Roderick Ornelas - Annual (Traffic Commissioner) RECEIVED
STATEMENT OF ECONOMIC INTERESTS SAIWPUIWingte eived
CALIFORNIA FORM 700 Official use Only
FAIR POLITICAL PRACTICES COMMISSION COVER PAGE APR 0.1 2019
Please type or print in ink. A PUBLIC DOCUMENT CITY CLERK'S OFFICE
BY:
NAME OF FILER (LAST) (FIRST) (MIDDLE)
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
Division, Board, Department, District, if applicable Your Position
► 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)
rgi Annual: The period covered is January 1, 2018,through ❑ Leaving Office: Date Left
December 31, 2018. (Check one circle.)
-or-
The period covered is ,through 0 The period covered is January 1, 2018,through the date of
December 31, 2018. -or-leaving office.
❑ Assuming Office: Date assumed 0 The period covered is_/_/ , through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
4. Schedule Summary (must complete) ► Total number of pages including this cover page:
Schedules attached
El 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- 0 None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended-Public Document)
DAYTIME TELEPHONE NUMBER I EMAIL ADDRESS i
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.
� -
Date Signed �� Signature
(month,
(month,day,year) (File the on.finally signed paper statement with your Sing official.)
FPPC Form 700(2018/2019)
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
Page-5