Bill Headley - Annual 2011CALIFORNIA FORm 700 STATEMENT OF ECONOMIC INTERESTS
DOCUMENT FAIR POLITICAL PRACTICES COMMISSION
A PUBLIC COVER PAGE
APR 2012
Please type or print in ink.►'ccEitK c ' ^^
NAME F FILER (LAST) (FIRST) C
1. Office, Agency, or Court
Agency Name
C $7
Division, Boar , Department, District, if appli ble Your Position
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► If filing for multiple positions, list below or on an attachment. +i
Agency: Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi- County
City of
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
'SKAnnual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left I
December 31, 2011, (Check one)
-or- The period covered is January 1, 2011, through the date of
The period covered is �� ,through O P ry 9
December 31, 2011. leaving office.
❑ Assuming Office: Date assumed I 1 O The period covered is I I through
the date of leaving office.
❑ Candidate: Election Year
4. Schedule Summary
Check applicable schedules or "None."
❑ Schedule A•1 - Investments — schedule attached
❑ Schedule A -2 - Investments — schedule attached
❑ Schedule B - Real Property — schedule attached
Office sought, if different than Part 1:
► Total number of pages including this cover page: I
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — 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 or Agency Address Recommended - Public Document) oa
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my kndwledgeTrieinform,
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 foregoin is true and correct.
Date Signed S J2-01 Signature
(month, day, year) 1101 (File the originally signed statement wit our fir official.)
`FPPC Form 700 (201112012)
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov