Wayne Co AnnualSTATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A PUBLIC DOCUMENT
Please type or print in Ink.
RECEIVED
Date Initial 9i 9PIRdWSWEAD
Filing Oficial Um Only
MAR 2 9 2023
CITY CLERK'S OFFICE
r. vutae, agency, or uourr
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, Refired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ Multi -County r� ❑ County of
X City of fLfittn,R'J ❑ Other
3. ���T[[[ype of Statement (check at least one box)
p(I Annual: The period covered is January 1, 2022, through ❑ Leaving Office: Date Left _J ---I
-or-
/\ December 31, 2022. (Check one circle.)
The period covered is —J I through ❑ The period covered is January 1, 2022, through the date of
December 31, 2022. -or-
leaving office.
❑ Assuming Office: Date assumed —J_I ❑ The period covered is — I through
the date of leaving office.
❑ Candidate: Date of Election and office sought, If different than Pan 1:
Schedule Summary (required) ► Total number of pages including this cover page:
Schedules attached
❑ Schedule A-1 - Investments – schedule attached ❑ Schedule C - Income, Loans, 6 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-4 None - No reportable interests on any schedule
Verification Q29 Ql-rlF
(Business orAgencyAddress
I have used all reasonable diligenua in preparing this statement. I have reviewed this statement and to the be
herein and in any attached schedules is true and complete, I acknowledge this is a public document.
I certify under penalty of pejury upeler the laws of the State of California that the foregoing is true and
Date Signed
-q-3
Signature
of my knowledge the information contained
FFV[ Form 700 - [over Page (2022/2023)
advice@fppcn.gov • 866-275-3772 • w Jppc.ca.gov
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