2003 (36)Please type or print in ink
NAME (LAST)
- 3 - 0 tta ST) A
(May be business address)
6838 E
C Eq opeived
or
STATEMENT OF ECONOMIC INTERE t §T E YOF RO p
COVER PAGE MAR 2 `,j 2004
A Public Document CITY CLERK'S OFFICE'
(FIRSTI. I (MIDDLE) DAYTIME TELEPHONE NUMI
1 . Office, Agency or Court
Name of Office, Agency or Court:
C� oT P -e
Division, Board, District, if applicable:
Your Position: T
aa� 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
�gCltyof Raseome4
❑ Multi -County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date: __J—l
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: _J __J—
(Check one)
0 The period covered is January 1, 2003, through
the date of leaving office.
-or-
0 The period covered is I I through
the date of leaving office.
❑ Candidate
W. (&�k ) l Yl
STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS
7
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 Mess man to %ci. snip)
Schedule A -2 ❑ Yes - schedule attached
Investments po% orgrealer ownersldp)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income & Business Positions (Income Omer man Loans, Gigs, end Travel)
Schedule D ❑ Yes - schedule attached
Income - Loans
Schedule E ❑ Yes - schedule attached
Income - Gilts
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
-or-
No reportable interests on any schedule
Total number of pages I
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 34
day, r)
Signature r
(File the o' m
Ily signed slalee h your filing o
FPPC Form 700 (200312004)
FPPC Toll -Free Helpline: 8661ASK -FPPC