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NAME OF FILER
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1. Office, Agency, or Court
STATEMENT OF ECONOMIC
COVER PAGE
(FIRST)
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Agency Name `-�/
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Division, Board, Department, District, if applicable Your Position
► If fling for multiple positions, list below or on an attachment.
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi -County
l Zity at
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
(�( Annual: The period covered is January 1, 2011, through
1 December 31, 2011.
-or-
The period covered is
December 31, 2011.
❑ Assuming Office: Date assumed
❑ Candidate: Election Year
O The period covered is —
the date of leaving office.
Office sought, if different than Part 1:
through
4. Schedule Summary
Check applicable schedules or "Norte.' ► Total number of pages including this cover page.
❑ Schedule A -1 - Investments - schedule attached ❑ Schedule C - Income, loans, & Business Positions- schedule attached
❑ Schedule A -2 - Investments- schedule attached ❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or-
None - No reportable interests on any schedule
5. Verification
MAILINGADDRESS STREET cIIT owm ur wuc
(Business o Agffl, Address Recommended - Public Dxumend
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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 acknowledge this is a public document.
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and c rrecct„.,,.�
Date Signed O a i f Signature
(.mM,, dayp.) (Fik dreariginalysrgnedsGr eM wbhyourfibigdrrculJ
FPPC Form 700 (2 01112 0 1 2)
FPPC Toll -Free Helpline: 8661275 -3772 w Jppc.ca.gov
❑ Leaving Office: Date Left ---J---J
(Check one)
through O The period covered is January 1, 2011, through the date of
leaving office.