes — schedule attached Rea( Property Schedule C ❑ Yes — schedule attached Income, Loans, & Business Positions (Income other than Gifts and Travel Payments) Schedule D (Eliminated — report loans on Schedule C) Schedule E ❑ Yes — schedule attached Income — Gifts Schedule F ❑ Yes — schedule attached Income — Travel Payments -or- r No reportable interests on any schedule Total number of pages - completed including this cover page: 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 �� / /� /� {month, day, year) Signature r —" (File the onginal signed statem with yo ling official.) FPPC Form 700 (2004/2005) FPPC Toll -Free Helpline: 866/ASK-FPPC