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2003 (29)STATEMENT OF ECONOMIC INTERESTS R E �� Aa FAIR POLITICAL PRACTICES COMMISSION I COVER PAGE MAR -3 2004 A Puh)ir nnrvnavnt A19`ir n, �....._ Please type or print in Ink +I I T vltWS llFfll, '. NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER L J) 4� �4 C G 2-& 6 -(,-`i -a / 7/ 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 C / T`/ 6 F as �itt�,4� 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