HomeMy Public PortalAboutMehlman - 700- 2018CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
A PUBLIC DOCUMENT
Please type or print in ink.
Date Initial Filing Received
STATEMENT OF ECONOMIC INTERESTS Official Use Only
COVER PAGEJC1
IA/ iq
NAME OF FILER (LAST)
Me)) J11)4 Yr)
r_ifTST)
e ✓r° 1r1
(MIDDLE)
1. Office, Agency, or Court
Agency Name(Donot use acrons)
C. ► 1 rJeavtr,onj
Division, Board, Department, District, if applicable Your Posit
1)- Cle(k
► 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 p) ecru opoia ❑ Other
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2017, through ❑ Leaving Office: Date Left / /
December 31, 2017. (Check one)
The period covered is ) 2_52—/ ) g' through 0 The period covered is January 1, 2017, through the date of
December 31, -2617 ' o j -or-leaving office.
❑ Assuming Office: Date assumed 0 The period covered is , through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1
4. Schedule Summary (must complete) r Total number of pages including this cover page:
Schedules attached
❑ Schedule A-1 - Investments — schedule attached
❑ Schedule A-2 - Investments — schedule attached
❑ Schedule B - Real Property — schedule attached
-or-
None - No reportable interests on any schedule
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
5. Verification
MAILING ADDRESS STREET CITY STATE
(Business or Agency Address
ZIP CODE -
Recommended -Public Document jj
c50 C�� 3 7ec 9eno n� C,4 /Zz27
DAYTIME TELEPHONE NUMBER p E-MAIL ADDRE S
( !�►7 ) ?ifq—�ic�,� �Meh ,4q6).COPt
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
1/
Signature
(month, day, year) (File the originally signed statement with your filing official.)
FPPC Form 700(2017/2018)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov