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65C - WARD 4 VACANCY
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65C - WARD 4 VACANCY
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Last modified
4/13/2019 2:34:33 PM
Creation date
4/11/2019 11:07:01 AM
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Clerk of the Council
Item #
65C
Date
3/22/2019
Destruction Year
2024
Notes
Correction on page 3: "...conduct an election in Fiscal Year 2019-2020 and Fiscal Year 2020-2021." Item 25D adjourned to the Adjourned Regular March 22, 2019 City Council meeting.
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Please type or print In Ink. <br />STATEMENT OF ECONOMIC INTERESTS <br />COVER PAGE <br />A PUBLIC DOCUMENT <br />Date Initial Filing Received <br />oRicief Use oMy <br />NAME OF FILER (LAST) (FIRST) (MIDDLE) @3Y' <br />Ortiz JR Phillip PElm nur 17 ltt`I <br />1. Office, Agency, or Court <br />Agency Name (Do not use acronyms) M4r�- �. t r,,'r-I" ..I' <br />City of Santa Ana <br />Division, Board, Department, District, if applicable Your Position <br />Ward 4 Council Member <br />► If fling for multiple positions, list below or on an attachment. (Do not use acronyms) <br />Agency: <br />2. Jurisdiction of Office (Check at least one box) <br />❑ State <br />❑ Multi -County <br />City of Santa Ana <br />Position: <br />❑ Judge or Court Commissioner (Statewide Jurisdiction) <br />❑ County of <br />❑ Other — <br />3. ' pe of Statement (Check at least one box) <br />Annual: The period covered is January 1, 2018, through ❑ Leaving Office: Date Left I I <br />-or. December 31, 2018. (Check one circle.) <br />The period covered is _ I__...J through O The period covered is January 1, 2018, through the date of <br />December 31, 2018. or. leaving office, <br />❑ Assuming Office: Date assumed I 1 O The period covered Is I I through <br />4.the date of leaving office, <br />,Candidate: Date of Election and office sought, If different than Pad 1: I� <br />Schedule Summary (must complete) o- Total number of pages including this cover page, 3 <br />Schedules attached <br />❑x Schedule A-1 • Investments - schedule attached ❑x Schedule C - Income, Loans, & Business Positions - schedule attached <br />❑ Schedule A-2 - Investments - schedule attached ❑ Schedule D - Income - Gifts - schedule attached <br />❑ Schedule B - Real Property - schedule attached ❑ Schedule E • Income - Gifts - Travel Payments - schedule attached <br />-or- ❑ None • No reportable interests on any schedule <br />5. Verification <br />MAILING ADDRESS STREET CITY STATE ZIP CODE <br />I have used all reasonable diligence In preparing this statement. I have reviewed this statement and to the best of my knowledge the Information contained <br />herein and in any attached schedules Is true and complete, I acknowledge this is a public document. <br />I certify under penalty of perjury under the laws of the State of California that the foregoing <br />Date Signed 03-11-2019 <br />with your aline 001CIA) <br />65C-44 FPPC Form 700 (2010/2019) <br />FPPC Advice Email: advice®fppc.ca.gov <br />FPPC Toll -Free Helpline: 866/275.3772 www.fppc.ca.gov <br />
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