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'• COVER PAGE CITY CLERK'S OFFICE
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NAME OF FILER (LAST) (FIRST) (MIDDLE)
1. Office, Agency, or Court
Agency ivame (uo nor Use acronyms
Department, District, if applicable
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency: e 1 � /ten
` r / 0 5 em W 4-4 Position:
2. Jurisdiction of Office (check at feast one box)
❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi -County ❑ County of
.x City of &05 EA'/ &AD ❑ Other
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3. Type of Statement (Check at feast one box)
Annual: The period covered is January 1, 2014, through
December 31, 2014.
-or-
The period covered is
December 31, 2014.
❑ Assuming Office: Date assumed
❑ Candidate: Election year
O The period covered is _
the date of leaving office.
and office sought, if different than Part 1:
through
Schedule Summary
Check applicable schedules or "None."
❑ Schedule A -1 - Investments — schedule attached
❑ Schedule A -2 - Investments — schedule attached
❑ Schedule B - Real Property— schedule attached
❑ Leaving Office: Date Left
(Check one)
through O The period covered is January 1, 2014, through the date of
leaving office.
► Total number of pages including this cover page:
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Giffs — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
-or-
None - No reportable interests on any schedule
5, Ventication
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
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
Date Signed 3 ?-° �l s
( Snth, day, year)
is true
FPPC Form 700 (2014/2015)
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov