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Joanne ItigakiSTATEMENT OF ECONOMIC Please type or print in ink. (LAST) (FIRST) COVER PAGE A Public Document CITY Itagaki Joanne ( 562 ) 908 -620 MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: E -MAIL ADDRESS (Business Address Acceptable) 13191 Crossroads Pkwy N. #405 Industry CA 91746 litagaki(aDwilldan.com 1 . Office, Agency, or Court Name of Office, Agency, or Court: City of Rosemead Division, Board, District, if applicable: Your Position: Consultant - Willdan Engineering ► 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 /east one box) ❑ State ❑ County of 0 City of Rosemead ❑ Multi- County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: I] 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: ___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 2 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 to% ownership) Schedule A -2 ❑ Yes - schedule attached investments (10% or Greater Ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C © Yes - schedule attached Income, Loans, & Business Positions (Income Omer than Gilts and Travel Payments) Schedule D ❑ Yes - schedule attached Income - Gifts Schedule E ❑ Yes - schedule attached Income - Gifts - Travel Payments -or- F] 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 10, 2010 (manor day,, year) Signature (File the originally signed statement im your filing oKclal.) FPPC Form 700 (2009/2010) FPPC Toll -Free Helpline: 866IASK -FPPC www.fppc.ca.gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME Joanne Itagaki - Willdan Engineering ADDRESS (Business Address Acceptable) 13191 Crossroads Pkwy N #405 Industry CA 91746 BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION Consultant GROSS INCOME RECEIVED ❑ $500 - $1,000 K❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income ❑ Loan repayment ❑ Sale of )%perty, ear, be r, etc.) ❑ Commission or ❑ Rental Income, Irsteachsourceof5to,aaoorm a ❑ Other (D..a ) NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1.000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income ❑ Loan repayment ❑ Sale of (Plop -* rar, beat, etc) ❑ Commission or ❑ Rental Income, list each source of slawo or more ❑ Other (Descrbe) 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 Comments: INTEREST RATE TERM (MOnthslYedrs) % ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property Street address city ❑ Guarantor ❑ Other (Describe) FPPC Form 700 (2009/2010) Sch. C FPPC Toll -Free Helpline: 866 /ASK -FPPC WWW,fppc.ca.gov