Allen, Jasmine - 2017-2018 Form 700CALIFORNIA • ' STATEMENT OF ECONOMIC INTEREST 11604§ Initial Use nl�eC2lVed
COMMISSIONFAIR POLITICAL PRACTICES ,�, Use
COVER PAGE ' PUBLIC °a CIF i
Please type or print in ink.
NAME OF FILER (LAST) (FIRST) (MIDDLE) F,
tq 11-�r7 v cF
1. Office, Agency, or Court
Agency Name (Do not use acrony�s)
-e,,l L-o
Division, Board, DepartmYnt, Di s rid/ f applicab e � � YquI,POsition
W 6 rlllt
► 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
f j City of �/ e'�CQ U_', '—Ln ❑ Other
3. Type of Statement (Check at least one box)
r Annual: The period covered is January 1, 2017, through ❑ Leaving Office: Date Left I I
December 31, 2017. (Check one)
-or- ��
The period covered is J. through
December 31, 2017.
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
O The period covered is January 1, 2017, through the date of
leaving office.
.or-
0 The period covered is through
the date of leaving office,
and office sought, if different than Part 1
4. Schedule Summary (must complete) ► Total number of pages including this cover page:
Schedules attached
.or-
❑ 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
- No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public ument) I / 9 �p�
3 S /`'j�c:n ' G �
(31 DAYTIME TELEPHONE
) 5- NUMBER7 ) ✓ b ✓ v I E-MAIL
w( a I(e,4 l "' e �.S42 1 Ct,_Y► Cj'v
I have used all reasonable diligence in preparing this statement. I have reviewO this statement and to th6 best of my knowledg"e 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 foregging is true and correct.
Date Signed (93 t7 / °
(month, day, year)
Signature
(File the odginally signed statement with your riling official.)
FPPC Form 700(2017/2018)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov