Date Left / /
(Check one)
The period covered is January 1, 2017, through the date of
leaving ofce.
The period covered is / / , through
the date of leaving ofce.
The period covered is January 1, 2017, through
December 31, 2017.
The period covered is / / , through
December 31, 2017.
FPPC Form 700 (2017/2018)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
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.
(month, day, year)
(Check at least one box)
State
Judge or Court Commissioner (Statewide Jurisdiction)
Multi-County
County of
City of
Other
(Check at least one box)
Date of Election and ofce sought, if different than Part 1:
Date assumed / /
DateInitial FilingReceived
Ofcial Use Only
Please type or print in ink.
700
FAIr POLITICAL PrACTICES COMMISSION
CALIFORNIA FORM
Agency Name (Do not use acronyms)
Division, Board, Department, District, if applicable Your Position
MAILING ADDRESS STREET CITY STATE ZIP CODE
()
DAYTIME TELEPHONE NUMBER
E-MAIL ADDRESS
(Business or Agency Address Recommended - Public Document)
(File the originally signed statement with your ling ofcial.)
A PuBLIC DOCuMENT
► If ling for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
Position:
-or-
-or-
None - No reportable interests on any schedule
Schedules attached
Investments – schedule attached
Investments – schedule attached
Real Property – schedule attached
►
Total number of pages including this cover page:
-or-
Income, Loans, & Business Positions – schedule attached
Income – Gifts – schedule attached
Income – Gifts – Travel Payments – schedule attached