Nancy Engi
STATEMENT OF ECONOMIC
Please type or print in ink.
COVER PAGE
A Public Document
JUL 15 Zoo
NAME (LAST)
(FIRST)
(MIDDLE) ISffi!1ME TELE PHONE NUMBER
(� 2 ) -2 k2 20
MAILING ADDRESS STREET
CITY
STATE
ZIP CODE
OPTIONAL: E -MAIL ADDRESS
(Business Address Acceptable)
P• D -tea .
�
/ /S' /eaS a� 2iMe', ,
CA
1 . Office, Agency, or Court
Name of Office, Agency, or Court:
PLANNING DIVISION
Division, Board, District, if applicable:
PLANNING COMMISSIONER
Your Position:
► If filing for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ County of
Picity of CITY OF ROSEMEAD
❑ Multi -County
❑ Other
3. Type of Statement (Check at least one box)
1:4 Assuming Office/Initial Date: _ _ O 6 0 7 j 1 0
❑ Annual: The period covered is January 1, 2009,
through December 31, 2009.
-or-
0 The period covered is __J___J—, through
December 31, 2009.
❑ Leaving Office Date Left: ---J ---J
(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
including this cover page:
► Check applicable schedules or "No reportable
interests."
1 have disclosed interests on one or more of the
attached schedules:
Schedule A -1 ❑ Yes - schedule attached
Investments (Less than 70% ownership)
Schedule A -2 ❑ Yes - schedule attached
Investments (70% or Greater Ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions (income other than Gilts
and Travel Payments)
Schedule D dYes - schedule attached
Income - Gifts
Schedule E ❑ Yes - schedule attached
Income - Gifts - Travel Payments
IQ C
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 7 S f2 / 0
(monifi. day, year)
Signature
(File the originally sig d tatement with your fdtng 1.)
FPPC Form 700 (200912010)
FPPC Toll -Free Helpline: 666 1ASK -FPPC www.fppc.ca.gov
SCHEDULE D
Income - Gifts
► NAME OF SOURCE
VALUE
ADDRESS (BUST s Address Acceptable)
x_ze e<�
6 D'ale s7 -0_
BUSINESS ACTIVITY, IF ANY OF SOURCE
DATE (Mm/d VALUE DESqYPTION
OF GIFT(S)
7
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE
—/— $
/ —/— $
DESCRIPTION OF GIFT(S)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mmidd/yy) VALUE
J —)— $
DESCRIPTION OF GIFT(S)
Comments:
► NAME OF SOURCE
Name
IV4Ncz, �(
ADDRESS Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mmldd /yy) VALUE DESCRIPTION OF GIFT(S)
��— $
—) —/— R
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mmldd/yy) VALUE DESCRIPTION OF GIFT(S)
$
— / —/ $
► NAME OF SOURCE
ADDRESS Business Address Acceptable) 4
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mmldd /yy)
VALUE
— / —J 3
DESCRIPTION OF GIFT(S)
FPPC Form 700 (200912010) Sch. D
FPPC Toll -Free Helpline: 866 /ASK -FPPC u .fppc.ca.gov
Please type or print in ink.
(LAST)
STATEMENT OF ECONOMIC
COVER PAGE
A Public Docum�
(FIRST) (ME
ftf'Ir n
S1 j ytl' ::
U
�t
ENG NANCY H. ( 6267288-74W J
MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: E -MAIL ADDRESS
(Business Address Acceptable)
P.O. BOX 115 ROSEMEAD CA 91770
1 . Office, Agency, or Court
Name of Office, Agency, or Court:
City of Rosemead - Planning Commission
Divi =_ion, Board, District, if applicable:
Your Position:
Commissioner
P. If filing for multiple positions, list additional agency(ies)l
position(s): (Attach a separate sheet if necessary.)
Agency: Garvey School District -Bond Oversight Comm
Position: Member
2. Jurisdiction of Office (Check at least one box)
❑ State
[X County or Los Angeles
Ivy ,. ,,, Rosemead -
❑ Multi- County
F nth., _
3. Type of Statement (Check at least one box)
❑ Assuming Officelinitial Date:
❑X Annual: The period covered is January 1, 2009,
through December 31, 2009.
-or-
0 The period covered is __J___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 __J—/, 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 than 70% Ownership)
Schedule A -2 ❑ Yes - schedule attached
Investments (70% or Greater Ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions (Imome Omer than Gifts
and Travel Payments)
Schedule D ❑ Yes - schedule attached
Income — Gifts .
Schedule E ❑ Yes - schedule attached
Income - Gifts - Travel Payments
-or-
® 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 March 31, 2010
(month, day, year)
Signature ° �-
(File the odginall, gn statement with your fi" o cial.)
FPPC Fenn 700 (200912010)
FPPC Toll -Free Helpline: 866 /ASK -FPPC www.fppc.ca.gov