James Piatt RECEIVED
urn OF aOSEMEAD
CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS
FAIR POLITICAL
ITICAL PRACTICES COMMISSION
A PUBLIC DOCUMENT COVER PAGE CITY CLHHMS OFFICE
BY
Please type or print in ink.
NAME OF FILER (LAST) (FIRST (MIDDLE)
I �-tT _ Y1wLm s Ti
1. Office, Agency, or Court
Agency Name (Do not use acronyms))/
t, Ods 5.,7 N�+L1Pd..i'
Division,Board, Department, istricl, if appllc a Your Position
or If filing for multipli positions, list below or on an attachment. (Do not use acronyms)
Agency: Position'.
2. Jurisdiction of Office (Check at lease one box)
❑State ❑Judge or Court Commissioner(Statewide Jurisdiction)
❑Multi-County n E County of
G�Clty of Sewt6.100 0 Other
3. Type-of Statement (Check at(ease one box)
gj'Annual: The period covered is January 1, 2016,through ❑ Leaving Office: Date Left J�
December 31,2016. (Check one)
-or- 0 The period covered is January 1,2016,through the date of
December
periodbcovered is_/_/ _. through,
ber 31,2016. leaving office.
-or-
❑ Assuming Office: Dale assumed 0 The period covered is—JJ ,through
the date of leaving office.
❑ Candidate: Election year and office sought, if different than Part I:
4. Schedule Summary (must complete) 0. Total number of pages including this cover page:
Schedules attached
❑ Schedule A-I -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- i
• None • No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(8uvres&Agency amass Ravnmenved-P be N[umeno
CF02aVi J,.(�e f l�aP rbsed4ek -
Q '� 9i7 t
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
( )
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 foregoiand correct.
Date Signed 3-(1 Signature
(mmln.daµw&) (Rom cape? red Agement Mdk your filing official.)
FPPC Farm 700(2016/2017)
FPPC Advice Email:advlce@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www,fppc.ca.gov