Roger Khan - Form 700 - Cansidate Statement by AprilY

VIEWS: 4 PAGES: 1

									                                                                                                                                                 Date Received
                                                                                                                                                  Official Use On/y
                                                           STATEMENT OF ECONOMIC INTERESTS
                                                                        COVER PAGE
                                                                     A Public Document
     a      P    O   P

NAME                                                                                        (MIDDLE)                                DAYTIME TELEPHONE NUMBER




MAILING ADDRESS
                 (F)hun       STREET
                                                            =%@qwJ
                                                              CITY                     STATE              ZIP CODE
                                                                                                                                                 Slo~~6f
                                                                                                                                    OPTIONAL. FAX I E-MAIL ADDRESS
(May use business




1. Office, Agency, or Court                                                 4. Schedule Summary
    Name of Office, Agency, or Court:
                                                       ‘
                                                                            ‘Total number of pages
                                                                               including this cover page:

                                                                            ‘ applicable schedules or “No reportable
                                                                             Check
                                                                               interests.”
    Your Position:                                                             I have disclosed interests on one or more of the

           hdc)cde                 LV      [GI; t q tounci
                                              &                      ‘P        attached schedules:

                                                                               Schedule A-1                 c Yes - schedule attached
                                                                                                             ]
          If filing for multiple positions, list additional agency(ies)/          V                          a              W        P
          position(s): (Attach a separate sheet if necessary.)
                                                                              Schedule A-2                  [7 Yes - schedule attached
    Agency:                                                                       V                        o g a            w        P

                                                                              Schedule B                             Yes - schedule attached
    Position:                                                                     a         OP


                                                                              Schedule C                             Yes - schedule attached
                                                                                  co          oa                                0    0      to             a     f
                 f
2. Jurisdiction o Office                        (Check at /east one box)      a        av        a
         State
                                                                              Schedule           D                   Yes   - schedule attached
    0County of                                                                    co                 f
 H C i t y of            t-cclcp                                              Schedule E                   0Yes - schedule attached
                                                                                  co                 av     a
    [7 Multi-County
         Other                                                                                                         -or-
-


3. Type Of Statement                      (Check at least one box)           H        No reportable interests on any schedule
                                                                                                                ~~




 0 Assuming Officellnitial                     Date:    I
                                                       2 -
                                                                            5. Verification
         Annual: The period covered is January 1, 2007,
         through December 31, 2007.                                         I have used all reasonable diligence in preparing this
                                                                            statement. I have reviewed this statement and to the best of
                                        -or-                                my knowledge the information contained herein and in any
         0 The period covered is 22-through
                                    ,                                       attached schedules is true and complete.
            December 31, 2007.
                                                                            I certify under penalty of perjury under the laws of the State
         Leaving Office     Date Left: 22-                                  of California that the foregoing is true and correct.
         (Check one)
         0 The period covered is January 1. 2007, through the
           date of leaving office.                                          Date Signed
                                                                                                                            Jhonth.      day, yeav
                               -or-
         0 The period covered is I  d ,
                                     - through
           the date of leaving office.                                      Signature

@ Candidate
                                                                                                                                  FPPC Form 700 (2007/2008)
                                                                                                                       FPPC Toll-Free Helpline: 866/ASK-FPPC

								
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