Mark Galoustian (2) CF- FD
Date Inial F.r FTe!Klved
CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS
FAIR POLITICAL ncnc PRACTICES COMMISSION CI1` Err )ITICE
A PUBLIC DOCUMENT COVER PAGE BY:..
Please type or print in ink
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Ct. y3- L U 51-1 &i44.10
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
C tT1 of- yLos r1A.Efil2 CODE ENf-f1✓LCE)"LENVT ofr=rCcY(
Division, Board, Department, District, if applicable Your Position
� LA6utr Sir--Epi
w 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 ❑County of
❑City of ❑Other
3. Type of Statement (Check at least one box)
E Annual: The period covered is January 1,2016,through ❑ Leaving Office: Date Left J_J
December 31,2016. (Check one)
ror
Dec period covered is_J_.1throughO The period covered is January 1,2016, through the date of
.
December 31, 2016. leaving office.
-pr
❑ Assuming Office: Date assumed—JJ 0 The period covered is through
the date of leaving office.
O 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 A-2-Investments-schedule attached ❑Schedule 0-Income-Gifts-schedule attached
O Schedule B-Real Property-schedule attached ❑Schedule E•income- Gifts-Travel Payments-schedule attached
-Or-
OR None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(&Wiess or Agency Address Recommended-Pod2 Document)
S3OI Cwutsl rI ri- oSc-nt o Cvi- 9r» 0
DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS
(cz&) ( tC/— ( 676
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 correct./or`
Date Signed II t / Signature , " "( '(-6 ` L1A
,4AN
holt day Year) DO the ahr*signed aaternent eM Your rdirg oflwal0
FPPC Form 700(2016/2017)
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3212 www.fppc.ca.gov