2003 (29)STATEMENT OF ECONOMIC INTERESTS R E
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FAIR POLITICAL PRACTICES COMMISSION I
COVER PAGE MAR -3 2004
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NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER
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MAILING ADDRESS STREET - CITY STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS
(May be business address)
1 . Office, Agency or Court
Name of Office, Agency or Cou
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Division, Board, District, if applicable:
Your Position:
s+ If fling for multiple positions, list additional agency(ies)/
posilion(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ County of
IN City of os &-MClq:,6
❑ 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)
0 The period covered is January 1, 2003, through
the date of leaving office.
-or-
0 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 you have any reportable
interests to disclose on:
Schedule A -1 ❑ Yes- schedule attached
Investments (Leta man loss ownership)
Schedule A - 2 ❑ Yes - schedule attached
Investments (to% or greater ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income & Business Positions (Income omerman LoanA ciis, ana rranep
Schedule D ❑ Yes - schedule attached
Income - Loans
Schedule E ❑Yes - schedule attached
Income - Gilts -
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
s0l, Iy0 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 v 3 aro 5
(month tl -
Signature
Ye the originallf signed statement with your filing official.)
FPPC Form 700 (2 0 0 312 00 4)
FPPC Toll -Free Helpline: 8661ASK -FPPC