Allen, Jasmine - 2018-2019 FPPC Form 700CALIFORNIA FORm7OO STATEMENT OF ECONOMIC INTERESTS RECEIVED , _
POLITICALFAIR COVER PAGE CITY CLERK'S OFFICE
Please type or print in ink. A PUBLIC DOCUMENT 2"1i 112, 0 / I1 @ `f 7--7P1Z
NAME OF FILER (LAST) (FIRST) (MIDDLE)
1. Office, Agenc , or Court
Agency Name ( not use
d
Division, Board, D en1
-
► If filing for multiple positi
I
Your Position
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 �j ❑ County of
City of�S„�! �A ❑Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2018, through ❑ Leaving Office: Date Left I I
December 31, 2018. (Check one circle.)
-or-
The period covered is through O The period covered is January 1, 2018, through the date of
December 31, 2018. -or- leaving office.
❑ Assuming Office: Date assumed _ — O The period covered is I I through
the date of leaving office.
❑ Candidate: Date of Election 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 A-2 - Investments - schedule attached
❑ Schedule B - Real Property - schedule attached
-or- None - No reportable interests on any schedule
5. Verification
❑ Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
t)
(A3 / O TE) EPHON� U�ER � � � � EAl91L ADDRESS
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I have used all reasonable diligence in preparing this statement. I have revievthis statemen nd to the bes of my knowledge the inf alion contained
herein and in any attached schedules is true and complete. I acknowledge this is a public document.
certify under penalty of perjury under tre laws of the State of California that the foregoing is true and correct.
Date Signed Signature
r n:rrr� day, , cup fi the originally signed paper statement with your filing official.)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
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