Henneberry 700Please type or print in ink.
NAME OF FILER
(LAST)
1. Office, Agenc or Court
Agency N
Division, Board, Department District if app icable k_1 Your Position
if filing for multiple positions, list below or on an attachment,
Agency:
Position.
2. Jurisdi of Office (Check at least one box
State Judge or Court Commissioner (Statewide Jurisdiction)
Multi- County F1 County of
M"" City of Other
I T e of Statement (Check at least one box)
Annual: The period covered is January 1, 2011, through Leaving Office: Date Left
December 31, 2011 a (Check one)
n
The period covered is _J ___J through 0 The period covered is January 1, 2011, through the date of
December 31, 2011, leaving office,
Schedule A -1 w Investments schedule attached [l Schedule C M Income, Loans, Business Positions schedule attached
Schedule A -2 Investments schedule attached Schedule D Income Gifts schedule attached
Schedule B Deal Property schedule attached E Schedule B Income Gifts Travel Payments schedule attached
uxr t Wt 1 tLtrHUNt NUMbLK
(50
E -I AIL AQORESS (OPTIONAL)
1 have used all reasonable diligence in preparing this statement. 1 have reviewed this statement and to the best of my knowledge the information contained
herein and in any attached schedules is true and complete, 1 acknowledge this is a public document,
I certify under penalty of perjury under the laws of the State of California that the foregoing iiAe and correct.
Date Signed
(month. day. year)
Signature
Originally s igned st�temer t with y Irng Officia
P Form e00 (201112012)
FPPC Toll Free Flelphne: 8001 772 www.fppc.ca.gov