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Daniel Lopez RECEIVED Da plyljtjld;F,iye®MtskOived CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS FAIR POLITICAL PRACTICES COMMISSION A PUBLIC DOCUMENT COVER PAGE Please type or print in ink CITY C j, RK'S OFFICE DV. AA//u�l//77�NLiC' NAME OF FILER (LAST) (FIRST) Lope z L),4AJt L 1. Office, Agency, or Court Agency Name (Do not use acronyms) fCocE<f4G1J Division, Boa/d Department, District,/� if applicable Your Position A4.viNN ` L'O/YI/Y(/SS/drt/e/C + 44-le c c,veet_lGaL e If filing for multiple positions,list below or on an attachment. (Do not use acronyms) Agency. Position: 2. Jurisdiction of Office (Check at least one box) ❑State ❑Judge or Court Commissioner(Statewide Jurisdiction) ❑Multi-County qqL�-,� ElCounty of City of S& 6173 ❑Other 3. Type of Statement (Check at least one box) A Annual: The period covered is January I,2016,through 0 Leaving Office: Date Left LJ December 31, 2016. (Check one) or- The period covered is ,through 0 The period covered is January 1,2018, through the date of December 31, 2016. leaving office, -or- ❑ Assuming Office: Date assumed iJ 0 The period covered is JJ ,through the date of leaving office. ❑ Candidate: Election year and office sought, if different than Part 1: 4. Schedule Summary (must complete) ► Total number of pages including this cover page: Schedules attached ❑ Schedule A-1 -investments-schedule attached ❑Schedule C-income, Loans, &Business Positions-schedule attached ❑ Schedule Ad-investments-schedule attached ❑Schedule D-Income-Gifts-schedule attached ❑ Schedule B-Real Property-schedule attached ❑Schedule E •income- Gifts- Travel Payments-schedule attached -or- LT{1 None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CIN STATE ZIP CODE (Bushes or Agency Address Recommended-Public Document) �1I_(('�'/��)) pAVeETE HO /NNMBERL R(13V E. VWIcJEMAIL Bkrok •55R ' CA 91770 (Z ) 56q- 2100 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 foreg 's true andncorrect. Date Signed /- Zy— 2-0/-7 Signature ti 1 / (month day.year) (Fife the originally seined slaloms lb king official) FPPC Form 700(2016/2017) FPPC Advice Email:advlce@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov