Henry Servin - Annual 2013STATEMENT OF ECONOMIC INTERESTS Date Othc ese Onl; cei1y
D OCUME NIT COVER PAGE
Please type or print in ink.
NAME OF FILER (LAST) ` y (FIIRRS[T)
�^
1. Office, Agincy, or Court
Agency Name JDo not use onym
A 11192 r1 /"Vee.R.
Division, Board, Department, District, if applica Your Position
i// re GAO rzS
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi- County
City of � � ey y
3. Type of Statement (Check at least one box)
nnual: The period covered is January 1, 2013, through
December 31, 2013.
-or-
The period covered is I I
December 31, 2013.
❑ Assuming Office: Date assumed
❑ 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
Position:
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left I I
(Check one)
through O The period covered is January 1, 2013, through the date of
leaving office.
O The period covered is I I through
the date of leaving office.
and office sought, if different than Part 1:
► Total number of pages including this cover page: —�
❑ 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 ommended - Public Document)
73.x/ 2-0
DAYTIME TELEPHONE NUMBER E- MAIIIADDRESS (OPTIONAL)
I have used all reasonable diligence in preparing this statement. I have reviewed this statement 5nd to the best of my knc
herein and in any atta hedules is true and complete. I acknowledge this is a public document.
I certify u penalty of 94rjury underjWJaws of the State of California that the for Is eXd correct.
r
Signature
(month, day, year) (File the originally
the inforge& cost ' ed
with yyerKg official.)
PPC Form 700 (2013/2014)
FPPC A ice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov