700 Statement of Economic InterestSTATEMENT OF ECONOMIC INT
COVER PAGE
Please type or print in ink.
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AUG 1 2 2016
NAME OF FILER (LAST) (FIRST)
C J PE RfITTBEC f TY CLERK LERK
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1. Office, Agency, or Court
Agency Name (Do not use acronyms)
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Division, Board, Department, District, if applicable Your Position
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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
,❑,.Multi -County
U City of C. U^ y- t 1 Vl 0
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2015, through
December 31, 2015.
.or -
The period covered is
December 31, 2015.
❑ Assuming Office: Date assumed
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other —
❑ Leaving Office: Date Left 1.
(Check one)
through O The period covered is January 1, 2015, through the date of
leaving office.
.or -
0 The period covered is through
the date of leaving office.
NKCCandidate: Election year 2 o LIP and office sought, if different than Part 1:
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
C%J vy-tIVI0 C A JS -o 1
DAYTIME TELEPHONE NUMBER E-MAILADDRESS
(
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, day, year) (File the originally signed stafement with your filing official.)
FPPC Form 700 (2015/2016)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov