Jerry MotaSTATEMENT OF ECONOMIC
1 . Office, Agency, or Court
Name of Office, Agency, or Court:
Division, Board, District, if applicable:
Your Position:
Recreation Supervisor
► If filing for multiple positions, list additional agency6es)1
position(s): (Attach a separate sheet if necessary.)
Agency:
Position: - --
2. Jurisdiction of Office (check at least one box)
[] State
County of
X City of Rosemead
l ii Multi- County
Other
3. Type of Statement (Check at least one box)
i✓' Assuming Office /Initial Date: 1
Annual: The period covered is January 1, 2009,
through December 31, 2009.
-or-
0 The period covered is /---J through
December 31, 2009.
Leaving Office Date Left: --/�.-
(Check one)
O The period covered is January 1, 2009, through the
date of leaving office.
-or-
0 The period covered is through
the date of leaving office.
[-] Candidate Election Year:
4. Schedule Summary
► Total number of pages 1
including this cover page:
► Check applicable schedules or "No reportable
interests."
I have disclosed interests on one or more of the
attached schedules:
Schedule A -1 ❑ Yes - schedule attached
Investments (Less then 10% Ownership)
Schedule A -2 i Yes - schedule attached
Investments (to% or Greater Ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions (Income Other man G
and Travel Payments)
Schedule D ❑ Yes - schedule attached
income - Gifts
Schedule E ❑ Yes - schedule attached
Income - Gifts - Travel Payments
-or-
X No reportable interests on any schedule
5. Verification
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 certify under penalty of perjury under the laws of the State
of California that the foregoing is true and correct.
Date Signed 03103/2010
MaMM, day, Year)
Signatul eC ` "^"'T" - ' --
dvitaiy arenerl ofafemeni wfih Ir ur fifie, oWiM)
FPPC Form 700 (2 0 0 912 01 0)
FPPC Toll -Free Helpline: 8661ASK -FPPC www.fppe.ca.gov
COVER PAGE
A Public Document
Please type or print in ink.
_
NAME (LAST)
(FIRST)
(MIDDLE)
DA DIME TELEPHONE NUMBER
-
Mota
Gerardo
Arturo
( 6 - � 6 ) 2?7- x'21 - 8 — �
-- -- --- — --- -------------- ---- -- STREET
MAILING ADDRESS STREET
CITV
- -------------- -- ----- --- -- - - - -- ----- — --------------------------
STATE T ZIP CODE OPTIONAL E -MAIL ADDRESS
(Business Address Acceptable)
i
8838 E. Valley Blvd.
Rosemead
CA j 91770
- j
1 . Office, Agency, or Court
Name of Office, Agency, or Court:
Division, Board, District, if applicable:
Your Position:
Recreation Supervisor
► If filing for multiple positions, list additional agency6es)1
position(s): (Attach a separate sheet if necessary.)
Agency:
Position: - --
2. Jurisdiction of Office (check at least one box)
[] State
County of
X City of Rosemead
l ii Multi- County
Other
3. Type of Statement (Check at least one box)
i✓' Assuming Office /Initial Date: 1
Annual: The period covered is January 1, 2009,
through December 31, 2009.
-or-
0 The period covered is /---J through
December 31, 2009.
Leaving Office Date Left: --/�.-
(Check one)
O The period covered is January 1, 2009, through the
date of leaving office.
-or-
0 The period covered is through
the date of leaving office.
[-] Candidate Election Year:
4. Schedule Summary
► Total number of pages 1
including this cover page:
► Check applicable schedules or "No reportable
interests."
I have disclosed interests on one or more of the
attached schedules:
Schedule A -1 ❑ Yes - schedule attached
Investments (Less then 10% Ownership)
Schedule A -2 i Yes - schedule attached
Investments (to% or Greater Ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions (Income Other man G
and Travel Payments)
Schedule D ❑ Yes - schedule attached
income - Gifts
Schedule E ❑ Yes - schedule attached
Income - Gifts - Travel Payments
-or-
X No reportable interests on any schedule
5. Verification
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 certify under penalty of perjury under the laws of the State
of California that the foregoing is true and correct.
Date Signed 03103/2010
MaMM, day, Year)
Signatul eC ` "^"'T" - ' --
dvitaiy arenerl ofafemeni wfih Ir ur fifie, oWiM)
FPPC Form 700 (2 0 0 912 01 0)
FPPC Toll -Free Helpline: 8661ASK -FPPC www.fppe.ca.gov