Consolidated CM - Annual 2015Please type or print in ink.
NAME OF FILER (LAST)
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1. Office, Agency, or Court
Agency Name (Do not use acronyms)
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Division, Boird, Department, District, if
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STATEMENT OF ECONOMIC INTERESTS
(FIRST)
N
COVER PAGE
Your Position
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Asa
iial Filing R
Official Use Only
APR22 ?016
► 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
[.City of 61 ' , ! "
❑ Other
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2015, through
❑ Leaving Office: Date Left I I
T December 31, 2015.
(Check one)
-or-
The period covered is I I
through O The period covered is January 1, 2015, through the date of
December 31, 2015.
-or- leaving office.
❑ Assuming Office: Date assumed I 1
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 (must complete) ► Total number of pages including this cover page:
Schedules attached
❑ 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-
[N,None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE
(
E -MAIL ADDRESS
I have used all reasonable diligence in preparing this statement. I have reviewed this staterrient and to the best o1
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
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