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Michelle Ramirez
STATEMENT OF ECONOMIC Please type or print in ink. COVER PAGE CITY NAME OF FILER (LAST) "Dallb R ec 01176.1 W, MAR 17 2011 Ramirez Michelle Gay 1. Office, Agency, or Court Agency Name Division, Board, Department, District, if applicable Your Position ► If filing for multiple positions, list below or on an attachment. Agency: Position: - 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Judge (Statewide Jurisdiction) ❑ Multi- County ❑ County of © city of Rosemead ❑ Other 3. Type of Statement (Cheek at least one box) ❑x Annual: The period covered is January 1, 2010, through December 31, ❑ Leaving Office: Date Left 2010. -or. -or (Check one) The period covered is �� —,- through December 31, O The period covered is January 1, 2010, through the date of 2010. leaving office. ❑ Assuming Office: Date O The period covered is through the date of leaving office. ❑ Candidate: Election Year Office sought, if different than Part 1: 4. Schedule Summary Check applicable schedules or "None." ► Total number of pages including this cover page: ❑ Schedule A -1 - Investments - schedule attached ❑ Schedule C - Income, Loans, 8 Business Positions - schedule attached ❑ Schedule A -2 - Investments - schedule attached 0 Schedule D - Income - Gifts - schedule attached ❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached -or. ❑ None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or AgencyAddraas Recommended - Public Oocumerd) 8838 E. Vallev Boulevard Rosemead CA 91770 626 ) 569 -2158 1 mramirez @cityofrosemead.org 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 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 foregoing is true and 7act.- I . . �� Date Signed 03/17/2011 Signature (month, day, year) (He the "FGPC Form 700 (2 01 012 011) FPPC Toll -Free Helpline: 8661276 -3772 www.fppc.ca.gov SCHEDULE D Income — Gifts ► NAME OF SOURCE Levine Management Group, Inc. ADDRESS (Business Address Acceptable) 822 S. Robertson Blvd., Suite 200, LA, CA 90035 BUSINESS ACTIVITY, IF ANY, OF SOURCE Management Company - Senior Apartements DATE (mm /dd/yy) VALUE DESCRIPTION OF GIFT(S) 12 / __ j 10 $ 43.55 All-Occasion Basket $ __J $ ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S) $ —/ __J_ $ ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm /ddtyy) VALUE $ $ DESCRIPTION OF GIFT(S) ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY. IF ANY. OF SOURCE, DATE (mm /ddtyy) VALUE DESCRIPTION OF GIFT(S) $ $ ��— s ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S) __J __J $ $ - —/� $ ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm /dd /yy) VALUE __j I $ __J $ --- J __J $ DESCRIPTION OF GIFT(S) Comments: All-Occasion Basket (Item No. 4559H) was placed in the City Hall kitchen for all employees to enjoy. FPPC Form 700 (201012011) Sch. D FPPC Toll -Free Helpline: 8661275 -3772 vry Jppc.ca.gov