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Michelle RamirezSTATEMENT OF ECONOMIC COVER PAGE Please type or print in ink. A Public Document MAR n 3 rd } C,t NAME (LAST) (FIRST) (MIDDLE) BfAYTIME TELEPHONE NUMB Michelle Ramirez Gayle ( 626 ) 589 -21 MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: E -MAIL ADDRESS (Business Address Acceptable) Fp(gtYllre 2 @a }Y afvDSemead, 8838 E. Valley Boulevard Rosemead CA 91770 0 P5 1 . Office, Agency, or Court Name of Office, Agency, or Court: Division, Board, District, if applicable: 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 feast one box) ❑ State ❑ County of ® City of Rosemead ❑ Multi- County ❑ Other Type of Statement (Check at least one box) ❑ Assuming Office/Initial Date: 0 Annual: The period covered is January 1, 2009, through December 31, 2009. -or- 0 The period covered is through December 31, 2009. ❑ Leaving Office Date Left: ---] --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: P. 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 (10% or Greater Ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C ❑ Yes - schedule attached Income, Loans, & Business Positions (Income Other than Gins and Travel Payments) Schedule D ❑x 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 03/03/2010 (m day, year) Signature �rtlL�ft -t-c.� l� �w7� &V ILA, (File the originally signer) statement with your ffag official.) FPPC Form 700 (200912010) FPPC Toll -Free Helpline: 8661ASK -FPPC www.fppc.ca.gov SCHEDULE D Income - Gifts Name Michelle G. Ramirez ► 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 Apartments DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S) 12 / ___ j 09 $ 53.00 All-Occasion Gift Baske __J __J $ ► 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 (mm /dd /yy) VALUE __J __J $ __J __J $ DESCRIPTION OF GIFT(S) ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm /ddlyy) VALUE t $ DESCRIPTION OF GIFT(S) ► 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 (mm /ddlyy) VALUE $ $ DESCRIPTION OF GIFT(S) Comments: All-Occasion Gift Basket was placed in the City Hall kitchen for all employees to enjoy. FPPC Form 700 (200912010) Sch. D FPPC Toll -Free Helpline: 866 /ASK -FPPC www.rppc.ca.gov