700 Blum - 2014 Assuming 10/02/2013Please type or print in Ink
NAME OF FILER
1. Office, Agency, or Court
(LAST)
RECEIVED
{
Date Received
ATEA} E NOMIC INTF��SI 16 P�j,� only .
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ER PAGE
_ Y', CITY OF LA Q UtHITA
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(MIDDLE)
Age cy Name (Do not u e acronyms)
L CIA -%J
r4 y
Pvv sion, Board, epartment, District, if applicable
Your Position
Con,VVNtsSlor"N
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► 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
2'City of �_� U /a ,LQ,
Q Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2013, through
❑ Leaving Office: Date Left —J— I
December 31, 2013.
(Check one)
-or-
The period covered is . /01 iQ 45 through
O The period'covere i. is January 1, 2013, through the date of
December. 31, 2013.
leaving office.
��
hd Assuming Office: Date assumed /O1 1070
O The. period covered is.I I through
the date of leaving office. .
❑ Candidate: Election year and office sought, if different than Part 1:
4. Schedule Summary
/
Chad applicable schedules or "None." ► Total number of pages including this cover page:
❑ 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-
&(None - No reportable . interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business arAgencyAddnm RecaermmW - FWk DoaxRo
va. k.1 edrno. Qum la
DAYTIME TELEPHONE NUMBER -MAIL ADDRESS (OPTIONAU
I have Used all reasonable diligence in preparing this statement I have reviewed this statement and to ftrbesf 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 / ! Signatu
(narkh, ft,ye 1 (Fie ft.adgirwrysFgned_sW-erdw0y—ffigof ad)
FPPC Form 700(2013/2014)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toil -Free Helpline: 866/275-3772 www.fppc.ca.gov-