Ben AnnualRECEIVED
•- STATEMENT OF ECONOMIC INTERESTS Date IIRi[PJPF
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Filing Only
COVER PAGE t0AR C ) 2023
A PUBLIC DOCUMENT
Please type or print in ink.
CITY CLERK'S OFFICE
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NAME OF FILER (LAST) L (FIRST)� (MIDDLE)
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
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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, Refired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ Multi-Countyt�
❑ County of
Sty of 1��-.�- C A/IG�LkD
❑ Other
3. Type of Statement (check at least one box)
[Annual: The period covered is January 1, 2022 through
❑ Leaving Office: Date Left —J___J
December 31, 2022.
(Check one circle)
or
The period covered is _J—J
through ❑ The period covered is January 1, 2022, through the date of
December 31, 2071:
leaving office.
•or•
❑ Assuming office: Date assumed J_J
❑ The period covered isthroughthrough
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
Schedule Summary (required) ► 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 D - Income - Gifts - schedule attached
❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - GIRs - Travel Payments - schedule attached
-Or- t&None - No reportable interests on any schedule
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MAILING ADDRESS STREET CITY STATE LP CODE
(Business orAgencyAddress Reconmendeo' - Public occurrent)
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I have used all reasonable diligence in (preparing this statement. I have reviewed this statement and to the best of my knowledge the information conte i
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
Date Signed /9 2/ Signature
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FPPC Form 700 - Cover Page (2D22/2023)
advice@fppc.ra.gov • 866-275-3772 a vrwar.fppc.c2.guv
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