Koster 700lcCALIIFORNIAfORMPft
PUSLLC DOCUMENT
Please type or print in ink.
NAME OF FILER (LAST)
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
Or:-
Division, Board, Department, District, if applicable
cl-r-Vkj J 1 A5m Ot'.71(-V-9%rD
STATEMENT OF ECONOMIC INTEREST
COVER PAGE
Your Position
o- If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at least one box)
[I] State
0 Multi-County
ra City of Al.'14A1
3. Type of Statement (Check at least one box)
Ej Annual: The period covered is January 1, 2016, through
December 31, 2016.
Position:
APR 03 2017
CITY OF ALAMEDA
CITY CLER" .IS OFFICE
0 Judge or Court Commissioner (Statewide Jurisdiction)
0 County of
Other
0 Leaving Office: Date Left / /
(Check one)
-or-
The period covered is / 1 through 0 The period covered is January 1, 2016, through the date of
December 31, 2016, leaving office.
-Or-
O Assuming Office: Date assumed 1 0 The period covered is 1 / , through
the date of leaving office.
El Candidate: Election year 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
0 Schedule B - Real Property - schedule attached
-or-.
'0 None - No reportable interests on any -schedule
5. Verification -47_4=-5-Zq A/ 6..-C jf
MAILING ADDRESS STREET CITY
(Business or Agency Address Recommended - Public Document)
DAYTIME TELEPHONE NUMBER
(S))
El Schedule C - Income, Loans, & Business Positions - schedule attached
Schedule D - Income - Gifts - schedule attached
Er] Schedule E - Income - Gifts - Travel Payments - schedule attached
STATE
E-MAIL ADDRESS
IZ_V-C2)(.-5-te‘/ IAA-CA
ZIP CODE
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best o 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
Date Signed
1
(ninth, day, year)
Signature
(File the originally signed statement with your filing official)
FPPC Form 700 (2016/2017)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov