700 Davidson 2017 from 01/01 - 12/31RECEIVED
Date Initial Filing Received
STATEMENT OF ECONOMIC INTERESTS Official Use Only
MAR 12 2018
COVER PAGE
Please type or print in ink. CITY OF LA 0004TA
r -P PPJTMENT
NAME OF FILER (LAST) (FIRST)
�� vi �s 0N' C2w��oG Y�
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
❑ Multi -County A
® City of /__/4 QC/
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2017, through
December 31, 2017.
-or-
The period covered is
December 31, 2017.
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left r
(Check one)
through O The period covered is January 1, 2017, through the date of
-or-
leaving office.
O The period covered is --J---J through
the date of leaving office.
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 A-2 - Investments — schedule attached
❑ Schedule B - Real Property — schedule attached
-or-
�_ None - No reportable interests on any schedule
5. Verification
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
MAILING ADDRESS STREET CITY STATE ZIP CODE
(business or Agency Add:�=allr
emended - FuW�c DocumenU /
7am plco 4af; Qaa 5 3
DAYTIME TELEPHONE. NUMBER tE-MAILADDRESS
( 0e � ��
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 for o is true a Signed orrect
/+
Date Si Si nature
� g
(month, day year) (File the originally signed dalaumt with your filing official)
FPPC Form 7"017/2018)
FPPC Advice Email: adviceCafppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772www.fppc.ca.gov