2003 (27)R ift�eived
a . STATEMENT OF ECONOMIC INTERE Wy of R0
FAIR POLITICAL PRACTICES COMMISSION I
COVER PAGE t `t3 2 6 2004
A Public Document CITY CL i
'Naaae type or Fort t, om
-------------------
11ir
NAME (LAST)
441_
(FIRST)
4
(MIDDLE)
R
DAYTIME TELEPHONE NUMBER
Iz ) 1 0-d/
MAILING ADDRESS STREET
(May be business address)
5s" u
CITY
�u yid .r d
STATE ZIP CODE
64 91 ;;)o
OPTIONAL: FAX I E -MAIL ADDRESS
�a� -3 9z.lY
1 . Office, Agency or Cou
Name of Office, Agency or Court:
Lase 11 19� 1,
Division, Board, Dp District, if applicable:
(? Ot° tXy/�pl
Your Position:
62h� ( dlln/I OlAdl
If filing for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (Cheek at least one box)
❑ State
❑ County of
VCilyof (x d)
aE 117 za 4*4
❑ 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, 2003,
through December 31, 2003.
-or-
0 The period covered is through
December 31, 2003.
❑ Leaving Office Date Left:
(Check one)
• The period covered is January 1, 2003, through
the date of leaving office.
-or-
• The period covered is _I _ / —, through
the date of leaving office.
❑ Candidate
4. Schedule Summary
(Check applicable schedules or "No reportable interests.')
During the reporting period, did you have any reportable
interests to disclose on:
Schedule A -1 ❑ Yes - schedule attached
Investments (Less man loss oanersnlp)
Schedule A -2 ❑ Yes - schedule attached
Investments (imc or greater D,w ,avp)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income & Business Positions frc. Diner men Loans, Gros, and T.1)
Schedule D ❑ Yes - schedule attached
Income - Loans -
Schedule E ❑ Yes - schedule attached
Income - Gifts
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
-or-
_x 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. 1 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
/ FPPC Form 700 (200312004)
FPPC Toll -Free Helpline: 866/ASK-FPPC